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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 cameraHealth Care Provider Education

MCH Strategy. Provide staff of birthing hospitals with training on infant safe sleep.

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Overview. After educational interventions (health care provider education) were conducted to change practice in well-newborn nurseries, parents have reported an increase in placing their infants in the supine position for sleep.1

Evidence. Emerging Evidence. Interventions targeting health care providers appear to be somewhat effective, specifically when combined with other interventions. 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 for training providers through the MCH Digital Library . Access the peer-reviewed evidence for provider educational materials through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Health 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 are currently 7 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 “Provide staff of birthing hospitals with training on infant safe sleep,” 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 birthing hospital staff trained on infant safe sleep.

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

  • Percent of birthing hospital staff trained on infant safe sleep.

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

  • Number of birthing hospital staff trained on infant safe sleep who report an increase in knowledge and skill.

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

  • Percent of birthing hospital staff trained on infant safe sleep who report an increase in knowledge and skill.

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 Gelfer, P., Cameron, R., Masters, K., & Kennedy, K. A. (2013). Integrating “Back to Sleep” recommendations into neonatal ICU practice. Pediatrics131(4), e1264-e1270.

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.