Tania Maria Albuquerque de Oliveira and Professor Catherine Coverston, Nursing
My original research was actually directed at African Americans in urban Utah. Research shows that even 15 years after the Back-to-Sleep Campaign (a national campaign focused on teaching best practices of infant sleep and care), African Americans still experience the highest incidence of SIDS (Sudden Infant Syndrome Death). This is due to the lack of trust when it comes to following medical advice as well as traditions that are hard to let go. I had a facilitator and a group of subjects that could be a part of my research project, but I was unaware of the barriers I would encounter as I started my project. The major barriers were lack of interest and commitment and difficulty in recruiting subjects.
After spending months trying to get the project going and not being able to recruit more than 2 subjects my mentor and I realized that we had only one option, we needed a new plan. I was leaving for Brazil shortly and so we decided that I could take my project with me and learn what SIDS in Brazil was like. The results were nothing like we had expected but I was very grateful for everything I learned there.
SIDS in Brazil
First thing I learned as I started working in my project was that there was not even a definitive term for SIDS in Portuguese. I had difficulty explaining what SIDS stood for because people had different ideas about it. They would associate SIDS with other medical conditions that were not related to it at all. Unfortunately in Brazil the infant population is subjected to so many more critical health problems that even the medical community is not concerned with the advent of SIDS. If the chances of an infant surviving the first year of life and overcoming the acute problems that exist there are high, then parents will worry about anything else.
My project consisted of a focus group meeting, a pre and post test and a teaching intervention. I was able to recruit 30 participants for the first phase of the project and about 20 of them responded the final test. The age range of my participants was between 20-30 years of age, from both sexes and most of them married with no children.
Although most of the subjects had never heard of SIDS before our encounter, they were very willing to learn and very interested in the subject. Brazilians are protective of their families and learning about SIDS made them realize that there was more that could be done to provide a safe first year of life to their infants.
As with the African American population in Utah, I soon learned that there were barriers to be overcome as I started the teaching intervention component of my project. At any place cultural beliefs and traditions are very hard to change and most Brazilians put their child to sleep in the prone position. Lack of education was another important factor to be taken into consideration, most participants had a high school diploma, but no further education, so I had to be mindful of the terms I used and level of literacy of the participants. Overall the participants were enthusiastic and excited to learn new things.
I was able to talk about common myths people have about SIDS (1. babies can catch it; 2. immunizations can cause it; 3. the next child is more likely to die from it). Also I taught about interventions that could reduce the incidence of SIDS (1. pacifier use; 2. no toys inside crib when babies are sleeping; 3. warm dressing but do not overdress; 4. immunizations are protective of overall health; 5. babies should sleep on their backs) and I encouraged them to breastfeed, to dress their babies according to the weather – most Brazilians tend to overdress their babies – and to share what they learned with their children’s caregivers and families.
The results were compiled and transferred to the table below. T1 corresponds to the pre-test and T2 corresponds to after the teaching intervention.
From the results gathered after data analysis we concluded that there is room for improvement; Brazilians are willing to learn and very teachable; culture and traditions are real barriers and finally, this study should be replicated involving more subjects in order to obtain more accurate results.
It was very gratifying for me to go back to my home town and to share with my fellow citizens what I have been learning here at Brigham Young University – College of Nursing. I know that the fact that I am a native helped them develop confidence and trust that the things that I was sharing with them were true and important and could help their families to be healthier and happier.