SUID/SIDS Prevention
These vignettes have been provided by SUID/SIDS colleagues across the country.
Issue:
Sleep-related death is a leading cause of infant mortality. Many of these deaths are preventable. In Franklin County (Ohio) from 2006-2010, 137 babies died while sleeping: 60% were sharing a sleep surface; 45% were sleeping on their stomach or side; and 70% were on unsafe sleep surfaces (adult bed, couch, chair, etc.).
Setting:
Columbus/Franklin County Ohio birthing hospitals, childcare providers and infant caregivers
Project:
The Infant Safe Sleep Task Force goal is to reduce sleep-related deaths by promoting safe-sleep practices for infant caregivers. Activities include developing, implementing and evaluating a hospital-based infant safe sleep initiative (observational audits, staff surveys); conducting trainings for childcare providers; and promoting infant safe-sleep though outreach, modeling and advocacy.
Accomplishments/Results:
Annual hospital audits show improvement from program pre-intervention to post-intervention. Trends changed from 50% of babies placed to sleep on their backs to 96%; 22% of cribs with blankets to 1%, and 13% of cribs with toys to 1%. 131 childcare providers attended workshops with pre- and post-tests assessing knowledge, attitudes and beliefs in safe-sleep practices. 168 healthcare professionals attended our conference, Sleep-Related Infant Deaths: Closing the Gap, in May, 2012. Evaluations were positive. Safe-sleep materials (grandparent brochure, billboard, PSA on ABCs of safe sleep, image guidelines) were shared by the presenter.
Barriers:
Challenges include engaging lactation professionals; community readiness; de-bunking myths; working with baby-product retailers; ongoing reinforcement of safe-sleep messaging; proper community role modeling; media misinformation.
Lessons Learned:
Too many babies die in unsafe sleep environments. Infant safe-sleep is optimally addressed in multiple settings to impact attitudes and behaviors. Safe-sleep practices among parents and caregivers are strongly influenced by nurse modeling and verbal instruction. Collaborative effort across government agencies, hospitals and childcare providers can be organized around a community health initiative. Public health provides a neutral forum for leadership in safe-sleep practices through group facilitation, coordination of interventions, and outcome evaluation.
Contact:
Karen Gray-Medina, MS, CHES
Program Manager
Family Health Division
Columbus Public Health
240 Parsons Avenue
Columbus, OH 43215
http://www.publichealth.columbus.gov
(614) 645-2134
kareng@columbus.gov
Issue:
The Upstate Cribs For Kids Program was the first established Cribs For Kids Charter in SC in 2007 and formally began offering services in 2008 after Greenville County detected a rise in infant deaths attributed to unsafe sleep.
Setting:
Train the trainer curriculum tailored to various settings from one-on-one sessions with caregivers, prenatally or after birth, to healthcare professionals and community members from Department of Social Services to daycare workers, and in Greenville Memorial Hospital.
Project:
The purpose of Upstate Cribs For Kids is to reduce the number of infants due to unsafe sleep practices through safe sleep education and dissemination of safe sleep materials and using a train the trainer approach to train community partners who can help identify at risk families. In addition our community partners provide each family with one-on-one safe sleep education and evaluates if the family continues to implement the safe sleep practices when the child is three months of age and again when the child is one year of age. The program is considered a success when the child reaches one year of age. To date there have been no reported unsafe sleep deaths among the families who have participated in this service since the program began. Information is confirmed via Child Fatality Review Committees for the counties served and via the two follow-up contacts with the family when the child is three months of age and one year of age.
As part of updated training and techniques, and to reach a wider audience base for sending the messaging about the importance of safe sleep the Upstate Cribs for Kids Program developed new messaging for referring agency partners, healthcare providers and anyone who may come in contact with parents/caregivers of infants. It is known as The 3 W's —
These three simple leading questions help anyone, anywhere assess families/caregivers for safe sleep knowledge and practices. When appropriate they may refer caregivers/parents for safe sleep education or for eligibility for a pack n play through the Upstate Cribs For Kids Program.
The training curriculum is tailored to various settings from one-on-one sessions with caregivers, prenatally or after birth, to healthcare professionals and community members from DSS to daycare workers. The successful train the trainer model has been replicated throughout the state and the curriculum which addressed SIDS/SUID, safe sleep and products/devices as well as real life sleep environments and situations.
