A Systematic Approach to Translating Evidence into Practice to Reduce Infant Mortality
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FROM THE FIELD
A Systematic Approach to Translating Evidence into Practice to Reduce Infant Mortality Erika T. A. Leslie1 · Melinda B. Buntin1
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Purpose To provide recommendations for improving rates of infant mortality in a U.S. southeastern city using a collective impact approach. Description A convening organization and its academic partner devised a systematic process involving national experts and local stakeholders. Assessment A panel of infant mortality experts reached consensus on eight recommendations and three key overarching principles. Local stakeholder groups advanced four recommendations, of which three aligned closely with expert panel recommendations: (1) increasing access to, and use of 17-alpha hydroxyprogesterone caproate (17P); (2) reshaping housing policy using a health lens, and (3) supporting pre-conception health, intra-conception health and family planning. Conclusion The dynamic process of recommendation development occurred within a larger collective impact framework and can be used to shape a community-based approach to infant mortality. Other communities interested in improving rates of infant mortality or tackling other challenging public health issues could engage in a similar process. Keywords Infant mortality · Public–private sector partnerships · Population health
Significance
Introduction/Purpose
Finding solutions for tackling difficult public health issues requires novel approaches. A significant body of literature argues for conducting, broad based, multi-sector strategies targeted towards shaping policy, involving community, utilizing media and improving health care delivery. Relatively less information is available on how to design and implement such processes and further, the outcome of such methods. This paper seeks to describe one such process and answers the question of what strategies pose the most potential for improving a specific community’s rates of infant mortality.
Improving the health and well-being of families and, by extension, the health of infants is a long standing public health objective. Infant mortality, the death of a live-born baby before his or her first birthday, is a key indicator of population health which researchers often use as a proxy for the quality of health care, public health practices, access to medical care, and structural factors affecting the health of entire populations. In 2016, the U.S. national infant mortality rate declined to 5.9, below the Healthy People 2020 goal of 6.0 deaths per 1000 live births (Kochanek et al. 2017). Though encouraging, the national infant mortality rate masks considerable variation. Specifically, African American families disproportionately bear the burden of infant mortality with rates two or more times higher than rates among white families (Loggins and Andrade 2014; Mathews et al. 2015; Riddell et al. 2017). Historical improvements in rates of infant mortality can be attributed to improvements in immediate environmental cond
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