Find State ESMs

Measure Status: Active

Evidence Level: There is limited research in the evidence base for this NPM to support this strategy.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase the number of birthing hospitals participating in the safe sleep program

Numerator: The number of births occurring at birthing hospitals participating in the sleep sack program

Denominator: The number of resident live births

Significance: Providing a consistent message about infant sleep safety is essential to reducing sleep-related infant deaths. Hospital-based programs provide opportunities to give accurate and consistent infant safe sleep information to hospital staff and enable modeling of safe sleep practices. Increasing the number of birthing hospitals participating in the safe sleep program will directly increase the number of parents and caregivers receiving infant safe sleep education and the number of babies utilizing sleep sacks. This in turn will lead a reduction in infant deaths related to unsafe sleep conditions. Safe to Sleep Campaign. Eunice Kennedy Shriver National Institute of Child Health and Human Development. U.S. Department of Health and Human Services.

Data Sources and Data Issues: Vital Statistics Data, Health Care Information, Center for Health Statistics, Oklahoma State Department of Health and MCH Sleep Sack Program

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: There is limited research in the evidence base to support this strategy.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Enabling services level of pyramid

Essential Public Health Services: 3. Inform and educate the public

Service Recipient: Activities related to systems-building

Goal: Expand outreach to Non-English-speaking families and care givers through translation of educational and general awareness safe sleep messages.

Numerator: Number of languages Departments of Health (DOH) & Human Services (DHS) safe sleep are available for Hawaii’s communities

Denominator: N/A

Significance: About 3,500 US infants die suddenly and unexpectedly each year. These deaths are referred to as sudden unexpected infant deaths (SUID). SUID is one of the three leading-causes of death among infants nationally and in Hawaii (Hayes DK, Calhoun CR, Byers TJ, Chock LR, Heu PL, Tomiyasu DW, Sakamoto DT, and Fuddy LJ. Saving Babies: Reducing Infant Mortality in Hawaii. Hawaii Journal of Medicine and Public Health. 2013. 72 (2): 246-251). The American Academy of Pediatrics (AAP) recommends a safe sleep environment to reduce the risk of all sleep-related infant deaths. AAP recommendations for a safe sleep environment include supine positioning, the use of a firm sleep surface, room-sharing without bed-sharing, and the avoidance of soft bedding and overheating. Additional recommendations for SUID reduction include the avoidance of exposure to smoke, alcohol, and illicit drugs; breastfeeding; routine immunization; and use of a pacifier. The AAP recommends education should include all who care for infants, including parents, child care providers, grandparents, foster parents, and babysitters, and should include strategies for overcoming barriers to behavior change. Research on health education and SUID outreach has found that response to safe sleep messages differed among different communities and racial/ethnic groups, which may help explain some of the lingering differences in SUID rates. Therefore, campaigns should have a special focus on getting safe sleep messages to parents and caregivers in diverse communities because of the higher incidence of SUID and other sleep-related infant deaths in these groups.

Data Sources and Data Issues: Data will be collected by Safe Sleep Hawaii about the efforts by DOH, DHS and the State Office of Language Access to translate educational materials into other languages for use by non-English speakers.

Year: 2020

Unit Type: Simple Count, Unit Number: 20

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=safe+sleep+certified&NPM=5&State=&RBA_Category=&MCH_Pyramid=&Recipient=&Status=Active) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/5-safe-sleep.php).

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities related to systems-building

Goal: To increase the number of Florida birthing hospitals that are Safe Sleep Certified.

Numerator: Number of Florida birthing hospitals in Florida that are Safe Sleep Certified

Denominator: N/A

Significance: Safe sleep guidelines are endorsed by the American Academy of Pediatrics, the National Institute of Health, the CDC and by other nationally recognized programs. A hospital safe sleep certification process would ensure that participating hospitals develop a policy to support safe sleep efforts and that trusted hospital professionals provide consistent safe sleep messaging to parents.

Data Sources and Data Issues: Cribs for Kids in Florida

Year: 2020

Unit Type: Simple Count, Unit Number: 100

Measure Status: Active

Evidence Level: Expert Opinion. Aligns with MCHbest strategy "Building on Campaigns with Conversations" (https://www.mchevidence.org/tools/strategies/5-7.php). Find other NPM 5 community-level strategies in MCHbest.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities related to systems-building

Goal: The overall goal of the Nebraska Safe Babies Campaign is to provide evidence-based education to parents of newborns as well as birthing hospital and pediatric clinical staff.

