F4 - Community-based Safe Sleep and Breastfeeding Promotion: Lessons Learned from the National Action Partnership to Promote Safe Sleep Innovation and Improvement Network

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Full Description: The National Institute for Children’s Health Quality (NICHQ) leads the National Action Partnership to Promote Safe Sleep Improvement and Innovation Network (NAPPSS-IIN), a project funded by the Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration (HRSA). The purpose of NAPPSS-IIN is to make safe infant sleep and breastfeeding a national norm. NAPPSS-IIN aims to do so by increasing infant caregiver adoption of breastfeeding and safe infant sleep practices as recommended by the American Academy of Pediatrics (AAP) by empowering champions for these protective behaviors within systems serving families at risk. The ultimate goal of NAPPSS-IIN is to reduce rates of sudden unexpected infant death (SUID) rates, increase rates of breastfeeding, and decrease disparities among Black and Indigenous infants.

As part of the NAPPSS-IIN evaluation, in Spring 2021 NICHQ hosted a series of Community Listening Sessions (focus groups) with community-level partners working in safe sleep and breastfeeding promotion. The purpose of the Community Listening Sessions and the research questions were: 1) What are the areas that community-level organizations need support to serve their population’s needs around safe sleep and breastfeeding, and 2) What tools or resources could assist them in improving their work promoting safe sleep and breastfeeding? Overall, there were four sessions comprised of 18 total individuals.

A phenomenological framework was employed to describe safe sleep and breastfeeding promotion activities through the lived experiences of community-based organizations. Transcripts were coded by two analysts using inductive and deductive qualitative analysis in NVivo. The analysts coded two cases independently and met to establish reliability (pooled K>0.80). Once reliability was achieved, one analyst coded the remaining two cases. A third analyst reviewed coding applications. Disagreements were mediated with the other analysts until reliability was achieved (pooled K>0.80). Key themes were identified and discussed by the entire coding team.

Preliminary findings indicated that facilitators and barriers to community-based safe sleep and breastfeeding promotion included education provided through clinician/patient relationship building and messaging consistency and modernization. Some participants shared that guidance on messaging and education from larger organizations could help address such barriers. Media and material resources were noted as tools to support safe sleep and breastfeeding adoption, but some noted that media could benefit from more contemporary and diverse imagery. Patient limitations, overwhelm, and reliance on instinct were a commonly reported barrier to safe sleep and breastfeeding promotion; several noted that policy supports could alleviate these obstacles. Implications for the larger NAPPSS-IIN project as well as safe sleep and breastfeeding programs, policies, and education will be discussed.

Abbreviated Description: The National Action Partnership to Promote Safe Sleep Improvement and Innovation Network (NAPPSS-IIN aims to reduce rates of sudden unexpected infant death, increase rates of breastfeeding, and decrease relative disparities by promoting the American Academy of Pediatrics guidelines.

NAPPSS-IIN hosted a series of Listening Sessions in Spring 2021 to address two research questions: (1) What are the areas that community-level organizations need support to serve their population’s needs around safe sleep and breastfeeding; (2) What tools or resources could assist them in improving their work promoting safe sleep and breastfeeding? Implications for safe sleep and breastfeeding policies and education will be discussed.