Protecting Infants

Nursing Students Use 'Floor Talkers' to Bring Awareness to Safe Sleep Practices
November 16, 2011

When it came to doing something meaningful in public health, Sonoma State University graduate nursing students could look no farther than their feet for answers.

The 23 nursing students spent this year developing a social marketing campaign to protect infants lives in Sonoma County by promoting "safe sleep" practices.

In a partnership with the Sonoma County Public Health Department, they have created awareness through a "floor talker" campaign - giant plastic decals installed on the floors of retail stores and agencies serving parents and caregivers of infants in 48 locations in southwest Santa Rosa.

These "floor talkers" are designed in both English and Spanish to educate mothers and family members about how to assure a safer infant sleep environment. Infants co-sleeping with and adult, or on soft surfaces have a great risk of suffocation or Sudden Infant Death Syndrome (SIDS), the unexpected death of an apparently healthy infant from unexplained causes during a sleep period.

Modeled after a successful program in Louisiana, the large decals show a mother lying outside her child's crib with "Back is Best" in large type. A secondary message reads "Lay me to sleep close to you but in my own bed, on my back with no bumpers, blankets or bears."

Rebecca Munger of the county's Maternal, Child and Adolescent Health Program, DHHS invited Michelle Kelly and her students in the Direct Entry M.S. Nursing Program at SSU to partner in launching the social marketing campaign.

A mini-grant from the CJ Foundation for SIDS education was obtained to support graphic design and printing costs of the floor decals but staffing the project was still a problem.

The needs of the maternal child health department merged with the nursing department's to provide clinical experience of 90 hours for masters' level students to develop public health nurse competencies.

Professor of Nursing Michelle Kelly, who directed the nursing students' efforts, says a community standard has been lacking in regard to infant sleep environments.

Kelly summarized findings in to a Sonoma County report on infant deaths. "Many high-risk populations recall receiving little or no education on safe sleep at hospital discharge or during prenatal and well baby visits," she cites. "Parents and other caretakers also have few other sources of reliable information on how to create a safe sleep environment."

Like any marketing campaign, the nurses became involved in focus groups and message development and graphic design to create the most effective messages to communicate to the target audience.

The decals were installed in April and the project is to run to the end of the year.

The Sonoma County Child Death Review Program reported that between 2003-2007 nine infants died in sleep environments locally. Four cases were diagnosed as SIDS and in four cases suffocation was identified as the cause of death.

Current research suggests infants be put sleep on their backs, in their own beds, without blankets or other soft bedding to reduce the risk of SIDS and other sleep-related infant deaths. Adults who sleep in the same bed as an infant can increase the risk of suffocation.

"It has been really rewarding to see the floor talkers we helped create actually out in the community where so many more people can be touched," says nursing student Laura Braughton. "I think it really is true that a picture is worth 1000 words. Seeing a picture of a mom looking at her baby while in a safe sleeping position catches your eye to read the message. It sticks with you."

Vienna Golovich agreed. "The SIDS project was very challenging initially since we felt as students we lacked credibility when trying to convince store managers to install floor-talkers," she says. 

"However, we began gaining confidence and momentum as our efforts progressed and we realized how much of a beneficial impact we could have in reducing preventable and tragic infant mortality. Looking back, it was one of the most rewarding experiences I had in nursing school and in my life."