If it’s easy to breathe, it’s safe to sleep: the role and impact of the Queensland Pēpi-Pod® Program in reducing infant mortality (#40)
Introduction and Aim: The Queensland Pēpi-Pod® Program was initiated as a staged intervention in partnership with Australian First Nations communities, and Change for our Children, New Zealand in 2012-2018 to determine cultural, community and individual acceptability, safety and feasibility (Young et al., 2018, 2019, 2020). This program comprised three integral components; sleep space, safe care, and family as safe sleep influencers, to address the vulnerability of infants in unsafe sleep environments that increase suffocation risk. The underlying gist message ‘If it’s safe to breathe, it’s safe to sleep’ underpinned health promotion messaging. While some communities continued to engage in the program post-research, the initial study was not designed to measure mortality benefit. The aim of this study was to determine if an infant mortality reduction was temporally associated with Pēpi-Pod® Program implementation.
Methods: Using research participant data (n=617) and linked Queensland population data, research sites were stratified into three subgroups based on participation rate within each geographic location and participant Indigeneity as a proportion of the location’s Indigenous population. Infant Mortality Rate (IMR) was the primary outcome, defined as all-cause post-neonatal infant mortality between one and six months of age. Comparisons within and between research location subgroups, and whole of Queensland Study IMR before and after the research intervention were undertaken.
Results: Study IMR fell in two of the three research location subgroups post Pēpi-Pod® Program intervention. The greatest fall occurred in the subgroup with the highest rate of participation and participant Indigeneity (Rate Ratio 0.25, {95% CI 0.06,1.08}, P=0.08). Whole of Queensland Study IMR decreased significantly after the intervention (RR 0.78 {95%CI 0.65,0.92}, P=0.004).
Conclusion: The Pēpi-Pod® Program was hypothesised to be responsible for this reduction in Study IMR (McEniery et al., 2022). This Program presents a practical and tangible strategy to reduce infant mortality experienced by priority populations.
- Young J, Craigie L, Cowan S, Kearney L, Watson K. (2018) Reducing risk for Aboriginal and Torres Strait Islander babies: trial of a safe sleep enabler to reduce the risk of sudden unexpected deaths in infancy in high risk environments (The Queensland Pepi-Pod Program). Final Research Project Report. University of the Sunshine Coast, Sippy Downs, Queensland. DOI: http://dx.doi.org/10.25907/5c6b462922760
- Young J, Watson K, Craigie L, Neville J, Hunt J. (2019) Best practice principles for research with Aboriginal and Torres Strait Islander communities in action: Case study of a safe infant sleep strategy. Women and Birth 32(5): 460-465. doi.10.1016/j.wombi.2019.06.022.
- Young J, Cowan S, Kearney L, Watson K, Craigie L. (2020) A strategy to promote safe sleeping environments and reduce the risk of Sudden Unexpected Death in Infancy in Aboriginal and Torres Strait Islander communities. (ID: 99489008702621) Final Implementation Project Report for the Department of Child Safety, Youth and Women, Queensland Government, 2018. Available at https://doi.org/10.25907/00011
- McEniery J, Young J, Cruice D, Archer J, Thompson JMD. (2022) Measuring effectiveness of the Pēpi-Pod® Program in reducing infant mortality in Queensland. State of Queensland (Queensland Health), May 2022. https://www.childrens.health.qld.gov.au/wp-content/uploads/Pepi-Pod-Report-QPQC.pdf
