Using Surveillance To Promote Public Health
Examples from the Pregnancy Risk Assessment Monitoring System (PRAMS)

EXECUTIVE SUMMARY PUBLICATION YEAR 2002

Infant Sleep Position

Positioning an infant for sleep has been identified as a modifiable behavior that can decrease the risk for SIDS. Consistently placing a healthy baby on its back to sleep for naps and at night has been found to reduce the risk.²¹ SIDS is a diagnosis for the sudden death of an infant less than 1 year of age that remains unexplained after a complete investigation, which includes an autopsy; examination of the death scene; and a review of the baby’s and/or family’s medical history, including an assessment of symptoms or illness prior to the infant’s death.²²

Georgia

The Georgia Department of Human Resources Sudden Infant Death Syndrome and Other Infant Death (SIDS and OID) Work Group regularly uses PRAMS data. The working group has received $100,000 in state funds to coordinate and promote SIDS risk-reduction and education activities throughout Georgia using an interagency work plan in collaboration with the Georgia Public Health SIDS and OID Information and Counseling Program and the SIDS Alliance of Georgia.

The SIDS and OID Work Group provided 1997 PRAMS data on sleep position to the Georgia Maternal and Infant Health Council (GMIHC). GMIHC used these data, along with information from other sources, to initiate the adoption of a revised position statement on supine sleep position. This position statement fully supports “back sleeping” as the safest sleep position for healthy, full-term infants. It was distributed to all birthing and pediatric hospitals in the state and is available on the Georgia Public Health Web site.

Programmatic changes have also resulted from SIDS and OID Work Group’s use of PRAMS data:

• Training programs about sleep safety and SIDS have been developed that incorporate information from PRAMS. The curricula for these programs have been tailored to meet the needs of various groups, including public health nurses, child-care providers, pre-hospital personnel, and child fatality review teams.
   
• PRAMS data demonstrating racial differences in the prevalence of positioning infants on their backs to sleep have provided the basis for the current SIDS risk-reduction outreach initiative to the African American community. Activities have included a public forum to address the issue and to develop strategies to lower risk in the African American population, a statewide billboard campaign, and a bus card initiative on Atlanta-area transit authority buses.

North Carolina

The North Carolina Back to Sleep (BTS) Campaign for SIDS Risk Reduction is a statewide education and awareness campaign aimed at increasing the public’s understanding about SIDS and ways to reduce the risks for SIDS. The North Carolina BTS Campaign has used PRAMS data to provide a measure of the statewide prevalence of placing infants to sleep on their backs and to identify characteristics of families and babies at increased risk for SIDS. This information has assisted in the targeting of media messages. PRAMS data are also being used to track trends in infant sleep position over time in the state.

The North Carolina BTS Campaign was awarded $40,000 in fiscal year 1999–2000 to use a multifaceted approach to increase awareness of infant sleep position and to lower SIDS risks. The campaign focused on women and their families as well as on the health care community. In 2000, more than 800 health professionals and lay health advisors participated in training or presentations that included

PRAMS data; participants included SIDS counselors, perinatal educators, health educators, parenting educators, and members of the SIDS Alliance of the Carolinas. The campaign also targeted licensed child care providers and dispensed educational messages to over 9,000 caregivers. More than 300,000 posters, information sheets, light-switch covers, and foto-novellas (comic book-like publications with photographs as illustrations) were distributed, along with news releases in newspapers and on radio and television. The SIDS Community Education Outreach and Training Demonstration Project used PRAMS data in a grant application to demonstrate level of need and to identify specific populations at increased risk for SIDS. The project received $16,130 for fiscal year 2000–2001 from the CJ (Carly Jenna) Foundation for SIDS to maximize the educational outreach of the existing network of SIDS counselors, to strengthen the effectiveness of the North Carolina BTS Campaign, and to focus on populations most at risk for SIDS such as African Americans and Native Americans. One of the components of the education outreach strategy of the BTS Campaign was to enhance local SIDS awareness and risk-reduction community education programs that are managed by SIDS counselors at county health departments throughout the state. The project entailed developing training materials, media packets, and community contact forms for use in SIDS community outreach training. Materials and a toolkit to assist SIDS counselors in educational outreach and audience targeting were developed.

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Page last reviewed: 3/24/06
Page last modified: 3/24/06

Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion