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Introduction and Aim
The Queensland Pēpi-Pod® Program was introduced as a staged research intervention
in partnership with Aboriginal and Torres Strait Islander communities, and Change
for our Children, New Zealand in 2012-2018 to determine cultural, community and individual
acceptability, safety and feasibility. This three-part program (sleep space, safe
care, family as safe sleep influencers) addressed the vulnerability of infants in
unsafe sleep environments that increase suffocation risk. ‘If it’s safe to breathe,
it’s safe to sleep’ was the underlying gist message promoted. While successfully implemented,
and with some communities continuing 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 the Pēpi-Pod® Program implementation was temporally associated with a
reduction in infant mortality in Queensland.
Methods
Using research participant data (n=617) and linked Queensland population data, research
locations 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 outcome, defined as all-cause
post-neonatal infant mortality between one and six months of age. Outcomes within
and between research location subgroups, and whole of Queensland Study IMR before
and after the research intervention were compared.
Results
After the Pēpi-Pod® Program intervention study IMR fell in two of the three research
location subgroups. The greatest fall occurred in the subgroup with the highest rate
of participation and participant Indigeneity (Rate Ratio 0.25, {95% Confidence Intervals
0.06,1.08}, P=0.08). The 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. This Program presents a practical and tangible strategy to reduce infant mortality
experienced by priority populations.
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Copyright
© 2022 Published by Elsevier Inc.
