July 24, 2017
By Brian Whepley
|Jenni Harshbarger, Ph.D.; Cari Schmidt, Ph.D.; and Stephanie Kuhlmann, D.O.|
Drawing on lessons gained through work on safe sleep practices and other maternal and infant health issues, a new center based at KU School of Medicine-Wichita plans to take aim at another challenging, multi-faceted health issue: infant mortality.
Cari Schmidt, director of research and associate research professor in the Department of Pediatrics, is director of the recently founded Center for Research on Infant Birth and Survival, or CRIBS for short. Dr. Stephanie Kuhlmann, pediatrics hospitalist and associate professor in the department, is the center's director of implementation.
A goal of the center is to be an instigator and a conduit - of research and best practices - and a connector of researchers and others working in infant mortality and related fields, such as safe sleep.
"The intention is for it to be a statewide center, so we will be collaborating and working with people at the Kansas City and Lawrence campuses as well as across the state with nonprofits and community organizations," Schmidt said. More than two dozen individuals and groups, including the Kansas Academy of Family Physicians, March of Dimes and a KDHE official, wrote letters supporting the center's creation.
"What we find is that throughout the state we have individuals working in silos, working with limited resources and having limited reach in what they're doing," she said. "So the idea was to connect with others who have similar interests and build projects that will have a greater impact on the infant mortality rate in Kansas."
In 2015, the latest year data is available, Kansas' infant mortality rate was 5.9 per 1,000 live births, its lowest ever and below the national average of 6.0. Sedgwick County's rate of 8.1 remains well above those averages, and is even higher among African-American births.
The idea for the center came out of work Schmidt, Kuhlmann and others have done through the Sedgwick County-based Maternal Infant Health Coalition and Safe Sleep Task Force. Both the coalition and task force are collaborative efforts supported by the medical school and the Medical Society of Sedgwick County. They involve a range of physicians, researchers, public health workers, nonprofits and others focusing on maternal and infant health matters. The Kansas Infant Death & SIDS Network - KIDS Network - and Executive Director Christy Schunn have been heavily involved in both.
For the last few years, KU Wichita Pediatrics has supported and become the presenting sponsor of one of the KIDS Network's main fundraisers, the Haley's SIDS Scramble golf tournament, which was founded in memory of Haley Slaymaker and all babies who have died in Kansas. This year's scramble, on Aug. 28, will serve as a launch event for CRIBS, with a portion of proceeds going to the center.
CRIBS is in its startup phase, working to assemble a board of directors and planning to seek grants to support research and operations.
"We believe that strengthening collaborations across the state among providers, universities, health systems, local governments, health departments, community groups and others will not only strengthen our work, but provide greater value for those capable of making outside investment in the form of grants for programs and research," said Dr. Brian Pate, chair of the Department of Pediatrics at the KU School of Medicine-Wichita.
The center's first big goal is to hold a summit late next spring or early summer that will draw researchers and others working to reduce infant mortality. What they hear then will help establish the center's areas of focus.
"Instead of coming in with predetermined ideas, what we would really like to do is identify areas people are interested in working on and build collaboration networks around those areas," Schmidt said.
Schmidt added that some areas could be natural topics. Birth spacing is one, as research has shown that births occurring a minimum of 18 months apart are healthier for mother and child. So the center could work on educating women on the importance of birth spacing, and how best to accomplish it.
"I can definitely envision things like smoking and tobacco cessation, which is a key driver of all three of our top infant mortality causes - congenital anomalies, low birth weight and preterm birth, and sleep-related deaths," Schmidt said.
"We don't want to just do research but build a network of sites to roll out best practices and evidence-informed strategies," Schmidt said.
"What's unique and important is that we plan to focus on implementation," Pate said. "When researchers find new ways of doing things that can improve clinical outcomes, like decreasing infant mortality rate, it can take years to fully translate those discoveries into actual practice. We plan to build a network of providers willing to use metrics derived from the evidence to work and learn together how best to put the evidence into every day practice."
As director of implementation, Kuhlmann said her role will be "taking research and working to apply it in either a clinical or a practical setting, to transfer research into action."
"With KUSM-Wichita resources and collaborations, we hope to support research and quality improvement opportunities for faculty, staff, residents and students. We also would like Kansas and the KUSM-W center to be an example to other states with high infant mortality," Pate said. The ultimate goal, of course, is "to improve the health of women and children in our state to the extent that fewer infants die every year."
The center will offer evaluation services for programs and grant holders. That will mesh with its research emphasis and desire for evidence-based programs. Reducing infant mortality is a challenge because so many factors come into play, from poor maternal nutrition to tobacco use and substance abuse, to birth spacing to SIDS and unsafe sleep practices.
"We need to have programs and services under all those areas and then we need to measure them," Schunn said. "The center is the missing piece to build capacity and effectiveness."
It can be difficult to make great progress overall - to move the needle - just by zeroing in on any single area. It takes pressure from many directions, with multiple approaches.
Schmidt, Schunn, Kuhlmann and her husband, Dr. Zachary Kuhlmann, an obstetrician-gynecologist, have worked on and researched safe sleep issues, including toolkits for doctors' offices and training of safe sleep instructors statewide. They have traveled to international conferences on SIDS, stillbirth and infant survival. The experiences led them to want to broaden their focus to infant mortality as a whole.
"We realized that safe sleep is only one of the issues we need to address," said Schunn. "What we needed to take the effort to the next level was comprehensive research, and we needed to look further down the road. It just makes sense."
"We all recognize that you have to hit maternal and infant health from several angles and you need a very wide approach with a broad, collaborative model," Dr. Stephanie Kuhlmann said. "With the center, we hope to tie together resources and be more impactful."
What: The golf scramble is an annual fundraiser for the KIDS Network and is sponsored by KU Wichita Pediatrics
Who benefits: The event raises money for the KIDS Network, which serves those who have lost a child to infant death or SIDS and supports the efforts of those working to reduce infant deaths. This year, KIDS will donate a portion of the proceeds to CRIBS, the new Center for Research on Infant Birth and Survival, based at KU School of Medicine-Wichita.
When: 1 p.m. Monday, Aug. 28
Where: Crestview Country Club, 1000 N. 127th St. E., Wichita
Cost: $150 per golfer, partially tax deductible. Sign up by Aug. 14 and you'll be guaranteed a shirt.
Sign up/ learn more: Details, registration forms, sponsorship opportunities can be found here.
KU School of Medicine-Wichita