Evidence Hub

Quick-read summary

This summary describes an evidence-based training intervention addressing prevention of Sudden Unexpected Deaths in Infancy (SUDI) for the multiagency workforce supporting vulnerable families in our region.

The aim of the work was to improve knowledge, skills, and engagement of staff providing services for vulnerable families with increased risk of SUDI.

The project was funded by the NIHR Applied Research Collaboration (ARC) North East and North Cumbria and delivered by a team led by Professor Helen Ball at Durham University.

What is the issue?

Following the ‘Back to Sleep’ and other infant sleep safety media campaigns during the late twentieth century rates of Sudden Unexpected Death in Infancy (SUDI) plummeted in the UK (and many other wealthy western nations). As a result, most sudden and unexpected deaths of babies in England now cluster in our most impoverished communities where simple public health messages can be difficult to implement and contribute to growing health disparities.

In 2020 a report from the National Child Safeguarding Practice review panel recommended that tackling SUDI in the UK is too challenging and complex to expect that any further reductions in infant deaths in the UK can be accomplished by health professionals alone.

They recommended bringing SUDI prevention for vulnerable families under the safeguarding umbrella and adopting a multi-agency approach to SUDI prevention.

Our response to this call was the Eyes on the Baby project that aimed to implement a multi-agency approach to tackling this issue in County Durham.

The project was a collaboration between Durham Infancy & Sleep Centre, Durham Integrated Care Board, Durham County Council Public Health Team and partners, and is funded by National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NENC).

The pilot has since been implemented and evaluated.

The evaluation used a post-training questionnaire and interviews with stakeholders. We aimed to assess how well the multiagency workforce accepted SUDI prevention as part of their remit and incorporated it into their everyday work.

Key findings

• Most multiagency staff were enthusiastic about the training and their role in SUDI prevention.
• Forty percent of invited staff completed the training.
• Knowledge and confidence around SUDI prevention improved following the Eyes on the Baby training.
• Evidence showed that by the time of evaluation, the earliest adopters were engaged in collective action.
• The research concludes 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.

Who is this evidence useful for?

Practitioners and policy-makers implementing multi-agency workforce interventions, or SUDI prevention interventions. Anyone devising an infant sleep safety or SUDI prevention policy.

Research summary

We identified a broad range of staff groups whose work brought them into contact with vulnerable families in County Durham.

• Job roles were grouped into three strands based on the frequency and degree of contact with vulnerable families.
• Training was co-produced and delivered via an online learning platform.
• Pre-and post-training surveys assessed staff knowledge and confidence, and follow-up surveys captured staff feedback and engagement.

Normalisation Process Theory (NPT) was used to support user engagement and embed SUDI prevention into everyday practice. We evaluated the initial phase of the project qualitatively and quantitatively using surveys, interviews, and group discussions.

What the research found

• Staff in 47 multi-agency workforce (MAW) roles were invited, and 993 staff registered for training.
• Eyes on the Baby training increased SUDI prevention knowledge and confidence; knowledge remained high two months after completion.
• Team leaders’ commitment was high.
• MAW staff commitment to SUDI prevention increased over time, however, some staff were initially dubious about involving MAW in SUDI prevention.
• SUDI Champions played an active role in embedding SUDI prevention into everyday practice.

Why is this important?

The process for establishing a training and implementation programme to support multi-agency SUDI prevention has not previously been documented.

Eyes on the Baby secured buy-in from a wide range of professionals in social care, health care, safeguarding and academia who worked together to devise a tailored SUDI programme that suited the needs of the local context.

Steering Committee members enthusiastically engaged in the project and took their stakeholder roles seriously, using their status and connections to promote Eyes on the Baby to their colleagues and staff, and setting expectations that the MAW over whom they had influence would engage with training and implementation.

Further work is needed to embed MAW for SUDI prevention in County Durham and establish sustainability; this project was a successful first step.

How were people/community groups involved in this work?

We involved families attending Parent and Baby Groups in several locations to assess the responses of parents in County Durham to the MAW approach to SUDI prevention. We attended seven groups and talked to 20 local parents.

What’s next?

Eyes on the Baby has been made available via the Durham Safeguarding Children Partnership training website to ensure SUDI prevention training continues to spread across the workforce.

Following further evaluation in Northumberland, we plan to expand Eyes on the Baby to other local authorities regionally, then nationally with a centralised oversight plan for governance and quality assurance.

Read more about this work

Read the full research paper

Find out more about this work

Lead researcher: Professor Helen Ball

Email: [email protected]