States Use Home Visiting Programs to Spread Safe Sleep Messages

Posted November 18, 2015 by Cindy Hutter

Asian Baby Sleeping on BackThe growing demand for maternal and child health services and support, coupled with stagnant or shrinking resources, is causing state health departments to find creative ways to do more with less. Many states are leveraging home visiting programs as a convenient way to spread important information and strategies related to safe sleep practices, a key component of infant mortality reduction efforts.

The Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) is a HRSA-funded initiative that provides home visiting services for at-risk pregnant women and parents with young children. The goal is to enhance the lives of these children and families by preventing child abuse and neglect, supporting positive parenting, improving maternal and child health, and promoting child development and school readiness. All states participate in MIECHV. Likewise, almost all states are participating in the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN) initiative led by NICHQ, which has synergistic goals: to reduce infant mortality and improve birth outcomes.

“With overlapping priorities and goals, there is a natural collaboration between home visiting programs and IM CoIIN,” says NICHQ’s IM CoIIN Project Director Elaine Fitzgerald, DrPH, MIA. “Home visitors are a fantastic, already established resource for bringing safe sleep messaging into the home. It’s a win for MIECHV, a win for IM CoIIN, and a win for families.”

In Arizona, 64 different organizations around the state provide home visiting services. Using MIECHV funds, the Arizona Department of Health Services formed a task force (comprised of members representing agencies in the state that take care of children) to coordinate home visiting efforts and standardize education for home visitors. The task forced led the design of a robust home visitor professional development website, which provides consistent messaging about safe sleep and other infant health related topics like breastfeeding and tobacco cessation.

“We put a great deal of money into professional development so there would be capacity in the state for all home visitors,” explains the Arizona Department of Health Services Women’s and Children’s Health Bureau Chief Mary Ellen Cunningham, MPA, RN.

In addition to adding safe sleep information to annual skills training on the professional development website, Arizona’s Safe Sleep Task Force, as part of IM CoIIN, is also conducting a small test of change on using safe sleep bassinet cards as visual reminders for nursery staff and parents in the hospital. Arizona’s IM CoIIN plans also include:
  • Providing safe sleep training for nursing and medical schools in the state
  • Engaging community members, tribal members, grandparents and other caregivers to spread education
  • Ensuring the state Bureau of Child Care Licensing is on board with safe sleep standards
The efforts are working. In Arizona, the state’s Licensing Department now requires surveyors conducting a license survey at an early education center to look for children sleeping on their back. The Women, Infant, and Children (WIC) unit is spreading safe sleep messages in its centers. The Injury Prevention Division is also educating first responders to look around a house for a safe sleep environment when responding to a call.

“The culture of maternal child health work in our state is to reach out to others and work with them to spread accurate public health messages and build networks,” says Cunningham. “That’s how you get the outcomes you want—health and wellness for Arizona’s women and children.”

IM CoIIN teams in Arkansas, the District of Columbia, Illinois, Michigan, Oklahoma and Virginia are also integrating their IM CoIIN safe sleep strategy with their home visiting programs. They are using assessment tools to screen for unsafe sleeping environments and are providing standardized messages, education and training for home visitors on current guidelines for infant safe sleep, including promoting breastfeeding in a safe sleep environment.

“The value of collaboration can’t be underscored enough,” says Fitzgerald. “When we work together and align our resources around shared goals we can have a greater impact on infant health.”

Interested in learning more about how IM CoIIN teams are implementing safe sleep messages in their state? Join the conversation in our online community. To register, email

Learn more about NICHQ's infant health work.
Learn more about the IM CoIIN initiative.


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