Practice Title: Creation and Expansion of a Community Portable Crib Program
Department: Austin Public Health
Size: Large (Population of 500,000+ people)
State: Texas
Summary of Practice:
Austin Public Health is an accredited public health department with jurisdiction over all of Travis County, Texas, which includes the City of Austin, with a total population of 1.2 million. Travis County is one of the fastest growing areas in the country, and the City of Austin is ranked as the 11th most populated city in the United States. Travis County is ethnically and linguistically diverse. In 2019, 49.1 percent of Travis County residents were non-Hispanic White, 33.9 percent were Hispanic/Latinx, 8.3 percent were Black/African American, and 7.9 percent were Asian. In Travis County, 31.4 percent of residents speak a language other than English at home. (US Census, American Community Survey, 2018 5 Year Data Profile).
Accidental suffocation or strangulation in bed (ASSB) is the leading cause of injury death for infants under 12 months of age in Travis County and the City of Austin.
APH convened the Austin Travis County Safe Sleep Coalition to identify strategies to reduce ASSB deaths. The coalition included partners from hospitals, Federally Qualified Health Centers, fire and police departments, The Travis County Medical Examiner’s office, medical emergency services, the State Department of Family Services, Center for Child Protection, and the Maternal Infant Outreach Program. Four committees were created: Clinical Policy, Practice and Education Committee; Resource Committee; Branding and Messaging Committee; and the Community Education Committee.
Through the Resource Committee, the Coalition developed a program to provide a safe sleep environment to families who did not have a safe place for their infant to sleep and who could not afford one. Since the program’s inception in October of 2019, APH has provided a total of 921 cribettes for 917 babies in 904 families through October 31, 2022. In addition, APH has supplied families receiving cribs in a hospital setting (newborns) a sleep sack to discourage the use of blankets.
Processes were developed to implement the crib program in a multitude of locations. Initially, cribs were provided to area hospitals and Federally Qualified Health Centers (FQHC) and has been expanded over the course of three years.
The crib program was successful in meeting the objectives that had been established for the group. All of the following objectives were met:
· To provide a safe sleep environment for those who cannot afford one and to gather data about those families to get a better sense of community needs.
· To have families use the portable crib instead of co-sleeping.
· To evaluate whether the cribs help families practice safe sleep.
APH was able to provide funding for the first year of the program and in the second year of the program, we received supplemental funding from the United Way. Fortunately, funding for the crib program has been identified in APH Chronic Disease and Injury Prevention operational budget for ongoing sustainability.
The public health impact of this practice is quite impressive. Of the crib recipients who commented on where their baby would or currently is sleeping, 278 recipients said baby would have slept in unsafe environment if not for the crib distribution. This included co-sleeping, with mom, in an adult bed, in a car seat, among other unsafe sleep environments. By providing a safe place for their infant to sleep, we have eliminated one barrier that may have resulted in families bed sharing or placing their infant in an unsafe sleep environment.
Twenty-one percent (22%) of cribs were given out in zip codes that had been identified as possibly high-risk for accidental suffocation deaths (78753 and 78723). We also identified 14 zip codes that received more portable cribs than the other 38 zip codes, which will help with outreach, education, and community support.
Because the Austin-Travis County community has a large percentage of Spanish speaking families, the Coalition made sure to create all materials in both Spanish and English. The crib video was provided by Cribs for Kids in English, and we had it translated to include Spanish subtitles. Sixty-four percent (63%) of crib recipients were Spanish speaking and six percent (6%) spoke something other than Spanish or English. In 2022, as two refugee service providers came on board with the program, we recognized the need for education in the Pashto language. APH worked with the Department of State Health Services and one of the refugee organizations to recreate the video with a voiceover in Pashto.
The crib program was intended for those who could not afford a crib and was promoted through partners that help families without health insurance or government assistance programs. The program was successful in reaching individuals in highest need of cribs. Ninety-five percent (92%) of families given a crib were also receiving some form of government assistance. Cribs were also provided to individuals experiencing homelessness and individuals residing in shelters for domestic violence.
The crib program began in 2019 and has continued and grown through the pandemic. This program has been identified as a sustainable change that will impact hundreds of infants each year. APH continues to facilitate the safe sleep coalition and the crib program continually looking at ways to improve safe sleep.
Program website: http://www.austintexas.gov/page/safe-sleep
Creation and Expansion of a Community Portable Crib Program
Category
Injury and Violence Prevention
Description