Photos Shared on Facebook in the Context of Safe Sleep Recommendations: Content Analysis of Images

Background

Sudden unexpected infant death (SUID) remains a leading cause of infant mortality; therefore, understanding parental practices of infant sleep at home is essential. Since social media analyses yield invaluable patient perspectives, understanding sleep practices in the context of safe sleep recommendations via a Facebook mothers' group is instrumental for policy makers, health care providers, and researchers.

Objective

This study aimed to identify photos shared by mothers discussing SUID and safe sleep online and assess their consistency with infant sleep guidelines per the American Academy of Pediatrics (AAP). We hypothesized the photos would not be consistent with guidelines based on prior research and increasing rates of accidental suffocation and strangulation in bed.

Methods

Data were extracted from a Facebook mothers' group in May 2019. After trialing various search terms, searching for the term "SIDS" on the selected Facebook group resulted in the most relevant discussions on SUID and safe sleep. The resulting data, including 20 posts and 912 comments among 512 mothers, were extracted and underwent qualitative descriptive content analysis. In completing the extraction and subsequent analysis, 24 shared personal photos were identified among the discussions. Of the photos, 14 pertained to the infant sleep environment. Photos of the infant sleep environment were then assessed for consistency with safe sleep guidelines per the AAP standards by 2 separate reviewers.

Results

Of the shared photos relating to the infant sleep environment, 86% (12/14) were not consistent with AAP safe sleep guidelines. Specific inconsistencies included prone sleeping, foreign objects in the sleeping environment, and use of infant sleeping devices. Use of infant monitoring devices was also identified.

Conclusions

This study is unique because the photos originated from the home setting, were in the context of SUID and safe sleep, and were obtained without researcher interference. Despite study limitations, the commonality of prone sleeping, foreign objects, and the use of both infant sleep and monitoring devices (ie, overall inconsistency regarding AAP safe sleep guidelines) sets the stage for future investigation regarding parental barriers to practicing safe infant sleep and has implications for policy makers, clinicians, and researchers.

Interdisciplinary approach to defining outdoor places of knowledge work: quantified photo analysis

Introduction

Working outdoors is an emerging, sparsely studied phenomenon in knowledge work. Office tasks have traditionally been considered to belong to indoor environments. The worldwide pandemic of COVID-19 has increased and changed attitudes toward multilocational working. The aim of this method study is 2-fold: first to define for interdisciplinary context outdoor environments when they are used as places of outdoor knowledge work and second to quantify the thematic photo analysis to support interdisciplinary understanding of the places of outdoor knowledge work.

Methods

The review of literature has been one of the methods to support the interdisciplinary approach of this article. The photographs of outdoor knowledge workplaces and views from the workstations are studied through photo analysis customized from the existing press photograph analysis.

Results

First, we defined outdoor environments when used as places of outdoor knowledge work, as unconditioned outdoor or semi-outdoor places (opposite to closed indoor spaces with stable, conditioned indoor climate) providing favorable action possibilities as sources of comfort and mitigating unfavorable conditions, for example, by microclimatic solutions. Instead of defining all spaces as outdoor environments not fulfilling a stable indoor climate (conditioned) definition, adaptation to thermal and physical environments also brought semi-outdoor space into the definition. In this context, favorable latent action possibilities (affordance) in the built environment are often related to microclimate as a source of comfort. Second, we focussed on photo analysis. The proposed model is based on journalistic photo analysis PPSA and the pOKW model, which have been further developed in this study to pOKW2 model for analyzing mobile-based collected self-reported photographs by the occupants. In this pOKW2 model, the photographs would have time-location information enabling the combining of data from other datasets and thereby reducing the number of characteristics to be analyzed from the photograph. We proposed rating (in numeric form) to detect the favorable and unfavorable characteristics in the photographs most likely supporting or hindering conditions of outdoor knowledge work. This quantification would enable the use of machine vision analysis and would support handling large quantities of photographs and their combination with other datasets in interdisciplinary research.

Discussion

The quantification of the photo analysis (pOKW2) includes the readiness to combine the analysis results with other time-location-specific datasets in an interdisciplinary research collaboration to advance our understanding of latent action possibilities for outdoor knowledge work.