Numerator: NA

Denominator: NA

Significance: A survey of all birthing hospitals in Nebraska revealed that hospitals are not providing consistent preventative education messages on Infant Safe Sleep and Abusive Head Trauma/Shaken Baby Syndrome Prevention Education (AHT/SBS). Providing a consistent baseline education for all hospital personnel caring for children under the age of one will provide a consistent, evidence-based message to parents of more than 26,000 newborns across the State.

Data Sources and Data Issues: Program data

Year: 2020

Unit Type: Simple Count, Unit Number: 100

Measure Status: Active

Evidence Level: There is limited research in the evidence base for this NPM to support this strategy.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: To support Simple County public health departments who have identified decreasing infant deaths due to unsafe sleep conditions as a priority need in their communities.

Numerator: Total number of Simple Counties choosing to use MCHBG funding for infant safe sleep education activities which have met their activity goals.

Denominator: Total number of Simple Counties choosing to use MCHBG funding for infant safe sleep education activities.

Significance: The FCHB will contract with CPHDs interested in decreasing the rate of infant deaths due to unsafe sleep conditions. These Simple Counties will implement and evaluate at least two community-level activities during the fiscal year. This will raise community-level understanding on the importance of implementing safe sleep recommendations for infants.

Data Sources and Data Issues: FCHB - The number of Simple Counties choosing to use MCHBG funding in this way may change from year to year.

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM measures access to/receipt of care, thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 3: Measuring quantity of effect (# of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities directed to families/children/youth

Goal: Increased numbers of infants will be placed on their backs to sleep. Challenges to safe sleep practices will be addressed

Numerator: Number of infants less than 6 months placed on their backs to sleep

Denominator: Total number of infants less than six months old

Significance: Reduction in infant mortality

Data Sources and Data Issues: PRAMS, home visiting programs assessing safe sleep environments

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM is based on state data and measures access to/receipt of care, thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase the use of the Infant Safe Sleep Environment (on co-sleeping, on back, no soft bedding)

Numerator: Mothers reporting Infant Safe Sleep Environment (no co-sleeping, on back, and no soft bedding) on the NJ PRAMS survey

Denominator: Mothers completing the NJ PRAMS survey

Significance: Tracking infant safe sleep practices using PRAMS data will inform the NJ DOH whether educational efforts to train health professionals and awareness campaigns targeting caregivers is having an impact on infant safe sleep practices. More information other than the percent of infants placed to sleep on their backs (NPM #5) is needed to ensure adherence to the complete Infant Safe Sleep message. Reporting NJ PRAMS data on co-sleeping and soft bedding in addition to on back would provide a more complete message on Infant Safe Sleep education.

Data Sources and Data Issues: NJ PRAMS Survey

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "Caregiver Education" (https://www.mchevidence.org/tools/strategies/5-1.php). Find other NPM 5 caregiver-level strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Promote safe and healthy infant sleep behaviors and environments, including improving support systems and the daily living conditions that make safe sleep practices and family functioning challenging

Numerator: Number of women enrolled in the WIC Plus Baby and Me Program who place their infant to sleep on their back

Denominator: Number of women enrolled in the WIC Plus Baby and Me Program with an infant

Significance: Sleep-related deaths is a major contributor of infant mortality in the United States and in Arkansas. Safe sleep practices can help lower the risk of sleep-related infant deaths, including sudden infant death syndrome (SIDS), accidental suffocation, and deaths from unknown causes. Safe sleep practices recommended by the American Academy of Pediatrics include: placing the baby on his or her back at all sleep times – including naps and at night; using a firm sleep surface, such as a safety-approved mattress and crib; keeping soft objects and loose bedding out of the baby’s sleep area; and sharing a room with baby, but not the same bed.

Data Sources and Data Issues: Arkansas WIC Plus Baby and Me Program data - Month 1 Pre-Crying Session Form

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM is based on state data and measures access to/receipt of care, thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase percent of WIC participants who report always placing their baby on his/her back to sleep to 83% by 2025.

Numerator: Number of WIC participants who complete the safe sleep survey who report always placing their baby on his/her back to sleep

Denominator: Number of WIC participants caring for an infant who complete the safe sleep survey

Significance: SIDS is the leading cause of death among babies between 1 month and 1 year of age. About 1,360 babies died of SIDS in 2017, the last year for which such statistics are available. Approximately 60% of Maine births are covered by MaineCare (medicaid). Those families are eligible for WIC's services. Increasing education on safe sleep practices with WIC participants will increase the number of people who report putting their baby on their back every time.

