Workshop/Breakout Title Workshop/Breakout Speaker(s)

1. Michigan Infant Safe Sleep Campaign Sandra J. Frank, JD, CAE, CFRM Executive Director Tomorrow’s Child/Michigan SIDS Workshop/Breakout Title Workshop/Breakout Speaker(s)

2. Tomorrow’s ChildMichigan SIDS • State’s Title V SIDS and Other Infant Death Program in partnership with the Michigan Department of Community Health • 501c3 nonprofit organization • RESOURCE for the Back to Sleep and Infant Safe Sleep campaigns • CENTRAL REFERRAL SITE for grief services related to all infant deaths

3. “Take Away Message” • Michigan has created unified infant safe sleep recommendations • Endorsed by Governor and Governor’s Children’s Cabinet = state policy • Institutionalize message; establish systems change • Formal evaluation and ongoing assessment

4. Presentation Outline • Process • Summary of Michigan Infant Safe Sleep Campaign • Evaluation

5. 1. Identify the data andgather the evidence • Mandated sources of information • Vital statistics • Federal reporting requirements for child abuse/neglect deaths - NCANDS • National research and recommendations • Valuable, additional sources • SIDS/OID program • PRAMS • Licensing data • CDR • FIMR • Death scene findings • Parent stories

6. National Studies and Recommendations A growing body of knowledge supported the finding that many infant deaths during sleep are related to unsafe sleep environments. (Lijowska, AS, et al, 1997; Scheers, NJ, et al. 1998; Kemp, JS, et al, 2000; Nakamura, SW, 2001; Flick, L, et al. 2001).

7. 1999 • CPSC study that adult beds and soft bedding are dangerous for infant sleep • AMA media advisory on unsafe sleep habits for infants

8. 2000 • CPSC safety campaign • AAP Infant Sleep Policy Statement • Pediatrics articles

9. 2002-2003 • Pediatrics article by NJ Scheers and J.Kemp • CPSC, JPMA announce national infant safe sleep campaign

10. 2. Analyzing the data and key findings • 71% decline in SIDS rates since 1994 • SIDS diagnosis appears to be going away • Postneonatal rate unchanged – diagnostic shift? • Sleep environment major risk factor

11. CONCLUSION: BEYOND SIDSBEYOND BACK TO SLEEP • Evolution in SIDS • Sleep related deaths • Preventability • BTS campaign experience • Infant Safe Sleep campaign

12. Changing infant sleep practices • Knowledge does not change behavior • Required change in attitudes, values, practice, behavior • Process of “unlearning” and relearning

13. Process! MDCH convened a broadly based group in 2004 to develop a statewide, consistent, comprehensive message and strategy to inform families and caregivers about unsafe sleep practices.

14. Membership • MDCH • Tomorrow’s Child/Michigan SIDS • Pediatricians • MDHS • MDOE • WIC • CDR • FIMR • Local public health • MPHI • Community representatives

15. Objectives • Create collaborative relationships to identify, achieve and maintain outcomes 2. Establish common mission • Secure leadership support 4. Provide the essential infrastructure

16. Objectives 5. Develop a consistent message 6. Determine interventions and priorities 7. Assure systems change, institutionalize • Provide funding options 9. Always have ongoing assessment and evaluation

17. Common Mission Understand, address and reduce infant deaths related to unsafe sleep practices

18. Leadership Support • MDCH • MDHS • MDOE

19. Developing a Consistent Message Strategy: Process, process, process! To define issues, address challenges, collaborate on solutions, describe interventions -Inclusive, respectful, non-judgmental -Evidence-based -Agreement that AAP guidelines followed

20. Target Interventions and Priorities Recommendations: • Audience • Priorities • Intervention strategies • Next steps

21. Why Systems Change? • Knowledge ≠ behavior change • BTS learning • Clinical audits • Studies of Nurses as Role Models • Anecdotal information from families and nurses

22. CONCLUSION:Institutionalize Infant Safe Sleep • Standards of care, policies, procedures, rules, legislation • Existing major systems that work with women of childbearing age, pregnant women, women with children under 1 year of age, caregivers

23. Strategies for InstitutionalizingInfant Safe Sleep Formal/regulatory • Policies • Hospitals • Health plans • State agencies • Licensure/rules • Child care • Procedures • Funding

24. Institutionalizing Infant Safe Sleep Informal • Materials - Social marketing/branding concepts • Coalitions and like-minded groups • Resource allocation • Training

25. LEADERSHIP SUPPORT • Formal and informal leadership • Buy–in on final product • Process and authority for implementation • Funding • Michigan - Governor’s Children’s Cabinet

26. Funding Think creatively! Be entrepreneurial! • Tobacco funds ($250,000) • MCH block grant • Child abuse and neglect • Grants State National Private Community Hospital Health plans Health associations • Fundraising • United Way • Federal earmark

27. Evaluation • BTS learning • Integral to all interventions • Professional evaluator

28. Achieving and Maintaining Outcomes Formal • Oversight committee • Reporting to Governor’s office • Evaluations and ongoing assessment • Vital statistics Informal • Focus groups • Community coalitions/collaborative relationships • Surveillance teams (CDR, FIMR)

29. Acknowledgements THE SKILLMAN FOUNDATION MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

30. Questions? Questions? Tomorrow’s Child www.tcmisids.org 1-800-331-7437