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Moreover, rates of accidental suffocation and strangulation in bed (often related to bed-sharing) are on the rise, with Black infants at two to three times greater risk than Whites. Multiple studies have identified risk factors for bed-sharing, but a gap remains between findings and translation into interventions. The socio-ecological model (SEM) has been suggested as a way to study and design interventions addressing complex public health issues. This article reconceptualizes the literature on mother\u2013infant bed-sharing using the SEM. PubMed, POPLINE, ERIC, and Psych Info were searched for articles that (a) included bed-sharing as the outcome variable, (b) were published between 2000 and 2013, (c) were conducted in the United States, and (d) included quantitative comparison of more than one factor. The following data were extracted: sample characteristics, bed-sharing definition, methods, factors examined, key findings, and conclusions. Data were summarized into five SEM levels\u2014infant, maternal, family and household, and community and society, nested within the historical context of race. Sixteen studies met inclusion criteria. Significant factors associated with bed-sharing were present within each SEM level of influence. Educational interventions may increase efficacy by attending to multiple levels of the SEM, especially when implementing such interventions within minority subpopulations. Using a harm reduction approach to reducing the risk around bed-sharing may be one way to account for the multiple influences on bed-sharing. The science and practice of minimizing mother\u2013infant bed-sharing may be advanced through use of the SEM.<\/jats:p>","DOI":"10.1177\/1090198114543010","type":"journal-article","created":{"date-parts":[[2014,8,14]],"date-time":"2014-08-14T02:37:31Z","timestamp":1407983851000},"page":"577-589","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":29,"title":["Application of a Socio-Ecological Model to Mother\u2013Infant Bed-Sharing"],"prefix":"10.1177","volume":"41","author":[{"given":"Trina C.","family":"Salm Ward","sequence":"first","affiliation":[{"name":"University of Georgia, Athens, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J.","family":"Doering","sequence":"additional","affiliation":[{"name":"University of Wisconsin-Milwaukee, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,8,13]]},"reference":[{"key":"bibr1-1090198114543010","first-page":"792","volume":"16","author":"Acegbembo A.","year":"2006","journal-title":"Ethnicity & Disease"},{"key":"bibr2-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1177\/0009922813518964"},{"key":"bibr3-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-0072"},{"key":"bibr4-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-009-0495-9"},{"key":"bibr5-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-009-0531-9"},{"key":"bibr6-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-1499"},{"key":"bibr7-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-2284"},{"key":"bibr8-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2008.00242.x"},{"key":"bibr9-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1021G"},{"key":"bibr10-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-1636"},{"key":"bibr11-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-0744"},{"issue":"1","key":"bibr12-1090198114543010","first-page":"29","volume":"85","author":"Ball H.","year":"2012","journal-title":"Community Practitioner"},{"key":"bibr13-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2012.03.025"},{"key":"bibr14-1090198114543010","volume-title":"Beliefs and practices regarding sudden infant death syndrome (SIDS) risk reduction among African American mothers, fathers, and caregivers in New York City: Summary of SIDS focus groups","author":"Bettegowda V.","year":"2004"},{"key":"bibr15-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1177\/003335490912400409"},{"key":"bibr16-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.157.1.33"},{"key":"bibr17-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.32.7.513"},{"key":"bibr18-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1037\/0012-1649.22.6.723"},{"key":"bibr19-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-011-0768-y"},{"key":"bibr20-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedhc.2006.04.006"},{"key":"bibr21-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1177\/0002764205283807"},{"key":"bibr22-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-002299"},{"key":"bibr23-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2008.11.005"},{"key":"bibr24-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.06.004"},{"key":"bibr25-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.54.10.805"},{"key":"bibr26-1090198114543010","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.94.12.2132"},{"key":"bibr27-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200005000-00019"},{"key":"bibr28-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.2560"},{"key":"bibr29-1090198114543010","volume-title":"Exploring bed-sharing mothers\u2019 motives and decision making for getting through the night intact: A grounded theory","author":"Culver E.","year":"2008"},{"key":"bibr30-1090198114543010","doi-asserted-by":"publisher","DOI":"10.1037\/0893-3200.21.1.1"},{"key":"bibr31-1090198114543010","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2005.068387"},{"key":"bibr32-1090198114543010","unstructured":"Department of Health & Human Services. 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