Preventing Infant Mortality in Georgia February 2019 - Page 12

12 Healthcare Georgia Foundation Only Lowndes County experienced a sleep-related death in the baseline year of TCOY, with no such deaths being experienced across the other years (Table 3). With the exception of the Colquitt County comparator group, the other county comparator groups did experience some sleep-related deaths throughout the Initiative. Table 3. Rates of Sleep-related Deaths for Each Program and County Comparator, 2012-2016 PROGRAM SITE 2012 2014 2015 2016 Clayton County Program participants n = 52 0 n = 256 0 n = 152 0 n = 119 0 County, NH-Black 7/4155 4/4234 3/4341 6/4356 Lowndes County Program participants n = 119 1 n = 78 0 n = 44 0 n = 47 0 County, NH-Black 1/1614 2/1598 1/1619 4/1537 Dougherty County Program participants n = 60 0 n = 58 0 n = 39 0 n = 40 0 County, NH-Black 2/1323 1/1272 2/1198 2/1242 Colquitt County Program participants n = 56 0 n = 54 0 n = 48 0 n = 28 0 County, Hispanic 0/684 0/673 0/609 0/660 A notable observation from the outcome evaluation, given state and national patterns in preterm birth for the same period, is that none of the grantees saw increases in their rates of preterm birth relative to the county comparator. According to the March of Dimes 2017 Prematurity Report, the U.S. preterm birth rate increased from 9.6% of births in 2015 to 9.8% in 2016. As part of this report, Georgia received a “D” grade given its stagnation in rates of preterm birth from 2014 to 2015 (10.8%) and its increase from 2015 to 2016 (from 10.8% to 11.2%). Furthermore, the U.S. report found increasing rates of preterm birth among all racial-ethnic groups for 2014-2016, underscoring that not getting worse was an important achievement for the TCOY sites. The Clayton and Lowndes sites did experience an increase in rates of low birth weight relative to their county comparator, which underscores the importance of continued efforts to address underlying women’s health and prenatal care in these communities. QUALITATIVE FINDINGS Several themes emerged from the qualitative data that reflect the availability and utilization of TCOY services by program participants. These themes centered on topics related to specific components of the TCOY Initiative, including reproductive life planning, breastfeeding, and safe sleep. In addition, facilitators and barriers to implementation of this initiative as expressed by TCOY program staff were identified. Findings also illustrate participants’ recommendations for future sustainability and improvement of TCOY and similar initiatives aimed at reducing adverse infant health outcomes. The most salient themes are:  TCOY Initiatives are regarded as important programs for providing essential healthcare services to women at high-risk for adverse maternal and infant health outcomes. Both focus group participants