KU School of Medicine-Wichita

22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . To eradicate preventable infant deaths. To conduct innovative research. To implement findings throughout Kansas. We realized that safe sleep is only one of the issues we need was research, and we needed to look further down the road. Taneisha Scheuermann, assistant professor of preventive medicine and public health at KU Medical Center in Kansas City. Other members are Jenni Harshbarger, Ph.D., a clinical psychologist in Wichita; Tara Neil, M.D., a member of the family medicine residency at Via Christi in Wichita; and Jeffrey Colvin, M.D., from Children's Mercy in Kansas City. The center has received grants from the March of Dimes and the Wichita Medical Research and Education Foundation and is seeking others. An existing grant, for the Baby Talk prenatal education program in Sedgwick County, has come under the center's umbrella. The center's first big goal was to hold a symposium this past spring, which drew researchers and others working to reduce infant mortality. It brought together about 50 people from six different counties across Kansas, and focused on three areas that contribute to infant deaths: access, excess and safe sleep. Access refers to the need for precon- ception care and counseling — half of all pregnancies are unplanned, which leads to delays in prenatal care — as well as the need for mental health services. Excess refers to tobacco and opioid use and working to identify and implement evidence-based interventions to reduce the problems, which contribute to stillbirth, congenital malformations, low birth weight and low gestational age at birth, and sudden unexpected infant death. The final focus involves SIDS and sleep-related deaths, which are the largest contributor to sudden unexpected infant deaths and one of the leading causes of infant death in Kansas. "We benefited from seeing what's happening in the rest of the state and seeing where we can leverage or connect preexisting services to improve the reach of those activities," Schmidt said. "I can definitely envision things like smoking and tobacco cessation, as smoking is a key driver of all three of our top infant mortality causes — congenital anomalies, low birth weight and preterm birth, and sleep-related deaths." As director of implementation, Kuhlmann said her role will be "taking research and working to apply it in either a clinical or practical setting, to transfer research into action." The center also offers evaluation services for programs and grant holders. That meshes with its research focus and the desire to create evidence-based programs and best practices. Confronting and reducing infant mortality is a challenge because so many factors come into play, from poor maternal nutrition to tobacco use and substance abuse to birth spacing to SIDS and unsafe sleep practices. "We need to have programs and services for all those areas and then we need to measure them," Schunn said. "Those outcomes will help us measure whether we're succeeding. The center is the missing piece to building capacity and effectiveness." Schmidt, Schunn and the Kuhlmanns have worked on and researched safe- sleep issues, including toolkits for doctors' offices, programs such as Baby Talk and training of safe-sleep instructors who go share information with providers and women across the state. They twice have traveled to international conferences on SIDS, stillbirth and infant survival. Those experiences led to broadening their focus to infant mortality as a whole. And to creating something like CRIBS. "We all recognize that you have to hit it from several angles, and you need a very wide approach with a wide, collaborative model," Stephanie Kuhlmann said. "With the center, we hope to tie all that together and be more impactful."

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