O22 - Reducing Infant Mortality in Queensland: the impact of the Pēpi-Pod® Program

Abstract

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. 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. 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). 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.