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0076 Using child fatality reviews to change organisational policies in licensed child care settings in colorado
  1. Colleen Kapsimalis
  1. Colorado Department of Public Health and Environment, Denver, CO, USA


Statement of purpose The Colorado Child Fatality Prevention System (CFPS) reviews all sudden unexpected infant deaths (SUID) that occur in Colorado. Thirteen of the 263 Colorado SUIDs (4.9 %) from 2009–2013 occurred in a child care environment, including 84% (11) in licensed child care centres or homes. The American Academy of Paediatrics (AAP) endorses infant safe sleep recommendations to help reduce the risk of SUID. None of the deaths reviewed by CFPS from 2009–2013 met all of the AAP’s safe sleep recommendations. This presentation will highlight how the CFPS used this data to improve child care centre policies related to safe sleep.

Methods/Approach State health department staff conducted a policy analysis to assess current rules that regulate licensed child care and determined they did not adhere to all the AAP recommendations. To reduce the risk of SUIDs in licensed child care, the CFPS issued a recommendation in the 2014 Legislative Report to “modify child care licensing regulations regarding infant safe sleep to better align with the AAP’s recommendations.” The CFPS capitalised on a window of opportunity presented by the media to implement this recommendation. CFPS worked with stakeholders to propose language for the updated rules and provided expert testimony at the rule hearing.

Results State human services amended the rules to incorporate the language proposed by the CFPS regarding best practices for infant safe sleep environments. Approximately 6,000 licensed child care providers will be impacted by this rule-making in Colorado.

Conclusions The CFPS will continue to monitor SUIDs in child care settings to understand the impact of the rule changes and to inform future prevention strategies. The CFPS will also collaborate with key partners to educate child care centres on the updated rules.

Significance and contribution to the field This organisational policy change in licensed child care settings will improve adherence to the AAP recommendations. Public health practitioners can duplicate this process to influence organisational policies.

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