Year of Publication



Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Corrine Williams

Committee Member

Dr. Jerod Stapleton

Committee Member

Dr. Marc Kiviniemi


The city of St. Louis in Missouri has an elevated infant mortality rate compared to St. Louis County, Missouri, and the United States. When controlling for race, black or African American infants are over twice as likely to die before their first birthday compared to their white counterparts. Two of the leading causes of infant death are sleep-related causes and sudden infant death syndrome (SIDS) which occur if the infant is placed in an unsafe sleeping environment. To address this burden Affinia Healthcare, Barnes Jewish Hospital, and St. Mary’s Hospital have decided to implement a hospital-based Safe to Sleep campaign. Safe to Sleep is an evidence-based program that was originally implemented statewide in Georgia and is based on the ABC’s of safe sleep as recommended by the American Academy of Pediatrics (AAP). It suggests that infants should sleep alone, on their backs, and in a crib. Once each hospital adopts a culture of safe infant sleep, the hospital staff will educate each mother on safe sleep habits, as well as provide a crib for those who are on Medicaid or uninsured. Process evaluation measures include said crib audits, a poster count and efficacy measure, as well as a measure to determine the providers self-efficacy to deliver the intervention as planned. Outcome evaluation will be assessed using a pretest posttest study design metric. Mothers will complete the Pregnancy Risk Assessment Monitoring System (PRAMS) questionnaire, a CDC developed survey to determine if the intervention is successful. Success will be measured through the short-term outcomes of increasing the knowledge of a safe sleep environment, increasing parental self-efficacy to follow the AAP safe sleep guidelines, decreasing rates of bed-sharing, increasing rates cribs in the house, and increasing rates of infants sleeping in the supine position. In turn, these will lead to the long-term outcomes of decreasing infant mortality rates and reducing health disparities related to infant health and infant mortality.

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