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The Right Information at the Right Time
Resources compiled by the MCH Library and the National SUID/SIDS Resource Center

Introduction

Public Health Approach to Infant MortalityThe number of deaths among near- and full-term infants (>36 "weeks' gestation") remains higher in the United States than in most of the industrialized world. Internationally, the United States now ranks 34th in infant mortality1—behind Japan, Singapore, Hong Kong, Australia, New Zealand, Canada, Israel, and most European nations.2 In 2010 (the most recent year for which statistics are available), the U.S. infant mortality rate was 6.15 deaths per 1,000 live births.3

This toolkit provides resources to help the Maternal and Child Health (MCH) work force strategically integrate the evidence base into plans for addressing infant mortality.

These resources are organized by a four-part conceptual model of public health, detailed below.

1. Surveillance and Monitoring

Resources in defining the problem through the systematic collection of information about the magnitude, scope, characteristics and consequences, of infant mortality. ▼/▲ See Resources

2. Identifying Risk Factors and Protective Factors

Resources in establishing why infant mortality occurs using research to determine causes and correlates of infant mortality, factors that increase or decrease risk for infant mortality, and factors that could be modified through interventions. ▼/▲ See Resources
  • Infant Mortality and Pregnancy Loss Knowledge Path. Resources that analyze data, reports on research, risk-reduction efforts, and bereavement-support programs. Separate sections identify resources on: birth defects, injuries, low birthweight and prematurity, pregnancy and preconception, and safe sleep environments. Developed by the MCH Library.
  • Bibliography, Organizations List, and Healthy Start Materials (updated continually). Materials from the MCH Library collection.
  • MCH Alert: Focus on Infant Mortality. An electronic newsletter that provides timely reference to research findings, policy developments, recently released publications, new programs, and initiatives. Developed by the MCH Library in collaboration with the National SUID/SIDS Resource Center.
  • SUID/SIDS Research Bibliographies. Bibliographies on frequently requested topics present the latest citations from PubMed, the National Library of Medicine's database of biomedical literature.

3. Developing and Testing of Prevention Strategies

Resources to find out what works in preventing infant mortality by designing, implementing and evaluating interventions in five areas of targeted improvement, as identified by Health Resources and Services Adminstration's (HRSA's) Maternal and Child Health Bureau (MCHB): (1) reduce elective delivery at <39 weeks, (2) expand access to interconception care through Medicaid, (3) increase smoking cessation among pregnant women, (4) prevent SIDS/SUID, and (5) expand perinatal regionalization. ▼/▲ See Resources


3.1.  Reduce elective delivery at <39 weeks

Perinatal morbidity is higher in infants delivered before 39 weeks' gestation.

3.2.  Expand access to interconception care through Medicaid

3.3.  Increase smoking cessation among pregnant women

  • Centers for Disease Control and Prevention (CDC). Smoking: How to Quit.
  • National Cancer Institute (NCI). Free Help to Quit Smoking. Provides a toll-free quit line, online chat service, and links to smoking-cessation materials.
  • SmokeFree.Gov. The section titled SmokeFree Women includes guidelines for pregnant women. This site also provides
    • An online Quit Guide.
    • Information on SmokefreeTXT. a free, smoking-cessation text messaging service designed for adolescents and young adults across the United States.
    • Information on the free Smokefree Smartphone Application. Developed by tobacco-control professionals and cessation counselors for NCI.
    • Resources for health professionals. Includes the QuitNowTXT Message Library developed by NCI's Tobacco Control Research Branch to provide health departments, academic institutions, and government agencies with an algorithm and database of messages designed to serve as smoking-cessation intervention for individuals who are ready to quit smoking.
  • SmokeFreeMoms. Coordinated pilot project focused on providing pregnant women who wish to quit smoking with personalized, interactive, and evidence-based health text messages. DHHS partners in the project include CDC, the Substance Abuse & Mental Health Services Administration, the National Institutes of Health (NIH), and the Food and Drug Administration. The SmokeFreeMoms text message library will be made publicly available and will be posted on HealthData.gov.
  • Smoking Cessation for Pregnancy and Beyond. Online continuing-education program for health professionals with case-based learning using simulated and actual patients, interactive activities, lectures, and links to additional resources.
  • Smoking Cessation During Pregnancy: A Clinician’s Guide to Helping Pregnant Women Quit Smoking. (2011). American College of Obstetricians and Gynecologists.
  • MCH Library Resources: Resource brief | Bibliography | Reproductive health services

3.4.  Prevent SIDS/SUID

  • National SUID/SIDS Consortium. HRSA's MCHB has developed a consortium of four partners to reduce infant deaths and to support families affected by infant mortality. All share the goal of reducing sudden infant deaths and assisting bereaved families, yet each center has a unique purpose and core responsibilities:
  • The Safe to Sleep campaign—formerly known as the Back to Sleep campaign—aims to educate parents, caregivers, and health professionals about ways to reduce the risk for Sudden Infant Death Syndrome (SIDS) and other sleep-related causes of infant death. Developed by the NIH/ Eunice Kennedy Shriver National Institute of Child Health And Human Development.
  • Cribs for Kids is a national organization that provides safe sleep education and products including a portable crib which are distributed to families through a network of over 325 partner organizations. Cribs for Kids also provides a Hospital Initiative Toolkit and the Safe Sleep Ambassador Education Outreach Program.
  • Office of Minority Health: A Healthy Baby Begins with You. Information about this national campaign to raise awareness about infant mortality with an emphasis on the African-American community. Includes campaign materials and infant-mortality-disparities fact sheets.

3.5.  Expand perinatal regionalization

Regionalized perinatal systems ensure that high-risk deliveries occur in the hospitals best equipped to optimize outcomes.

4. Ensuring Widespread Adoption

Resources to implement effective and promising interventions in a wide range of settings. The effects of these interventions on risk factors and the target outcome should be monitored, and their impact and cost-effectiveness should be evaluated. ▼/▲ See Resources

 


Notes

1. United Nations, Department of Economic and Social Affairs, Population Division. 2011. UN World Population Prospects Report, by 5 Year Averages.

2. Central Intelligence Agency. 2012. CIA World Factbook, Infant Mortality Rate (2012 estimates). Washington, DC: Central Intelligence Agency.

3. Centers for Disease Control and Prevention, National Center for Health Statistics. 2013. Vital Statistics Available Online.


Infant Mortality Toolkit (May 2013).

Authors: John Richards, M.A., AITP, and Beth DeFrancis, M.L.S., MCH Library and National SUID/SIDS Resource Center.
Reviewers: Rochelle Mayer, Ed.D., and Olivia K. Pickett, M.A., M.L.S., MCH Library and National SUID/SIDS Resource Center.
Editor: Ruth Barzel, M.A., MCH Library.