Abstract

To collaboratively explore the cultural acceptance of the Pepi-Pod® program as an alternate safe sleep space and to explore the process of implementing the Pepi-Pod® program in a mainstream health service for Aboriginal families living in urban South Australia. Aboriginal and Torres Strait Islander infants continue to die from sudden infant death syndrome (SIDS) and sudden unexpected death in infancy (SUDI) at rates three to four times greater than other infants born in Australia despite Council of Australian Governments commitment to halve the gap in the Indigenous infant mortality rate by 2018. The Pepi-Pod® program is evidenced in New Zealand and Queensland to provide a culturally appropriate safe sleep alternative that contributes to the reduction of SIDS and SUDI. We have no evidence of acceptability or feasibility when offered through mainstream services in metropolitan South Australia. With a focus on decolonizing the research process through a two-way process for mutual learning between Aboriginal and non-Aboriginal team members and community, a novel qualitative design was employed including photo elicited yarning sessions (n = 7), focus groups (n = 2), and field notes (n = 15). Four themes emerged: 'you don't have to worry'; 'a way of sharing knowledge'; 'it looks like a bread box?' and 'need for consistent safe sleep messages'. The findings suggest that participants believe the Pepi-Pod® program may enrich Aboriginal families' lives evoking feelings of comfort and safety; however, the design could be improved to make them more culturally appropriate. There was confusion around safe sleep processes and education with a call for streamlining safe sleep messaging.

Highlights

  • Aboriginal and Torres Strait Islander infants die from sudden infant death syndrome (SIDS) and sudden unexpected death in infancy (SUDI) at rates 3–4 times greater than other infants born in Australia (Australian Health Ministers’ Advisory Council (AHMAC), 2017)

  • This paper reports on the findings of a pilot study trialling use of the Pepi-Pod® program through mainstream health services with urban Aboriginal families living in South Australia

  • The findings suggest that families, community members, and health care professionals believe that the Pepi-Pod® program may enrich Aboriginal families’ lives evoking feelings of comfort and safety

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Summary

Introduction

Aboriginal and Torres Strait Islander infants die from sudden infant death syndrome (SIDS) and sudden unexpected death in infancy (SUDI) at rates 3–4 times greater than other infants born in Australia (Australian Health Ministers’ Advisory Council (AHMAC), 2017). Disparities in health outcomes between Aboriginal and Torres Strait Islander and other Australians are well documented (Shepherd et al, 2012) Likewise, these disparities exist in the IMR and in SUDI and SIDS. The triple risk model (Filiano and Kinney, 1994) is a widely accepted framework for understanding the intrinsic and extrinsic factors contributing to SIDS It brings together evidence on infant critical development periods, underlying predisposition and environmental factors, contending that together they result in acute vulnerability (ibid)

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