In Colorado, Sudden Unexpected Infant Death (SUID) is a leading cause of death for children with an average of 48 SUID a year. Between 2017 and 2021, 241 SUID occurred in Colorado, accounting for 15.2% of all infant deaths (under 1 year of age). All-cause infant-mortality has decreased, however SUID deathrates have not, indicating an urgent need to invest in SUID prevention. Documenting and understanding the circumstances surrounding infant death and injury is essential to change practice, policy and behaviors. The purpose of the Colorado SUID Case Registry is to improve the quality, utility and impact of SUID data. High quality data are essential to drive and inform effective prevention strategies. The proposed project will enable Colorado to maintain its current surveillance of SUID by implementing the components of a state-based SUID Case Registry and to develop community participatory, data-driven prevention strategies to reduce SUID in communities, with a focus on those most at risk for SUID, including families of color and preterm and medically-complex infants who spend their earliest days of life in the NICU. The two goals of the Colorado SUID Case Registry are to reduce the overall incidence of SUID in Colorado by 15% from a three-year average of 51 per year between 2019-2021, to a three-year average of 43 between 2026-2028 and to reduce the SUID rate among Black infants by 15% from a crude death rate of 179.2 per 100,000 live births in 2019-2021 to no more than 152.3 per 100,000 live births in 2026-2028. The Colorado Department of Public Health and Environment (CDPHE) will achieve these goals by implementing the following eight strategies: 1) identify all SUID within 30 days of death; 2) conduct multidisciplinary reviews of all SUID within 150 days of identification; 3) categorize each SUID using the SUID Categorization Algorithm; 4) enter all case information, including review team recommendations, within 30 days of review; 5) perform
quality assurance checks/protocols on all cases within 30 days of entering case information; 6) analyze data with a focus on identifying disparities and associated social determinants of health (SDOH); 7) disseminate data to internal and external audiences to inform practice and policy changes to prevent deaths and reduce disparities; 8) develop one or more community participatory, data-driven prevention strategies. CDPHE and partners will engage families at highest risk of SUID and those impacted by SUID in Year 1 to inform prevention messaging and strategies. This will be conducted through interviews with families impacted by SUID to understand environmental factors and community strengths and challenges; families with preterm and medically-complex infants in the NICU will also be engaged to inform culturally respectful messaging for safe-sleep promotion messages. All prevention strategies will align with the American Academy of Pediatrics (AAP) safe sleep recommendations and best practices. CDPHE maintains strong collaborations with community partners and will focus efforts through this project to build and foster new relationships within communities disproportionately impacted by SUID.