113 - Telling parent stories as part of a data-informed community-driven infant safe sleep campaign: Lessons from Indiana

Abstract Information: This study examines the development and implementation of an infant safe sleep campaign aimed at reducing Sudden Unexpected Infant Death (SUID) rates in Indiana, as part of the evaluation of the Child Safety Forward Indiana project. The study used a mixed-methods approach, analyzing data from child fatality reviews to identify factors contributing to sleep-related infant deaths (N=528 SUIDs) and from focus groups with parents exploring safe sleep messaging and their perceptions and experiences regarding safe sleep practices. A five-year retrospective review of SUIDs indicated that Non-Hispanic Black infants were overrepresented (35%); more than half of the deaths occurred while infants were sleeping in adult beds and a third occurred while the infant was napping. SUIDs are preventable through consistent safe sleep practices. However, the study found that many caregivers, despite having received safe sleep education, choose not to engage in these practices. Participants identified mistrust of agencies and ads as the main reasons. They stated that they would listen and connect to parent stories. Thus, a safe sleep campaign was designed and implemented, integrating these findings in imagery and messaging. The campaign includes videos telling stories of parents who lost a child in unsafe sleep environments, which has been seen over 1.5 million times. This study also highlights the importance of using evidence-based recommendations and culturally responsive approaches in designing safe sleep interventions, providing valuable lessons learned around prevention strategies to improve infant health outcomes so that all children fulfill their promise.

Relevance Statement: The safe sleep campaign aimed at reducing Sudden Unexpected Infant Death (SUID) rates in Indiana has significant implications for the field of evaluation, as it was developed integrating findings from quantitative and qualitative data. SUIDs are largely preventable through consistent safe sleep practices. However, many caregivers, despite having received safe sleep education, choose not to engage in these practices. This mixed methods study analyzed data from child fatality reviews to identify factors contributing to sleep-related infant deaths (N=528 SUIDs) that occurred in Indiana from 2015 to 2019. This study also used data from 8 focus groups, providing valuable insights into parents' perceptions and experiences regarding infant safe sleep practices, which helped inform the development of effective statewide infant safe sleep campaigns and community-led interventions. The safe sleep campaign includes stories of parents who lost a child in unsafe sleep environments, among imagery and messaging that integrates data from SUIDs fatality reviews and focus groups with caregivers and thus, contributes to the knowledge base on SUID prevention and inform the design of future evaluation efforts. We also include reach data, as the videos have been seen over 1.5 million times. The study reflects relevant standards of quality in evaluation theory, methods, and practice. The use of five-year retrospective review of SUIDs uses data collected through a process of multidisciplinary collaborative child fatality reviews to explain why deaths occur and identify strategies to prevent future deaths. The use of qualitative research methods, such as focus groups, is appropriate for exploring complex social phenomena and understanding the perspectives and experiences of participants. The study also highlights the importance of using evidence-based recommendations from reputable sources, such as the American Academy of Pediatrics (AAP), in designing safe sleep campaigns. Furthermore, the safe sleep campaign adds to knowledge in the evaluation field by highlighting the need for tailored interventions to address racial and ethnic disparities in SUID rates. The study reveals that SUID rates are higher among non-Hispanic Black and Hispanic infants than among non-Hispanic White infants in Indiana, which underscores the importance of considering cultural and social factors in designing and implementing safe sleep interventions. This finding aligns with the principles of culturally responsive evaluation, which emphasize the importance of recognizing and addressing cultural differences and power dynamics in evaluation efforts. Overall, the safe sleep campaign is relevant and important to the field of evaluation because it provides valuable insights into how to design effective interventions to reduce SUID rates and addresses racial and ethnic disparities in infant mortality. By using evidence-based recommendations and culturally responsive approaches, safe sleep campaigns can make a significant impact on reducing the incidence of SUID and improving infant health outcomes.