• Ashley H Hirai, William M Sappenfield, Reem M Ghandour, Sara Donahue, Vanessa Lee, and Michael C Lu.
• Ashley H. Hirai, Reem M. Ghandour, and Vanessa Lee are with the Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. William M. Sappenfield is with the Department of Community and Family Health, University of South Florida, Tampa. At the time of the study, Sara Donahue was with Abt Associates, Cambridge, MA. Michael C. Lu was with the Health Resources and Services Administration, US Department of Health and Human Services, Rockville.
• Am J Public Health. 2018 Jun 1; 108 (6): 815-821.

ObjectivesTo 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.MethodsWe 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.ResultsFor 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.ConclusionsThe 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.

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