Data Sources and Data Issues: Annual safe sleep survey of WIC participants

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=case+review&NPM=5&State=&RBA_Category=&MCH_Pyramid=&Recipient=&Status=Active) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/5-safe-sleep.php).

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 1. Assess and monitor population health

Service Recipient: Activities related to systems-building

Goal: To improve investigative quality in order to support accurate classification and data related to SUID deaths by ensuring that SUID investigations include a scene reenactment and scene photos.

Numerator: Number of SUID cases reviewed by MCDR in the prior year with scene reenactment and investigative photos completed by the investigating agency.

Denominator: All SUID cases reviewed by the MCDR in the prior year.

Significance: In order to prevent SUID deaths, it is necessary to understand the exact circumstances in which each such death occurs. Knowing these circumstances enables the Maternal Child Death Review (MCDR) program to determine underlying risk factors and craft recommendations that inform prevention measures. In spite of progress with completion of SUIDI forms, the quality of investigations continues to pose challenges towards fully understanding each death, particularly with the respect to the thoroughness of interviews and evidence collection. A scene reenactment with the caregivers, using an appropriate weighted doll as an investigative tool, is a key component of the SUID Investigation. It not only provides information essential to accurate SUID categorization, but also reflects a level of effort and attention to the case that may not occur without a reenactment, even if the form is completed. The MCDR program has undertaken a new project to support investigating agencies with tools and training to help address some of these issues. The MCDR program is significantly funded by Title V.

Data Sources and Data Issues: MCDR Database. Cases reviewed by MCDR in a calendar year are based upon availability of records. Most cases are reviewed within one year, however, there are occasional delays, often related to pending legal cases. For example, the 2019 review year included one death which occurred in 2015. Therefore, we expect to see some delay in improvement for this indicator in response to interventions such as investigator training.

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM measures access to/receipt of care, thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Reduce the number of infants (under 1 year of age) who are laid to sleep in a high-risk sleep position and/or environment

Numerator: Number of PRAMS respondents who report their infants (under 1 year of age) were laid to sleep in a high-risk sleep position and /or environment

Denominator: Number of PRAMS respondents

Significance: In 2016, the American Academy of Pediatrics (AAP) developed specific recommendations expanding on the importance of sleep position for infants up to 1 year old. To reduce the risk of SIIDS, for safe sleep in a supine position (wholly on the back) for every sleep by every caregiver until the child reaches 1 year of age. Side sleeping is not safe and is not advised.

Data Sources and Data Issues: Nevada Pregnancy Risk Assessment Monitoring System; Data represents 2018 calendar year births. Nevada PRAMS receives data in fall of the preceding birth year, resulting in a year lag (2019 data is not received until fall 2020). That is why 2018 calendar year was used. 2018 Nevada PRAMS data had a response rate of 39.4% which is under the Centers for Disease Control and Prevention (CDC) required response rate threshold of 55% to publish data. Interpret data with caution due to the response rate.

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=collaborative&NPM=5&State=&RBA_Category=&MCH_Pyramid=&Recipient=&Status=Active) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/5-safe-sleep.php).

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities directed to families/children/youth

Goal: To increase the percent of infants placed to sleep on their backs and on a separate approved surface, without soft objects or loose bedding

Numerator: A) Number of mothers reporting that they place their baby to sleep on their back

Denominator: Number of infants with information reported

Significance: Sleep-related infant deaths, also called Sudden Unexpected Infant Deaths (SUID), are the leading cause of infant death after the first month of life and the third leading cause of infant death overall. Sleep-related SUIDs include Sudden Infant Death Syndrome (SIDS), unknown cause, and accidental suffocation and strangulation in bed. Due to heightened risk of SIDS when infants are placed to sleep in side (lateral) or stomach (prone) sleep positions, the American Academy of Pediatrics (AAP) has long recommended the back (supine) sleep position. In 2011, AAP expanded its recommendations to help reduce the risk of all sleep-related deaths through a safe sleep environment that includes use of the back-sleep position, on a separate firm sleep surface (room-sharing without bed sharing), and without loose bedding. http://pediatrics.aappublications.org/content/128/5/1030

Data Sources and Data Issues: Kansas Perinatal Community Collaborative (KPCC)/Becoming a Mom (BaM) Birth Outcome Card

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=home+visit&NPM=5&State=&RBA_Category=&MCH_Pyramid=&Recipient=&Status=Active) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/5-safe-sleep.php).

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: By 2025, increase the percentage of infants of 6 months of age, in Title V Home Visiting Program, placed to sleep in a safe environment.