The program has also assisted the Greenville Memorial Hospital in implementing Safe Sleep Policies for specific units within the hospital system as well as staff training. As part of The Newborn Drug Exposure Protocol — mandatory safe sleep education/consult is required for all for parents/caregivers who will be caring for a newborn that was exposed to drugs prenatally and under the protocol. Physician's also order safe sleep consults for parents/caregivers displaying unsafe sleep practices while in the hospital as well as for those who have experienced a previous infant's death due to SIDs or unsafe sleep.
Due in large to the efforts of Upstate Cribs for Kids, The South Carolina Joint Citizens and Legislative Committee on Children has made Safe Sleeping for Infants a major priority for the state "to encourage an emphasis to more effective, less costly preventive services…" As a result the Upstate Cribs For Kids Program is continuing to provide public awareness about the importance of safe sleep through media interviews, editorials and conferences. The next step for our program is the training of Upstate Coroners and First Responders to ensure accurate information and consistency in reporting, documenting and education regarding unsafe sleep deaths as well as the promotion of safe sleep practices.
Accomplishments:
Since 2008 the program has:
Resource Materials:
Evaluation of Program Success:
Our community partners evaluates if the family continues to implement the safe sleep practices when the child is three months of age and again when the child is one year of age by giving them a written evaluation form to complete. Each evaluation is tallied and scored by the program manager. The program is considered a success when the child reaches one year of age. To date there have been no reported unsafe sleep deaths among the families who have participated in this service since the program began. Information is confirmed via Child Fatality Review Committees for the counties served and via the two follow-up contacts with the family when the child is three months of age and one year of age.
Funding of the Program:
Upstate Cribs for Kids is funded through a number of grants and the support of Greenville Hospital System, our parent organization. Funding includes but is not limited to:
Program Partners:
A Child's Haven
Center for Pediatric Medicine
Clemson Child Development Center
Family Friends Program-Oconee DSS
GHS Beginnings & Beyond Program
Greenville County Disabilities & Special Needs Board
Greenville County Schools-Pregnant Teens Program
Greenville First Steps
GHS Nurse Family Partnership
New Horizons Family Health Services
Nurse Family Partnership DHEC Region I
Parenting & Family Literacy
The Parenting Place
PASOS Program
Principles of Parenting Successfully
Reedy Fork Baptist Church
Shady Grove Baptist Church
In addition to the above named partners Upstate Cribs For Kids has developed a new working relationship with the Greenville County Coroner's Office and The Greenville County Department of Social Services. These new partnerships have helped to raise the awareness of unsafe sleep issues as well as expand into other areas to help educate professionals who meet families under different circumstances. By working with both agencies, educators can identify trends in unsafe sleep practices and provide up-to-date training and information based on identified needs in the area.
Contact:
Michelle Greco, RNC-MNN, CCE, BSN
Greenville Hospital System Women's Hospital
Women's Education Department
The Beginnings and Beyond Program & The Upstate Cribs For Kids Program
701 Grove Rd.
6th Floor Support Tower
Greenville, SC 29605
(864) 455-1408
mgreco@ghs.org
Setting:
Materials are used by community partners who work with targeted persons, and information is also provided on a website and in a state-wide TV and radio media campaign. This is a project of TEAM for West Virginia Children, with funding from the WV Department of Health and Human Resources, WV Children's Trust Fund, and the Claude Worthington Benedum Foundation.
Project:
Our Babies: Safe and Sound is an educational campaign that provides parents and other caregivers of infants under the age of one, as well as expectant parents and professionals, with information and tips on ways to keep babies safe while sleeping, and how to keep cool when babies cry. The overall goal of the campaign is to help protect West Virginia infants from injury and death. Campaign themes:
The campaign features three levels of activity:
Accomplishments/Results:
Free materials (brochures, posters, DVDs) and resources (agencies, organizations, advocacy groups) have been provided to over 200 community partner organization across the state to use in one-on-one or group environments, as part of a home, office or hospital visits, or in other appropriate settings. Interested representatives from states including Maine, Oklahoma, and Idaho have signed contracts to localize Our Babies Safe and Sound materials in their respective states. All materials use positive messaging instead of telling parents and caregivers what not to do.
Evaluation results show that Our Babies: Safe and Sound has had positive and desired effects during the initial phase of the campaign in 2010. A limited outcomes evaluation, using surveys of parents and caregivers of infants, measured attitudes, beliefs, and behaviors related to safe sleep and crying. Responses from a spring 2010 pre-campaign survey were compared to post-campaign survey data later in the year. An evaluation for Year 2 is under way.
Contact:
Eileen Barker, Coordinator
ewbarker@suddenlink.net
(304) 342-1330
Becky King, Coordinator:
bk0517@gmail.com
(304) 757-9456
http://www.safesoundbabies.com