12/03/13 LHJ:

Deliverable Form E – 5-Year Action Plans

(For further instructions see separate document titled “Action Plan Guidelines”)

MCAH SOW Goal 3_: Improve Infant Health
Problem Category / From Deliverable Form B of your Title V Needs Assessment
SIDS
Problem Statement(s) / From Deliverable Form B of your Title V Needs Assessment
Community partners lack of coordination with the implementation of SIDS protocols and procedures due to a low county incidence rate
Infants die of asphyxia due to bed sharing and unsafe sleep environment
Latino and White infants are experiencing unexplained deaths possibly due to bed sharing influenced by low income/poverty and unsafe sleep environments
Five Year Local Goal(s) / Common messaging for safe sleep environments and coordination and implementation of SIDS protocols across all partners
Infants sleeping in safe sleep environments
Increased knowledge of SIDS risk reduction and infant safe sleep among WIC participants
First responders will adopt and implement the protocols for CDC’s first responder response to infant death into their current practice
Reduce incidence of SIDS
Risk/Contributing Factors / Unsafe infant sleep environments, prone/side sleep positioning, lack of knowledge of SIDS risk reduction and infant safe sleep practices, first responder staff turnover, cultural norms
Best Practice Strategies/ Interventions / Coordination intervention: convening community partners and establishing SIDS prevention intervention protocols and procedures
Bed sharing/unsafe sleep environment: engage breastfeeding advocates to coordinate messaging to address the cultural component; safe sleep collaborative including birth hospitals and First 5; develop simple safe sleep intervention that goes beyond “Back to Sleep” – bedside patient information tool that is not text heavy or picture oriented; establish a “Cribs for Kids” intervention to address the need for a crib at home
Intervention Population(s) / First responders, breastfeeding advocates, birth hospitals, First 5, police/sheriff/ Coroners, WIC, parents and caregivers
Short and/or Intermediate Objective(s)
*Keep S.M.A.R.T. in mind as you develop objectives. / Inputs, including Community Partner involvement / Intervention Activities to Meet Objectives / Performance Measures
Short and/or Intermediate /
Process Description and Measure(s) including data source / Outcome Measure(s) including data source /
Fiscal Year 1
Coordinating partners
By 6/30/2016, 6/8 first responders will adopt and implement the CDC’s protocols for first responder response to infant death into their practice / ·  Police/Sheriff/ Coroner’s Departments
·  First responders / Activities to Implement the CDC’s protocol for first responders responding to an infant death
·  Identify and convene first responders and present materials
·  Develop and maintain relationships with local first responders
·  Commitment to adopt and implement CDC protocols into their practice
·  Develop and implement a quality assurance (QA) process (e.g., 3/6/9-month follow-up to discuss challenges and success of implementation)
o  Ongoing follow-up regarding updates, changes, new staff, etc.
o  Provide technical assistance (TA) as needed / ·  Number of first responders who were convened /6
·  Number of first responders received materials/6
·  Describe QA process developed
·  Describe first responders response to presentations
·  Describe TA provided / ·  Number of first responders who adopted and implemented the CDC’s protocols for first responder response to infant death/6
·  Describe results of follow-up survey of first responders
·  % of time the infant death protocol was followed upon death of an infant (goal is 100%)
·  Describe outcomes of QA
·  Describe any protocols or policies developed and implemented
Fiscal Year 2
Safe sleep environment
1.  By 6/30/2017, distribute safe sleep environment materials to all mothers involved in WIC who are pregnant or have infants
2.  By June 30, 2017, 90% of mothers participating in WIC with infants less than one year of age will express an intention of creating a safe sleep environment for their infant
3.  By 6/30/2017, 100% of CPSP providers will adopt and develop protocols to deliver consistent messaging regarding safe sleep environments / ·  WIC
·  Hospitals
·  First 5
·  Other funders
·  PCPs
·  Midwives
·  CPSP health workers and providers / ·  Use consistent, standardized messaging for infant safe sleep and SIDS risk reduction education
·  Develop/maintain relationship with local WIC and CPSP offices
·  Train WIC staff to provide effective SIDS risk reduction and infant safe sleep education to WIC participants
·  WIC staff - Develop a process to measure knowledge change and intent to implement what was learned
·  Assist WIC leadership to develop policies or protocols to ensure that all WIC participants receive SIDS risk reduction and infant safe sleep education
·  Develop a QA process to ensure that policies developed are implemented as intended and the impact
·  Distribute NICHD Safe to Sleep, CPSC materials as appropriate to providers and clients
·  Present material in a WIC-mandated class
·  WIC clients - Develop a process to measure knowledge change and intent to implement what was learned into practice
·  Distribution of information regarding safe sleep environment to partners
·  Develop/maintain relationships with CPSP providers
·  Train CPSP providers; develop a process to measure knowledge change and intent to implement what was learned into their practice
·  Assist providers to develop and implement protocols to deliver consistent safe sleep messages
·  Develop QA process to ensure that protocols are implemented as intended and the impact (example - Survey 100% of participants)
·  Provide TA as needed / ·  Number of participants in WIC-mandated classes/all WIC participants
·  Number of brochures or materials distributed to WIC clients and providers
·  Number of participants and WIC staff using online education resources
·  Number of WIC staff trained
·  Describe process to measure knowledge change and intent to implement what was learned for WIC staff and WIC clients
·  Describe QA process developed
·  Describe barriers and opportunities for success
·  Number of CPSP staff trained
·  Describe process to measure knowledge change and intent to implement what was learned into practice
·  Description of relationships developed/maintained
·  Amount of information/materials distributed
·  Describe QA process developed
·  Describe TA provided / ·  Percent of WIC participants who expressed intention to create a safe sleep environment for their infant (goal is 90%)
·  Briefly describe knowledge gained and intent to implement what was learned
·  Describe outcomes of QA process
·  Describe any policies or protocols developed and implemented at WIC
·  Percent of CPSP providers who have adopted and are delivering consistent infant safe sleep messaging (goal is 100%)
·  Describe the results of knowledge change and intent to implement what was learned
·  Describe protocols implemented
Fiscal Year 3
Safe sleep environment
By 6/30/2018, will have… / ·  Day care providers
·  Breastfeeding advocates / ·  Community awareness campaign
Fiscal Year 4
Fiscal Year 5

Local Health Jurisdictions (LHJ) Needs Assessment Timeline and Deliverables Page 3 of 3