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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 5: Safe Sleep

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infant in a crib looking up at the cameraCaregiver/Parent Education

MCH Strategy. Partner with WIC, home visiting, and other programs to provide safe sleep education and counseling to new caregivers.

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Overview. One-on-one education with parents and caregivers has the potential to affect maternal decision making for choice of infant sleep position. The moments spent instructing and demonstrating infant care to caregivers are crucial. Time allotment for patient teaching can have a positive impact on supine sleeping position if done in an iterative manner.1,2

Evidence. Emerging Evidence. Interventions targeting caregivers only appear to be somewhat effective. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library for provision of education and training materials. (Read more about understanding evidence ratings).

Target Audience. Caregiver.

Outcome. Infants placed to sleep on their backs. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. There are currently 5 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the strategy “Partner with WIC, home visiting, and other programs to provide safe sleep education and counseling to new caregivers,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of caregivers who receive counseling around safe sleep practices through their local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or home visiting program.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of caregivers who receive counseling around safe sleep practices through their local WIC or home visiting program.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of caregivers who receive counseling around safe sleep practices through their local WIC or home visiting program and report always placing their infants on their back to sleep.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of caregivers who receive counseling around safe sleep practices through their local WIC or home visiting program and report always placing their infants on their back to sleep.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


Reference:

1 Hauck, F. R., Tanabe, K. O., McMurry, T., & Moon, R. Y. (2015). Evaluation of bedtime basics for babies: a national crib distribution program to reduce the risk of sleep-related sudden infant deaths. Journal of community health40(3), 457-463.

2 Moon, R. Y., Hauck, F. R., Colson, E. R., Kellams, A. L., Geller, N. L., Heeren, T., & Corwin, M. J. (2017). The effect of nursing quality improvement and mobile health interventions on infant sleep practices: a randomized clinical trial. Jama318(4), 351-359.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.