Skip Navigation

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

MCH Best Logo

infant in a crib looking up at the cameraChild Care Provider Education

MCH Strategy. Enforce laws regarding mandatory training for child care providers on infant safe sleep practices.

Return to main MCH Best page >>

Overview. There is insufficient evidence to definitively state that educating child care providers in isolation from other interventions is effective to increasing the percent of infants placed on their backs for sleep; however, initial results suggest that this method may be effective when paired with other strategies.1

Evidence. Emerging Evidence. Interventions targeting child care providers appear to be somewhat effective. This strategy has been tested more than once and results trend positive overall. More research is needed for conclusive results. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Child Care Provider.

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 is currently 1 ESMs across all states/jurisdictions that usse this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use this ESM to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the strategy “Enforce laws regarding mandatory training for child care providers on infant safe sleep practices,” 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 audited child care providers in compliance with regulation.

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

  • Percent of audited child care providers in compliance with regulation.

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

  • Number of audited child care providers in compliance with regulation who's employees feel confident in their ability to apply safe sleep practices.

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

  • Percent of audited child care providers in compliance with regulation who's employees feel confident in their ability to apply safe sleep practices.

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 Moon, R. Y., Calabrese, T., & Aird, L. (2008). Reducing the risk of sudden infant death syndrome in child care and changing provider practices: lessons learned from a demonstration project. Pediatrics, 122(4), 788-798..

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.