MCHbest. NPM 5: Safe Sleep
Strategy. Multicomponent Strategy: Caregiver Education + Health Care Provider Education + Hospital Safe Sleep Policy
Approach. Implement a multicomponent strategy that targets caregivers, child care providers, health care providers, and hospital systems (not including quality improvement components).
Overview. Implementation of site-specific interventions including education for caregivers, child care providers, and health care providers as well as hospital-level policies seem to improve overall safe sleep practices.1
Evidence. Moderate Evidence. Multicomponent interventions implemented at the caregiver, health care provider, and hospital levels without quality improvement initiatives appear to be effective and have more impact than implementing single-strategy interventions focused on one group. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).
Target Audience. Multiple (caregiver + child care provider + health care provider + hospital systems).
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. More than 14 states have ESMs 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.
In addition, NICHQ through its MCHB funded National Action Partnership to Promote Safe Sleep (NAPPSS) activities is working at sites in five states to utilize quality improvement methods to integrate safe sleep and breastfeeding promotion within hospitals, with prenatal health care providers and with community partners.
The Role of Title V. Title V Agencies can support this approach through systems building by engaging Title V programs (e.g., Home Visitors and Healthy Start to work directly with families) and partners across systems and functions (other community based programs, AAP, healthcare provider organizations, hospitals, managed care organizations, early care organizations) to support Safe Sleep efforts.
For additional suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies.
Sample ESMs. Using the approach “Implement a multicomponent strategy that targets caregivers, child care providers, health care providers, and hospital systems,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework:
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).
1 Kuhlmann, S., Ahlers-Schmidt, C. R., Lukasiewicz, G., & Truong, T. M. (2016). Interventions to improve safe sleep among hospitalized infants at eight children’s hospitals. Hospital Pediatrics, 6(2), 88-94.