Numerator: Infants of 6 months of age, in Title V HVP placed on their backs, on a separate approved sleep surface, and without soft objects or loose bedding by September 2025.

Denominator: Infants of 6 months of age, in Title V Home Visiting Program.

Significance: In Puerto Rico sleep-related Sudden Unexpected Infant Deaths (SUIDs), was among the leading causes of infant deaths between 1 to 12 months of age in 2016 and as the first cause in 2017 and 2018. The PR-PRAMS results raise concern of the knowledge and practices of safe sleep in PR, with only 8.7% placing their infants in a safe sleeping environment. Recognizing this as a priority, the PR Title V Home Visiting Program proposes to promote infant safe sleep practices among participants, by offering prenatal and post-partum orientation and evaluating safe sleep practices. Participants in the HVP receive orientation on Safe Sleep practices beginning in the second trimester of pregnancy and continued in the post-partum period. The participants for this program are chosen based on the identification of risk factors that increase infant mortality such as adolescent pregnancy, chronic disease, previous pregnancy lost, and maternal age older than 35 years.

Data Sources and Data Issues: Title V Home Visiting Program logs, reports and produced documents.

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=home+visit&NPM=5&State=&RBA_Category=&MCH_Pyramid=&Recipient=&Status=Active) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/5-safe-sleep.php).

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: By January 2022, 50% of infants enrolled I home visiting will always be places to sleep on their back, without bed-sharing or soft bedding

Numerator: Number of infants (less than 1 year old) enrolled in home visiting whose primary caregiver reports always placing the infant on their back, without bed-sharing or soft bedding.

Denominator: Number of infant (less than 1 year old) enrolled in the home visiting program

Significance: The American Academy of Pediatrics recommends that infants be put to sleep on their backs to reduce the risk of Sudden Infant Death Syndrome (SIDS); also that home visitors are trained on safe sleep using an evidence-based curriculum, prenatally through age one, to support maternal and infant health.

Data Sources and Data Issues: Home Visiting data (Social Solutions)

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Multicomponent Strategy: Caregiver Education + Health Care Provider Education + Hospital Safe Sleep Policy" (https://www.mchevidence.org/tools/strategies/5-4.php). Find other NPM 5 hospital-level strategies in MCHbest.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Enabling services level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities related to systems-building

Goal: Increase the number of hospitals teaching parents to place infants in a safe sleep environment.

Numerator: Number of birthing hospitals (1) recognized as a National Cribs for Kids certified hospital or with an approved safe sleep policy, and (2) submitting crib audit reports with ≤ 10% of infants being found in an unsafe sleep environment

Denominator: Number of birthing hospitals in Tennessee

Significance: The infant sleep behaviors modeled by hospital staff after birth have been shown to be important in determining the practices new parents adopt when returning home. Because of this highly influential role, it is key to ensure that all birthing hospitals in Tennessee are exemplifying proper safe sleep behaviors and demonstrating to parents that babies should sleep alone, on their back, and in a crib, bassinet, or pack n’ play. By increasing the number of hospitals that meet this standard, we can increase the number of Tennessee parents who benefit from a positive example of safe sleep and, by extension, the number who continue to put their infant to sleep safely at home.

Data Sources and Data Issues: Family Health and Wellness tracking tool

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "Caregiver Education" (https://www.mchevidence.org/tools/strategies/5-1.php). Find other NPM 5 caregiver-level strategies in MCHbest.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Enabling services level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities related to systems-building

Goal: Increase the percentage of hospitals and birthing facilities (pediatric departments, NICUs, and Children's Hospitals) providing education and modeling safe infant sleep to parents with newborns or infants

Numerator: Number of hospitals and birthing facilities (pediatric departments, NICUs, and Children's Hospitals) actively participating in the Georgia Safe to Sleep hospital-based program and providing safe infant sleep education to parents/caregivers

Denominator: Total number of hospitals and birthing facilities

Significance: Safe sleep guidelines are endorsed by the American Academy of Pediatrics, the National Institutes of Health, the CDC and other nationally recognized programs. A hospital safe sleep program ensures that participating hospitals develop a policy to support safe sleep efforts and that trusted hospital professionals provide accurate and consistent safe infant sleep messaging to parents/caregivers.

Data Sources and Data Issues: Data Source: Georgia Safe to Sleep Program Data

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "Caregiver/Parent Education" (https://www.mchevidence.org/tools/strategies/5-1.php). Find other NPM 5 caregiver-level strategies in MCHbest.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Enabling services level of pyramid

Essential Public Health Services: 3. Inform and educate the public

Service Recipient: Activities directed to families/children/youth

Goal: To increase safe sleep educational awareness to families through materials and resources distributed at District hospitals.

