Piloting Eyes on the Baby: A Multiagency Training and Implementation Intervention Linking Sudden Unexpected Infant Death Prevention and Safeguarding

We describe the coproduction, pilot implementation, and user evaluation of an evidence-based training intervention addressing prevention of Sudden Unexpected Deaths in Infancy (SUDI) for the multiagency workforce supporting vulnerable families with babies in a northern English county. We aimed in this pilot study to improve knowledge, skills, and engagement of professionals and support staff providing services for vulnerable families with increased risk of SUDI. The training intervention was co-produced by the academic team and the project Steering Committee which comprised senior leaders from the local authority, health and care sectors, and third-sector organisations, and rolled out to multiagency teams between November 2022 and March 2023. Evaluation data were collected using a post-training questionnaire, followed up by the Normalisation Process Theory (NPT) NoMAD survey issued at two time-points post-training, and interviews with stakeholders. The evaluation, conducted from January to May 2023, aimed to assess how well the multiagency workforce accepted SUDI prevention as part of their remit and incorporated SUDI prevention activities into their everyday work. Most multiagency professionals and support staff were enthusiastic about the training and their role in SUDI prevention. Fewer health professionals completed the training than expected. Forty percent (397/993) of invited staff completed the training. Our results revealed initial lack of knowledge and confidence around SUDI prevention and targeted provision for vulnerable families which improved following the Eyes on the Baby training. The proportion of nonhealth professionals rating their knowledge of SUDI prevention as good or excellent increased significantly from 28% before training to 57% afterwards. Self-rated confidence in discussing SUDI prevention with families increased significantly from 71% to 97%. Health professionals’ ratings increased significantly for knowledge from 62% to 96%, and confidence from 85% to 100%. Use of NPT allowed us to identify that by the time of evaluation, the earliest adopters were cognitively involved with the programme and engaged in collective action, while later adopters had not yet reached this stage. We conclude that effective implementation of multiagency working for SUDI prevention can be accomplished by providing clear training and guidance for all staff who have regular or opportunistic contact with vulnerable families. Our next step is to evaluate the sustainability of MAW SUDI prevention over the medium to long term and assess the responses of recipient families to this approach

Multiagency approaches to preventing sudden unexpected death in infancy (SUDI): a review and analysis of UK policies

Background Recent reviews of sudden unexpected deaths in infancy (SUDI) in England recommend a multiagency working (MAW) approach to prevention but lack clear guidance around how this might be implemented.Aims In England, local authorities commission and oversee public health services. This review examines how local authority policies address implementation of MAW for SUDI prevention to understand local variations and identify strengths and weaknesses.Methods Using a comprehensive list of all metropolitan, county, unitary councils and London boroughs in England, we systematically searched local authority websites for relevant published documents and submitted freedom of information (FOI) requests where policies or guidance for SUDI prevention had not been sourced online. We extracted data from documents using a standardised form to summarise policy contents which were then collated, described and appraised.Findings We searched the websites of 152 council and London boroughs, identifying 36 relevant policies and guidelines for staff. We submitted 116 FOI requests which yielded 64 responses including six valid documents: 45% (52/116) of local authorities did not respond. Seventeen councils shared the same guidance under safeguarding partnerships; removal of duplicates resulted in 26 unique documents. Only 15% (4/26) of the documents included a detailed plan for how MAW approaches were to be implemented despite 73% (19/26) of the documents mentioning the importance of engaging the MAW in raising awareness of safe sleep for babies with vulnerable families. Five areas of variation were identified across policies: (1) scope, (2) responsibilities, (3) training, (4) implementation and (5) evaluation.Conclusions There are discrepancies between local authorities in England in whether and how MAW for SUDI prevention is carried out. Strengths and weaknesses of approaches are identified to inform future development of MAW for SUDI prevention

The Words-in-Noise (WIN) Test With Multitalker Babble and Speech-Spectrum Noise Maskers

The Words-in-Noise (WIN) test uses monosyllabic words in seven signal-to-noise ratios of multitalker babble (MTB) to evaluate the ability of individuals to understand speech in background noise. The purpose of this study was to evaluate the criterion validity of the WIN by comparing recognition performances under MTB and speech-spectrum noise (SSN) using listeners with normal hearing and listeners with hearing loss. The MTB and SSN had identical rms and similar spectra but different amplitude-modulation characteristics. The performances by the listeners with normal hearing, which were 2 dB better in MTB than in SSN, were about 10 dB better than the performances by the listeners with hearing loss, which were about 0.5 dB better in MTB with 56% of the listeners better in MTB and 40% better in SSN. The slopes of the functions for the normal-hearing listeners (8-9%/dB) were steeper than the functions for the listeners with hearing loss (5-6%/dB). The data indicate that the WIN has good criterion validity

Possible impact of the tick programme in New Zealand on selected nutrient intakes: tentative estimates and methodological complexities

