The Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality: An Outcome Evaluation From the US South, 2011 to 2014
The Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality: An Outcome Evaluation From the US South, 2011 to 2014
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DOI：
10.2105/ajph.2018.304371
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发表时间：
2018-06-01
影响因子：
12.7
通讯作者：
Lu, Michael C.
中科院分区：
文献类型：
--
作者：
Hirai, Ashley H.;Sappenfield, William M.;Lu, Michael C.
目标。在美国卫生资源和服务管理局的支持下，评估南部公共卫生地区（IV 区和 IV 区）协作改进和创新网络 (CoIIN) 对降低婴儿死亡率的影响。方法。我们检查了 CoIIN 策略的前后变化（2011-2014 年），并使用来自重要记录（早期选择性分娩、吸烟）和妊娠风险评估监测系统（安全睡眠）的可用结果数据以及 IV 区和 VI 区相对于所有其他地区的早产和婴儿死亡率。结果。对于大多数结果而言，第四区和第六区的 CoIIN 改善程度高于其他地区。例如，早产率在其他地区减少了 22%，而其他地区为 14%；怀孕期间戒烟率增加了 7%，而其他地区为 2%；仰卧睡姿增加了 5%，而其他地区为 2%。早产率下降了 4%，是其他地区的两倍，但婴儿死亡率的下降没有显着差异。结论。 CoIIN 改善公共卫生的方法显示出在加速中期结果和早产方面取得进展的希望。对婴儿死亡率的影响可能需要额外的策略和持续的努力。
Objectives. To evaluate the impact of the Southern Public Health Regions' (Regions IV and IV) Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality, supported by the US Health Resources and Services Administration.Methods. We examined pre-post change (2011-2014) for CoIIN strategies with available outcome data from vital records (early elective delivery, smoking) and the Pregnancy Risk Assessment Monitoring System (safe sleep) as well as preterm birth and infant mortality for Regions IV and VI relative to all other regions.Results. For most outcomes, CoIIN improvements were greater in Regions IV and VI than in other regions. For example, early elective delivery decreased by 22% versus 14% in other regions, smoking cessation during pregnancy increased by 7% versus 2%, and back sleep position increased by 5% versus 2%. Preterm birth decreased by 4%, twice that observed in other regions, but infant mortality reductions did not differ significantly.Conclusions. The CoIIN approach to public health improvement shows promise in accelerating progress in intermediate outcomes and preterm birth. Impact on infant mortality may require additional strategies and sustained efforts.