Ohio department of Health – Infant safe sleep Campaign

1. Ohio department of Health – Infant safe sleep Campaign Ohio Chapter, American Academy of Pediatrics Roundtable Friday, April 4 Christy Beeghly, MPH, ODH Violence and Injury Prevention Program Administrator

2. Ohio Injury Prevention Partnership (OIPP) • The Ohio Injury Prevention Partnership (OIPP) is a statewide group of professionals representing a broad range of agencies and organizations concerned with the prevention of injury. • Priorities for the OIPP include Prescription Drug Misuse, Falls Among Older Adults, and Child Injury.

3. Child Injury Action Group (CIAG) • The Child Injury Action Group was formed as an action group of the OIPP and developed its strategic plan • Child Injury Action Group Strategic Priorities: • Teen Driving • Child Passenger Safety Law Review/Revision • Sports-related Traumatic Brain Injury • Bicycle and Wheeled Sports Helmets • Infant Sleep-related Suffocation

4. Infant Sleep-related Deaths SUID rates per 100,000, OHio and U.S. 1999-2010* Sleep-related Infant Death Rates have remained relatively stable in the U.S during the past decade. *Source: CDC WONDER

5. CIAG Infant Safe Sleep Subcommittee • The CIAG Goal: Reduce unintentional sleep-related deaths for infants aged <1 year from 38.0 per 100,000 by 10% by 2016. • The CIAG Infant Safe Sleep Subcommittee was formed and created action plans for the following objectives: • Promote and support parent education policies in birthing hospitals and licensed child care centers • Partner with baby product retailer to promote safe sleep to customers • Ensure that prenatal care providers and pediatric health care providers are promoting and distributing current safe sleep messages • Collaborate with other organizations to conduct a statewide safe sleep campaign • Enact a policy requiring all identified state agencies with a role in parent education, early intervention, or child care to follow and promote current safe sleep recommendations

6. Partnerships • CIAG ISS Committee Members • Safe sleep experts from across Ohio including LHDs, birthing and children’s hospitals, parent advocates, etc. • Internal ODH Partners • VIP Program • MCH Programs • Office of Public Affairs • Ohio Collaborative to Prevent Infant Mortality • SID Network of Ohio • Ohio Chapter, American Academy of Pediatrics • Cribs for Kids • Ohio Hospital Association • Ohio Children’s Trust Fund

7. Marketing Campaign Development Process Began in early 2012 with regular planning and working meetings with CIAG ISS subcommittee members. • Review of data to determine most at risk populations • Development of marketing concepts • Focus group testing of marketing concepts with priority populations.

8. Campaign Development- Data Review • Overall sleep-related death rates have remained relatively stable but have not declined. • Ohio rates are higher than the U.S. • Black infants are at disparately high risk for suffocation. • Most suffocation deaths occur within the first 3 months. • More than 2 out of 3 infant suffocations are sleep-related (68%); while 28% are other/unspecified. • Urban areas, small towns and south eastern Ohio have higher SUID rates. Source: ODH, Office of Vital Statistics

9. Campaign Development- Data Review Safe Sleep Behaviors Among Ohio Mother - PRAMS Leastlikely to place their infants on their backs to sleep:* • Single • Less than 20 years old • Non-Hispanic black • Less than 12 years of education • Receiving Medicaid *Source: 2006-08 Ohio Pregnancy Risk Assessment Monitoring System, Center for Public Health Statistics and Informatics, ODH 2010

10. Campaign Development- Data Review 2007- 2011 Child Fatality Review Findings • Leading cause of infant mortality after prematurity • 819 sleep-related infant deaths • 56% were boys • 38% were African American • 88% were to infants younger than 6 months, again pointing to those first months as being the most important

11. Campaign Development- Data Review 2007-2011 Child Fatality Review Sleep Environments • Only 23% (192) occurred in a crib or bassinette • 60% (494) occurred in unsafe places: adult beds, sofas, chairs • 58% (473) were sharing a sleep surface with another person ABCs of Safe Sleep Indicators • Of 819 sleep-related deaths, only 51 (6%) of reviews indicated the baby was placed Alone, On the Back, In a Crib or Bassinet

12. Campaign Concept Development CIAG Committee members reviewed existing campaigns from national, state and local levels Existing Campaigns: • National Back to Sleep change to Safe to Sleep released during process • ABCs approach – Alone. Back. Crib.

