Effectiveness of Play2Sleep with Mothers and Fathers of Infants: A Mixed Methods Study
Date
2019-04-25
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Abstract
Infant sleep disturbances distress approximately one in four Canadian families and are associated with poorer parental health, family well-being, and child developmental outcomes. Assisting families to manage infant sleep disturbances may improve well-being, as well as support child development. However, addressing only sleep-related parenting behaviors and interactions may be ineffective in improving broader parenting difficulties that may underlie infant sleep disturbances. Play2Sleep combines personalized infant sleep information with examples from a self-modelled video recorded structured parent-infant play session to provide feedback aimed at enhancing parental ability to identify and respond appropriately to their infant’s specific sleep-related and social cues. This approach could help address broader parenting difficulties that may underlie infant sleep disturbances. An explanatory sequential mixed methods design combining a randomized controlled trial with thematic analysis of semi-structured family interviews was used to answer the following research questions: Quantitative - Does one dose of Play2Sleep delivered during home visits with mothers and fathers of 5-month-old infants with infant sleep disturbances reduce the number of night wakings at age 7 months? Qualitative - What are parental perceptions of family experiences, processes, and contexts related to Play2Sleep and infant sleep disturbances? Mixed Methods - How do parental perceptions of family experiences, processes, and contexts related to infant sleep explain the effectiveness of Play2Sleep? Play2Sleep was not effective in reducing parent-reported night wakings; however, it was effective in reducing maternal-reported infant nocturnal wakefulness and the number of paternal-reported naps. With Play2Sleep, there were significant subjective improvements in problematic infant sleep that were not observed in the comparison group. Three themes (information overwhelm, learning infant cues, and working together with a sub-theme of father involvement) were developed to propose a potential mechanism for Play2Sleep. Six themes describe broader parental experiences of infant sleep disturbances: developing routines; changed attitudes and beliefs; fears, concerns, and anxieties; support; sleep associations; and context of infant sleep disturbance. Play2Sleep shows promise to reduce infant sleep disturbances. Including fathers was novel and the qualitative analysis contributed to understanding the how and why of intervention effects. Areas for future research are prevention, precision-care models, workforce development, and parent engagement.
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Keywords
infant, mothers, fathers, parent-child interaction, sleep, mixed methods
Citation
Keys, E. (2019). Effectiveness of Play2Sleep with Mothers and Fathers of Infants: A Mixed Methods Study (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.