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
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.
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
INFANT SLEEP-RELATED DEATHS
Sleep-related Infant Death Rates have remained relatively
stable in the U.S during the past decade.
Rate per 100,000
SUID RATES PER 100,000, OHIO AND U.S. 1999-2010*
180
160
140
120
100
80
60
40
20
0
Ohio
US
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Year
*Source: CDC WONDER
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
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
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.
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
CAMPAIGN DEVELOPMENT- DATA REVIEW
Safe Sleep Behaviors Among Ohio Mother - PRAMS
Least likely 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
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
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
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.
CAMPAIGN CONCEPT DEVELOPMENT
Existing Campaigns:
 Scare tactic approaches
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
CAMPAIGN DEVELOPMENT – FOCUS GROUPS
Demographic Breakdown
Female, Caucasian, pregnant or parent of infant, less than 25 years of
age, 12 or less than 12 years of education (2 Focus Groups)
Female, Non-Hispanic Black, 12 or less than 12 years education,
Medicaid Recipient, unmarried.
Location
Athens or
Marietta
Cincinnati
Cleveland
Columbus
Male, primarily Non-Hispanic Black, urban residents, caregiver of
infant.
Caucasian, college-educated, pregnant or parent of infant, primarily,
married or unmarried, less than 45 years of age.
Female, primarily Non-Hispanic Black, other caregivers of young
infants (i.e. grandparent, aunt, etc.).
Female, pregnant or parent of infant, Hispanic, 12 or less than 12 years
education. (Spanish speaking)
Cleveland
Cincinnati
Cincinnati
Columbus
Cleveland
Columbus
Cincinnati
MARKETING CAMPAIGN DEVELOPMENT – CONCEPTS
MARKETING CAMPAIGN DEVELOPMENT – CONCEPTS
MARKETING CAMPAIGN DEVELOPMENT – CONCEPTS
MARKETING CAMPAIGN DEVELOPMENT – CONCEPTS
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.
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
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
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
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
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
THIS SIDE UP…
FIGHTING BARRIERS…
Barrier: Choking
• Breathe Easy
• Babies who sleep on their backs
are less likely to choke than those
who sleep on their stomachs!
FIGHTING BARRIERS…
Barrier:
Warmth/Comfort/Bonding/Bumpers
• Safe and Sound
• This crib may look empty, but I’m
warm and safe here.
THE BABIES …
THE BABIES …
http://www.healthy.ohio.gov/vipp/drug/ProjectDAWN.aspx
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
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
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
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
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.
CONTACT
INFORMATION
Christy Beeghly, MPH
Christy.beeghly@odh.ohio.gov
614/728-4116
www.SafeSleep.Ohio.gov