Discussion
sleep behaviors
Prior to this study research regarding safe sleep and the provision of the baby boxes were limited to assessing modes of safe sleep education in addition to provision of the box and for a short window of time or epidemiological data collected as part of a comprehensive maternal/child health initiative. This is the first study investigating the use of the baby boxes to use the same mode of AAP education for all mothers, thus isolating the impact of the provision of the box itself. Results from this study indicated that receiving the box led to safer sleep practices and safer sleep environments. Less than a third (29%) of those who received the box actually reported using it frequently as an overnight sleeping option, however, just having the box in the home may have served as a reminder or cue to practice other safe sleep behaviors, more so than having a diaper bag. Both groups received other reminders such as the safe sleep card, but the box may have served as a larger, more visible reminder for other safe sleep practices based on its purpose and decor. In open-ended feedback many participants remarked that the box was attractive, as they were covered with a baby-friendly decorative film, which may have contributed to positive behavior change as indicated by the Grol’s Framework [Previous researchers have debated whether the box would negatively impact breastfeeding, and our findings suggest they were not impacted, however with such a small sample who used the box and breastfed it is difficult to draw conclusions [