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Sudden Infant Death Syndrome (SIDS) Awareness Month: Highlights of NICHD Outreach

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NICHD outreach efforts are ongoing to help spread safe sleep messages to different audiences

Two parents standing over a crib, with their child sleeping on its backSIDS is the sudden, unexplained death of an infant younger than one year of age. It is the leading cause of death in children between one month and one year of age. In 2006, more than 2,300 infants died of SIDS in the United States.

The NICHD Spotlights for October—SIDS Awareness Month—highlight the Institute’s activities related to SIDS. The first one focused on Timely Advice on Safe Infant Sleep: Research on Sudden Infant Death Syndrome (SIDS) and described the NICHD’s research efforts and findings related to SIDS. The NICHD’s portfolio on SIDS also includes outreach—involving communities in reducing SIDS risk. This Spotlight describes the Institute’s activities related to SIDS education and risk-reduction activities, part of its multifaceted approach to understanding SIDS and eliminating it worldwide.


Early Outreach Efforts
Outreach to Specific Audiences
New Trends in Outreach
For More Information

Early NICHD Outreach Efforts

The NICHD has been conducting and supporting research to understand SIDS for many decades. In 1974, Congress passed the Sudden Infant Death Syndrome Act (Public Law 93-270), which not only placed the NICHD at the forefront of SIDS research, but also charged the NICHD with providing information to the public about SIDS and ways to reduce the risk of SIDS.

In 1994, the NICHD, the American Academy of Pediatrics (AAP), and other partners established a public health campaign to educate parents, caregivers, and health care providers about ways to reduce the risk of SIDS. At the time, research from the NICHD and other sources revealed that healthy babies should be placed on their backs or sides to sleep to reduce the risk of SIDS. From these research findings, "back to sleep" became the main message and name of the campaign. The message was further refined in 1996, when findings from NICHD-supported and other research led the AAP to revise its recommendation to say that healthy babies should sleep wholly on their backs as the best way to reduce the risk of SIDS.

In 1993, before the Back to Sleep campaign began, the U.S. SIDS rate was 1.17 deaths for each 1,000 live births. By 2000, the U.S. SIDS rate decreased by about 50 percent (PDF - 49 KB) to 0.62 for each 1,000 live births and has continued to decline. Although thousands of infants have not succumbed to SIDS, babies are still dying of SIDS, and rates in certain populations are much higher than the national average.

The NICHD’s goal is ultimately to eliminate SIDS deaths, both in the United States and worldwide. To do so, the Back to Sleep campaign and the NICHD continue reaching out to various communities with safe sleep messages. A complete list of safe sleep messages is available through the Safe to Sleep Web site.

Outreach to Specific Audiences

Using studies of health education and of SIDS outreach, campaign leaders discovered that response to safe sleep messages differs among different communities and ethnicities. To reach as many people with safe sleep messages as possible, the campaign has created several outreach efforts tailored to different audiences. For example:

  • Back to Sleep began offering materials in Spanish very early in the campaign’s existence and provides a variety of Spanish materials today to help spread safe sleep messages to Spanish-speaking communities.
  • In 2000, the NICHD and its Back to Sleep partners worked with national African American organizations to design materials about SIDS for African American families and communities.
    • In addition to a suite of materials focused on reaching African Americans, the NICHD also partnered with the Alpha Kappa Alpha Sorority, the Women in the National Association for the Advancement of Colored People (NAACP), and the National Coalition of 100 Black Women to hold outreach summits in different parts of the country. The summits focused on training members of these organizations on ways to spread safe sleep messages in their communities.
    • These groups also collaborated on a series of radio Public Service Announcements (PSAs) that ran nationwide on the RadioOne network and printed PSAs that were placed on mass transit venues in the Washington, D.C., area.
  • In 2006, the NICHD began the Mississippi SIDS African American Outreach Project to expand and improve coordination and delivery of SIDS risk-reduction information to pregnant and parenting women, their families, and other caregivers of infants younger than one year of age in the state of Mississippi. The project partners include the Mississippi Department of Health, local organizations, churches, and community groups that promote the use of culturally tailored SIDS risk-reduction materials developed by the NICHD for African American communities.
    • To date, more than 80 mini-grants have been awarded to community- and faith-based organizations to implement SIDS risk-reduction activities.
    • Train-the-trainer sessions are also conducted for those who provide health and support services in all nine health district across Mississippi.
  • In 2003-2004, the NICHD began working with representatives from American Indian/Alaska Native (AI/AN) communities to understand the unique information needs of these communities. As a result, in 2009, the NICHD and its AI/AN partners released safe sleep materials tailored for AI/ANs. Additional items within this set of materials for AI/ANs will be released later in 2010.
  • Health care providers have been a primary audience for information about ways to reduce the risk of SIDS since the campaign started but, early on, this outreach focused mostly on doctors.
    • Research showed that parents are more likely to follow safe sleep practices if they see those practices modeled by nurses and other nursery staff. So in 2007, in collaboration with the National Institute on Nursing Research and other national organizations, the NICHD launched the printed Continuing Education Module on SIDS Risk Reduction: Curriculum for Nurses to help nurses take advantage of their unique position as trusted advisors to parents and families. Since the printed module launched, more than 9,500 nurses have completed the course.
    • The NICHD is currently working in partnership with several national pharmacist organizations and other groups to create a similar printed module on SIDS risk reduction for pharmacists.
    • In addition, the campaign continues to provide materials for health care providers in general.