Numerator: 303

Denominator: 976

Significance: Sleep-related infant deaths, also called Sudden Unexpected Infant Deaths (SUID), are the leading cause of infant death after the first month of life and the third leading cause of infant death overall. Sleep-related SUIDs include Sudden Infant Death Syndrome (SIDS), unknown cause, and accidental suffocation and strangulation in bed. Due to heightened risk of SIDS when infants are placed to sleep in side (lateral) or stomach (prone) sleep positions, the AAP has long recommended the back (supine) sleep position. However, in 2011, AAP expanded its recommendations to help reduce the risk of all sleep-related deaths through a safe sleep environment that includes use of the back-sleep position, on a separate firm sleep surface (room-sharing without bed sharing), and without loose bedding. Among others, additional higher-level recommendations include breastfeeding and avoiding smoke exposure during pregnancy and after birth. These expanded recommendations have formed the basis of the National Institute of Child Health and Development (NICHD) Safe to Sleep Campaign.

Data Sources and Data Issues: Title V Program

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=safe+sleep+certified&NPM=5&State=&RBA_Category=&MCH_Pyramid=&Recipient=&Status=Active ) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/5-safe-sleep.php).

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities directed to families/children/youth

Goal: Increase the number of hospitals in MN with national Safe Sleep Hospital certification

Numerator: Number of live births that occurred at hospitals that have any level of the national Safe Sleep Hospital certification during calendar year

Denominator: Number of live births in calendar year

Significance: The National Hospital Safe Sleep Certification Program is an initiative of Crib for Kids that recognizes hospitals for demonstrating leadership around infant safe sleep practices and education and for modeling safe sleep. Safe sleep modeling occurs when hospitals develop, implement, maintain and enforce a safe sleep policy that aims to prevent sleep-related injuries and deaths, and staff in turn serve as role models for safe sleep by intentionally conveying messages and cues to parents that promote sleep safety for infants. Because parents/caregivers tend to imitate the behaviors and practices they observe in the hospital later on at home, it is important that all birthing hospitals in Minnesota seek certification through the national certification program. By participating in this initiative, Minnesota-based birthing hospitals will be required to: (1) develop, implement, and maintain a safe sleep policy based on the American Academy of Pediatrics (AAP) safe sleep recommendations, (2) provide safe sleep training for staff, and (3) offer safe sleep counseling to parents/caregivers prior to discharge. The program was developed based on a growing body of evidence to suggest that parents are more likely to follow safe sleep practices after discharge when they observe safe sleep modeling in hospitals or receive safe sleep education from hospital staff.

Data Sources and Data Issues: Data Source: Cribs for Kids Website https://cribsforkids.org/hospitalcertification/ Limitations of Data: Hospitals are certified for a period of time, if a hospital is certified and doesn’t choose to recertify the estimates could go down.

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "Health Care Provider Education" (https://www.mchevidence.org/tools/strategies/5-3.php). Find other NPM 5 hospital/provider-level strategies in MCHbest.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities related to systems-building

Goal: Increase the number of birthing hospitals that are trained using the evidence-based curriculum for safe sleep education from 95% in 2020 to 100% by 2024.

Numerator: Number of birthing hospitals in the state that have been trained using the “Say YES to Safe Sleep” curriculum

Denominator: Number of birthing hospitals in the state

Significance: Currently, 95% of births in WV occur in a birthing hospital that uses the “Say YES to Safe Sleep” curriculum to provide safe sleep education to new families. By increasing the number of birthing hospitals who are trained to use the curriculum, a greater percentage of the birth population will be reached with Safe Sleep education.

Data Sources and Data Issues: The number of birthing hospitals in the State is determined by state licensing. The number of hospitals that have been trained is collected from “Our Babies: Safe and Sound” project.

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM is based on state data and measures access to/receipt of care, thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: Increase by 5 percent annually, the percentage of WIC prenatal participants placing their infants to sleep on their backs by providing safe infant sleep education

Numerator: Number of WIC prenatal participants placing their infants to sleep on their backs

Denominator: Number of WIC prenatal participants

Significance: Increasing safe sleep education to WIC participants before the birth of the infant helps to raise awareness of safe sleep recommendations and practices thereby increasing the likelihood of the infants being placed on their backs and in safe sleep environments for sleep after delivery.

Data Sources and Data Issues: WIC program data or other applicable data sources

Year: 2020

Unit Type: Percentage, Unit Number: 100