PU508 Unit 10 Grandparent Safe Sleep Proposal Example

Back to Sleep at Grandma's House: A Theory-Based Proposal Using PRECEDE-PROCEED to Plan Safe Infant Sleep Support for Grandparent Caregivers in a Composite County, Linking Every Activity to the Predisposing, Reinforcing or Enabling Factor It Is Meant to Change

[Student Name]

Purdue University Global

PU508: Social and Behavioral Theory and Frameworks

Unit 10 Theory-Based Proposal

[Instructor Name]

[Date]

The county, its figures and the budget are composite and bracketed for the writer's own data; the model and research cited are real.

Problem Statement

Over five years, the county recorded [14] sudden unexpected infant deaths; in [five], the infant was in the care of a grandparent at the time. National pediatric guidance calls for supine sleep for every nap and every night, a bare crib or play yard with a fitted sheet, and sharing a room rather than a bed (Task Force on Sudden Infant Death Syndrome, 2016). In a survey of [239] grandmothers caring for an infant at least weekly, only [45] percent reported placing the infant on the back on an appropriate surface at the grandmother's own home, compared with [58] percent when at the mother's home (Aitken et al., 2016).

Why PRECEDE-PROCEED

The model begins with outcomes and works backward through behavior and environment to the factors that shape them, then forward through implementation and evaluation (Green & Kreuter, 2005). Its three factor types fit the determinants found in earlier units: beliefs grandparents hold, the people who reinforce or contradict them, and the resources that make safe sleep possible.

Social and Epidemiological Assessment

Quality of life concern: families' grief and fear after infant deaths, raised repeatedly at community meetings. Health problem: sudden unexpected infant death. Behaviors: placing infants prone or on soft surfaces, and sleeping with an infant on a couch. Environmental factor: no crib or play yard at many grandparents' homes.

Determinants Table

Predisposing factors. Belief that back sleeping causes choking, held by [61] percent of grandparents in a local survey; belief that infants sleep better on their stomachs; low awareness that guidance changed in the 1990s; perceived low risk because their own children were fine. Reinforcing factors. Mothers' instructions, often hesitant out of respect; pediatric clinicians' advice, rarely given to grandparents directly; peers and church friends who share older practices. Enabling factors. No safe sleep surface at the grandparent's home; cost of a play yard; limited access to classes, which are offered to new parents in hospitals but not to grandparents. The factor most often missed in past programs was enabling: many grandparents had no safe place to put the baby down.

What Grandparents Said

In [five] listening sessions with [48] grandparents, three themes recurred. First, many had been told by their own doctors decades ago to place babies on their stomachs so they would not choke, and they had done so with every child. Second, they felt that their daughters and daughters-in-law gave instructions without explaining them, which made the advice feel like criticism. Third, many simply had nowhere safe for a baby to sleep: grandchildren napped on beds, couches or in car seats. One grandmother said she would follow the new advice gladly if someone showed her why it changed and gave her a crib to use. These themes map directly onto the model's three factors and shaped the activities.

Why Earlier Programs Missed Grandparents

Most safe sleep education in the county happens in the hospital after birth, at prenatal classes and through home visiting for new mothers. All three reach parents. Grandparents learn second-hand, if at all, and often from mothers who are reluctant to correct them. A program designed for parents assumes the parent controls the infant's sleep, which is not true for the many hours an infant spends with grandparents. PRECEDE-PROCEED made that gap visible by asking who reinforces and who enables the behavior, not just who performs it.

Activities by Factor

Predisposing. A [60]-minute grandparent session at senior centers and churches, led by a nurse and a peer grandparent, addressing the choking belief with a simple demonstration of the infant airway and why back sleeping is safe. A one-page card showing why guidance changed. Reinforcing. A coaching script for mothers on how to talk with grandparents, distributed at postpartum visits; pediatric clinics invite grandparents to the two-week visit and include them in safe sleep counseling; peer grandparents trained as champions in congregations. Enabling. Free portable play yards for grandparents who provide care at least weekly and lack a safe surface, delivered with a short setup demonstration.

Checking for Gaps

Every factor type has at least one activity. The weakest coverage is the belief that infants sleep better prone, which the session addresses only briefly; the card will add a section on settling techniques for back sleeping.

Administrative and Policy Assessment

Partners: the county health department as lead, two pediatric clinics, the hospital's maternity unit, four senior centers and [12] congregations. Policy: the hospital will add grandparents to discharge teaching when they will provide care. Resources: [$96,000] for the first year, including play yards for [300] households at about [$110] each, staff time, training and materials.

Implementation

Months one to three: train nurses and peer champions, set up play yard distribution and enroll clinics. Months four to twelve: deliver sessions, distribute play yards and track reach.

Evaluation

Process: number of grandparents reached through each channel, sessions held, play yards delivered and clinics inviting grandparents. Impact: change in the share of grandparents who report placing infants on their backs on a safe surface at their own home, measured by survey before and after, and change in the choking belief. Outcome: sudden unexpected infant deaths in the county, tracked over five years, recognizing that small numbers make short-term change hard to detect.

What Earlier Units Contributed

The model was chosen for its fit with the determinants review; the construct work identified the beliefs; the ecological analysis showed why enabling factors and reinforcement from mothers and clinicians matter; and the measurement plan supplied the survey items.

Risks

Grandparents may feel judged; sessions will be framed around changes in science, not past mistakes. Some mothers may not wish to involve grandparents; the program respects that choice. Play yards may go unused if grandparents find them hard to fold; delivery includes a hands-on setup demonstration.

Budget Summary

Play yards [$33,000]; nurse and peer champion time [$38,000]; training and materials [$15,000]; evaluation [$10,000].

Conclusion

Grandparents are a large and often overlooked group of infant caregivers. A program built on PRECEDE-PROCEED reaches their beliefs, the people who influence them and the resources they lack, and makes each activity answerable to the factor it targets.

References

Aitken, M. E., Rose, A., Mullins, S. H., Miller, B. K., Nick, T., Rettiganti, M., Nabaweesi, R., & Whiteside-Mansell, L. (2016). Grandmothers' beliefs and practices in infant safe sleep. Maternal and Child Health Journal, 20(7), 1464-1471. https://doi.org/10.1007/s10995-016-1945-9

Green, L. W., & Kreuter, M. W. (2005). Health program planning: An educational and ecological approach (4th ed.). McGraw-Hill.

Task Force on Sudden Infant Death Syndrome. (2016). SIDS and other sleep-related infant deaths: Updated 2016 recommendations for a safe infant sleeping environment. Pediatrics, 138(5), e20162938. https://doi.org/10.1542/peds.2016-2938