New Trends in Outreach

Back to Sleep outreach no longer relies solely on in-person distribution of printed materials. Although the campaign still provides printed materials, it also uses various media formats to reach various audiences. For example:

  • In 2010, the NICHD, the National Institute on Nursing Research, and other national organizations, launched the online Continuing Education Program on SIDS Risk Reduction: Curriculum for Nurses as a complement to the printed version. Both the printed and online modules provide a quick and portable way for nurses to learn about SIDS and how to educate parents and caregivers about reducing SIDS risk. Since the online module launched in February 2010, more than 5,000 nurses have completed the course.
  • Later in 2010, the NICHD will launch a similar online continuing education module on SIDS risk reduction for pharmacists.
  • Among the additional materials for outreach to AI/AN communities is the Healthy Native Babies Project Toolkit—an interactive CDROM that will allow health workers and other outreach personnel to tailor materials to specific Tribal areas and Tribes using photos, language, and other graphic elements specific to those Tribes. The Toolkit provides flexibility for creating outreach materials that are culturally tailored to different AI/AN Tribes.
  • The NICHD will also be working with its AI/AN partners to create an online self-study module on SIDS risk reduction that will allow community health and outreach workers even in rural areas to have access to the latest information on SIDS risk reduction.
  • The NICHD is in the process of revamping the Back to Sleep Web site to make it more comprehensive and more interactive. Plans for the site include an interactive "game" to help parents and caregivers learn how to make a safe sleep environment for their babies. The new Web site is scheduled to launch in early 2011.
  • The NICHD also took part in the text4baby program—a free service that delivers evidence-based health information about pregnancy and baby’s first year directly to the mobile devices of moms-to-be and new moms. Those interested can opt-in to this public-private partnership between the National Healthy Mothers Healthy Babies Coalition, the White House Office of Science and Technology Policy, other agencies—including NICHD, and other organizations. Safe sleep messages from the Back to Sleep campaign and other healthy pregnancy and healthy infant messages have gone to the program’s more than 90,000 subscribers.

In addition, the NICHD and leaders of the Back to Sleep campaign are constantly seeking ways to better understand what factors contribute to the success or failure of safe sleep outreach. For example, the Study of Attitudes and Factors Affecting Infant Care (SAFE) aims to better understand what makes people follow or not follow specific safe sleep messages related to infant sleep position, bed sharing, and pacifier use. SAFE focuses on understanding attitudes and barriers to behavioral change. Findings from this study will help the Back to Sleep campaign and other outreach efforts further refine their messages and their outreach methods to make them more effective and successful.

The NICHD will continue its multifaceted efforts to understand SIDS and eliminate it as a cause of infant death. The Institute will continue to support and conduct cutting-edge science to understand the causes of and contributors to SIDS as a way to move toward detection and possible prevention. At the same time, the NICHD will continue to refine the Back to Sleep campaign, its messages, and its outreach methods to most effectively reach all parents and caregivers with important safe sleep messages.

For More Information

For more information, select one of the links below:


Originally posted: October 21, 2010

All NICHD Spotlights

Last Updated Date: 03/21/2011
Last Reviewed Date: 03/21/2011
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