13. Campaign Concept Development Existing Campaigns: • Scare tactic approaches

14. Campaign Development – Focus Groups Purpose: Assess ISS knowledge, attitudes and beliefs: • Knowledge about infant sleep related suffocations. • Knowledge of the data • Attitudes of their own risk • Knowledge about safe sleep practices. • Where learned safe sleep practices and belief of sources. • Personal sleeping practices for infant(s). • Barriers to compliance (if not in compliance with ABC’s of safe sleep). • Assess reaction to the draft marketing concepts

15. Campaign Development – Focus Groups

16. Marketing Campaign Development – Concepts

17. Marketing Campaign Development – Concepts

18. Marketing Campaign Development – Concepts

19. Marketing Campaign Development – Concepts

20. Campaign – Focus Group Key Findings • Knowledge of ISS: • Most had heard most or all ISS recommendations at some point but not as the “ABC’s of safe sleep”. • Less than 30% of participants reported putting their infants to sleep per all the ABCs.

21. Campaign – Focus Group Key Findings • Barriers to ABCs: • Choking Concerns - Skeptical of back sleeping being safest • Warmth/Comfort - Bare Crib is “sterile” – needed a full-body sleep sack as bare arms/legs made baby appear cold • Safety/Bonding – Babies are safest with mom and bumper pads are important b/c they “protect baby” • Don’t tell me what to do! • Parents want the why of ABCs

22. Campaign – Focus Group Key Findings • Current Practice of Parents • Experience Counts • First-hand experience • “Bed Sharing Can be Done Safely” • “Baby is Safer with Me” • Trust Pediatrician vs. Mother’s instinct • Grandparents don’t bed share • No difference in perception safe sleep beliefs across SES, gender, race or generational divide

23. Campaign – Focus Group Key Findings • Feedback on Ad Concepts • Statistics Speak! “3 babies per week….” • Model Safe Environments – Show me a warm looking baby in a safe crib • Ohio Department of Health logo

24. Fighting barriers… • Main Image • Builds on onesie that started so many conversations • Focus groups liked the simple message which interested them in the rest of the ad

25. Fighting barriers… • Barrier: Bed Sharing • I My Crib • 2 out of 3 babies who died while sleeping were sharing an adult bed, couch or chair – I have to sleep alone in my crib

26. This Side Up…

27. Fighting barriers… • Barrier: Choking • Breathe Easy • Babies who sleep on their backs are less likely to choke than those who sleep on their stomachs!

28. Fighting barriers… • Barrier: Warmth/Comfort/Bonding/Bumpers • Safe and Sound • This crib may look empty, but I’m warm and safe here.

29. The babies …

30. The babies …

31. http://www.healthy.ohio.gov/vipp/drug/ProjectDAWN.aspx

32. Marketing Campaign Launch • Goal: Educate the target population (mothers 16-45, fathers and grandparents in high-rate infant mortality areas of Ohio i.e. Cleveland, Columbus, Cincinnati, Dayton, Youngstown, Akron, Toledo and SE Ohio) Mediums – • Television Ads • Interior Transit Ads • Bus wraps • Movie Theaters Ads • Web banner ads • Billboards • Radio Ads

33. Timing and Marketing Strategy • Now! Through June 30, 2015 • Cable PSA’s began airing 4/1 • ODH planning a press release 4/8-4/15 to officially launch the campaign. • Saturation through multi-media layering; multiple flights

34. Marketing Campaign Launch Supporting Projects • Development of website for parents/caregivers www.safesleep.ohio.gov (still under development) • Printing/Distribution of brochures, posters, etc. • Expansion/Support of Cribs for Kids in Ohio • Customized Survival Kits (~>3,800 over 2 years) with Ohio marketing materials, Charlie’s Kids books, sleep sacks, fitted crib sheets, pack n plays • CFK sites supported in 9 OEI cities

35. Partner Projects • Ohio AAP Hospitalist & Primary Care QI Projects • Ohio Hospital Association Kits • ODH Safe Sleep Policy and video training • Senator Jones’ SIDS Awareness bill

36. Future ciag projects • Safe Sleep Awards for health care providers, retailers, state agency, etc. • Development of model policies for hospitals and other needed materials based on outcome of SB 276 • Development of toolkits for reaching out to pediatricians, OB/GYNs, birthing educators, etc.

37. Contact Information Christy Beeghly, MPH Christy.beeghly@odh.ohio.gov 614/728-4116 www.SafeSleep.Ohio.gov