Various countries allow health-related endorsements in the form of symbols or logos on packaged foods.1–3 This is also the case for the Heart Foundation in Australia and New Zealand with Tick Programmes.4 There is some evidence in favour of such endorsement programmes from experiments,5 changes in food composition,6,7 and in terms of cost-effectiveness.8 However, the likely impact in the New Zealand setting is largely unquantified, with just one study published in 2002 on sodium reductions.4To inform modelling work on the cost-effectiveness of cardiovascular disease prevention strategies, we aimed to estimate the difference in selected nutrients in the diet between: (i) New Zealand with the Tick Programme; and (ii) the counterfactual of no Tick Programme having existed in the country

Piloting Eyes on the Baby: A Multiagency Training and Implementation Intervention Linking Sudden Unexpected Infant Death Prevention and Safeguarding

We describe the coproduction, pilot implementation, and user evaluation of an evidence-based training intervention addressing prevention of Sudden Unexpected Deaths in Infancy (SUDI) for the multiagency workforce supporting vulnerable families with babies in a northern English county. We aimed in this pilot study to improve knowledge, skills, and engagement of professionals and support staff providing services for vulnerable families with increased risk of SUDI. The training intervention was co-produced by the academic team and the project Steering Committee which comprised senior leaders from the local authority, health and care sectors, and third-sector organisations, and rolled out to multiagency teams between November 2022 and March 2023. Evaluation data were collected using a post-training questionnaire, followed up by the Normalisation Process Theory (NPT) NoMAD survey issued at two time-points post-training, and interviews with stakeholders. The evaluation, conducted from January to May 2023, aimed to assess how well the multiagency workforce accepted SUDI prevention as part of their remit and incorporated SUDI prevention activities into their everyday work. Most multiagency professionals and support staff were enthusiastic about the training and their role in SUDI prevention. Fewer health professionals completed the training than expected. Forty percent (397/993) of invited staff completed the training. Our results revealed initial lack of knowledge and confidence around SUDI prevention and targeted provision for vulnerable families which improved following the Eyes on the Baby training. The proportion of nonhealth professionals rating their knowledge of SUDI prevention as good or excellent increased significantly from 28% before training to 57% afterwards. Self-rated confidence in discussing SUDI prevention with families increased significantly from 71% to 97%. Health professionals’ ratings increased significantly for knowledge from 62% to 96%, and confidence from 85% to 100%. Use of NPT allowed us to identify that by the time of evaluation, the earliest adopters were cognitively involved with the programme and engaged in collective action, while later adopters had not yet reached this stage. We conclude that effective implementation of multiagency working for SUDI prevention can be accomplished by providing clear training and guidance for all staff who have regular or opportunistic contact with vulnerable families. Our next step is to evaluate the sustainability of MAW SUDI prevention over the medium to long term and assess the responses of recipient families to this approach

Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand.

Countries are increasingly considering how to reduce or even end tobacco consumption, and raising tobacco taxes is a potential strategy to achieve these goals. We estimated the impacts on health, health inequalities, and health system costs of ongoing tobacco tax increases (10% annually from 2011 to 2031, compared to no tax increases from 2011 ["business as usual," BAU]), in a country (New Zealand) with large ethnic inequalities in smoking-related and noncommunicable disease (NCD) burden.We modeled 16 tobacco-related diseases in parallel, using rich national data by sex, age, and ethnicity, to estimate undiscounted quality-adjusted life-years (QALYs) gained and net health system costs over the remaining life of the 2011 population (n = 4.4 million). A total of 260,000 (95% uncertainty interval [UI]: 155,000-419,000) QALYs were gained among the 2011 cohort exposed to annual tobacco tax increases, compared to BAU, and cost savings were US$2,550 million (95$1,480 to US$4,000). QALY gains and cost savings took 50 y to peak, owing to such factors as the price sensitivity of youth and young adult smokers. The QALY gains per capita were 3.7 times greater for Māori (indigenous population) compared to non-Māori because of higher background smoking prevalence and price sensitivity in Māori. Health inequalities measured by differences in 45+ y-old standardized mortality rates between Māori and non-Māori were projected to be 2.31% (95% UI: 1.49% to 3.41%) less in 2041 with ongoing tax rises, compared to BAU. Percentage reductions in inequalities in 2041 were maximal for 45-64-y-old women (3.01%). As with all such modeling, there were limitations pertaining to the model structure and input parameters.Ongoing tobacco tax increases deliver sizeable health gains and health sector cost savings and are likely to reduce health inequalities. However, if policy makers are to achieve more rapid reductions in the NCD burden and health inequalities, they will also need to complement tobacco tax increases with additional tobacco control interventions focused on cessation

Input parameters.

<p>Input parameters.</p

Projected percentage changes in ethnic inequalities in all-cause mortality rates for 10% increases in tobacco tax per annum from 2011 to 2031—Standardized rate differences (SRD) in mortality.

<p>Rates are standardized to the WHO world population.</p

Correction: Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand

<p>Correction: Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand</p