Barriers to Implementing Behavioral Sleep Interventions for Infants and Toddlers: A Path Analysis of Parental Cognition and Sleeping Arrangement.

OBJECTIVES

Evidence-based behavioral sleep interventions (BSIs) effectively consolidate and improve infant sleep. While BSIs are widely implemented in Western countries, very little is known about the knowledge and use of BSIs in Asian countries where bed-sharing is common. The current study aims to explore environmental (e.g. sleep arrangements) and personal (e.g. parental cognitions) barriers in implementing BSIs among parents in South Korea.

METHOD: A total of 507 parents with children aged 6 to 36 months. Participants completed the Parental Understanding and Misperceptions about Baby's sleep- Questionnaire (PUMBA-Q) and Brief Infant Sleep Questionnaire-Revised (BISQ-R). Path analysis tested a model predicting BSIs implementation and child's sleep.

RESULTS

Only 21.9% of parents reported implementing at least one BSIs. Children who received BSIs had significantly longer total sleep (t(505) = -3.422, p < .001). Path analysis indicated a direct effect of parental cognition about child's sleep (PUMBA-Q scores) and bed-sharing on implementations of BSIs, and an indirect effect on child's TST through implementation of BSIs.

CONCLUSIONS

South Korean parents reported lower BSIs implementation rates than Western parents. This study identifies both sleeping arrangement and parental cognition as barriers to implementing BSIs, which may inform tailored BSIs strategies.