1. Indianapolis Healthy Start CityMatCH PPOR Seminar October 10, 2006 Speakers: Yvonne Beasley, MN, RN Director, Maternal and Child Health Marion County Health Department Indianapolis Healthy Start Program Director Teri Conard, MS, RN FIMR Coordinator Marion County Fetal Infant Mortality Review Barbara Himes, CLC Infant Health and Survival Coordinator Indiana Perinatal Network Lola D. King, MS, RD, CD Special Projects Coordinator Indianapolis Healthy Babies Consortium Shelley Vaughn, MS Indianapolis Healthy Start Project Manager

2. Agenda Yvonne Beasley, MN, RN PPOR Data Review and Efforts Panel Introductions Shelley Vaughn, MS Indianapolis Healthy Start Response Lola K. King, MS, RD, CD Indianapolis Healthy Babies Consortium Response Teri Conard, MS, RN Fetal Infant Mortality Review Response Barbara Himes, CLC Safe Sleep: Getting Out the Right Message Conference Safe Sleep Survey Results

3. PPOR Team Members  Originally started with only three members; currently 13 members:  Marion County Health Department – 7 members  Population Health Bureau Director, Maternal & Child Health Director, Healthy Start, FIMR, and Epidemiology  Indiana State Department of Health – 2 members  MCH Nurse Consultant, Epidemiology  Indiana Perinatal Network – 2 members  Indiana Access, SIDS & Infant Health and Survival  Wishard Health Services – 1 member  Indiana University Child Protection Team  Child Fatality Review Team  Healthy Families – 1 member

4. PPOR Findings and Efforts  Infant health was the second highest PPOR category  Causes of death  #1 - Other accidental suffocation and strangulation  #2 – Other external causes  #3 – Accidental suffocation and strangulation in bed  Focused efforts as a result of PPOR  Data collection of safe sleep policies  Consumer and provider knowledge  Consumer insight on personal infant loss experience  Increasing awareness of AAP guidelines

5. Indianapolis Healthy Start Response  Community Participants  Media campaign – radio, billboard, bus cards, posters, brochures, newspaper, Safe Sleep conference press release  Canvassing  Health fairs  Faith community – SIDS Sundays  Daycare training  Barber/Beauty shops  Seniors  Health education classes/OB registration  Program Participants  Safe sleep education – “Back to Sleep” Onesies  Safe sleep environment assessment  Indiana Women’s Prison  Baby First Advocate Presentation/Education Annual Events  Block Party  Grandmother Tea  Baby Shower

6. Indianapolis Healthy Babies Consortium Response  Consortium Meeting  July 28, 2006  Approximately 67 MCH care providers in attendance  Parent Panel  Their tragic stories  3 month old infant death in daycare setting  28 day old infant death in bed sharing setting  Key messages  First responders  Consistent safe sleep messages  Assistance maneuvering the system after an infant death  Provider survey responses

7. Preliminary FIMR findings from Unsafe Sleep Related Cases  In 2005: Positional Asphyxia Cases-6, SIDS 4, Related: 2 – Abstracted-2 Reviewed 2  In 2006: Positional Asphyxia Cases 1, SIDS 4 Sleep Position/Place : Placed on side & found face down on mattress, couch, on the bed not breathing without pulse, Prone, Placed on stomach, turned head to side & propped bottle, adult mattress & bed sharing

8. Preliminary FIMR findings from Unsafe Sleep Related Cases Documentation of Safe Sleep Education :  No education documented  Cases where health literature discounted safe sleep education  Cast care book given to mother was misinterpreted Environmental:  Second hand smoke

9. Preliminary FIMR findings from Unsafe Sleep Related Cases: Community services  Bereavement services for residential deaths are not as available  Coroner’s Office: Reported by parents to be helpful at scene  Problem identified with length of time to obtain autopsy results (four to eleven months)

10. Safe Sleep: Getting Out the Right Message Conference  Interpret national, state and local data on leading causes of infant death and the contributing factors.  Understand current American Academy of Pediatrics (AAP) risk reduction recommendations and guidelines.  Gain insights on what parents want and need to know about safe-sleep recommendations and guidelines.  Understand Centers for Disease Control & Prevention (CDC) death scene protocols.

11. Safe Sleep Surveys  Baby First Advocates  Completed and analyzed 140 surveys  WIC Clinics and Vital Records  250 completed

12. Contact Information Yvonne Beasley, MN, RNBarbara Himes, CLCShelley Vaughn, MS Director, Maternal and Child HealthInfant Health and Survival CoordinatorMarion County Health Department Marion County Health DepartmentIndiana Perinatal NetworkProject Manager Project Director, Indianapolis Healthy Start1991 E. 56 th Street (effective 12/18/06)Indianapolis Healthy Start 3838 N. Rural StreetIndianapolis, IN 46220Indianapolis, IN 46205 Indianapolis, IN 46205(317) 725-3754(317) 221-2126 (317) 221-2312sidsbhimes@aol.comsvaughn@hhcorp.org ybeasley@hhcorp.org Teri Conard, MS, RNLola D. King, MS, RD, CD Marion County Health DepartmentSpecial Projects Coordinator FIRM CoordinatorMarion County Health Department 3838 N. Rural StreetIndianapolis Healthy Babies Consortium Indianapolis, IN 462053838 N. Rural Street (317) 221-3103Indianapolis, IN 46205 tconard@hhcorp.orglking@hhcorp.org P. Joseph Gibson, MPH Ph.D. Julie K. Sautter, MSW Director, EpidemiologyPPOR Team Coordinator Health & Hospital Corporation of Marion CountyMarion County Health Department 3838 N. Rural StreetData Manager, Indianapolis Healthy Start Indianapolis, IN 462053838 N. Rural Street (317) 221-3142Indianapolis, IN 46205 jgibson@hhcorp.orgjsautter@hhcorp.org