How educators and medical professionals are innovating to protect Michigan children from harm

Joann Moss knows that most common childhood injuries can be prevented, and that information is a powerful tool in the fight against injury and accidental death. That's why she and fellow injury prevention educators work broadly, spreading information on burn and scald prevention, safe sleep instruction, and child passenger safety seat checks to as many families in metro Detroit as possible. 

But casting such a wide net makes tracking effectiveness a difficult task indeed.

In Southeast Michigan, abuse and injury prevention experts are beginning to work smarter by taking a closer look at how, and to whom, they focus their efforts, and by seeking innovative ways to help parents, families, and caregivers keep kids safe.

Moss and her colleagues at the Kohl's SAFE 4 Kids Program (KS4K) at Children's Hospital of Michigan recognize that it's not enough to spread information and hope for change; their efforts must show a decrease in preventable injuries and deaths. 

In other words, their work must be data driven.

Determined to target resources where they could do the most good, the KS4K team and funding partner Children's Hospital of Michigan Foundation pored over emergency room injury data at DMC Children's Hospital of Michigan and found higher levels of injury and death in Detroit, compared to other areas.

Between 2010 and 2015, 871 infants died in Michigan due to unsafe sleep practices. Wayne County claimed 267 of these deaths, with about 63 percent of those occurring in Detroit.

"With such a large percentage [of the deaths] in Detroit, we knew we needed to focus our efforts where the heart of the injuries were," says Moss, injury prevention education coordinator for the Kohl's SAFE 4 Kids program. After consulting data from the Michigan Department of Community Health, Moss and her team formed a plan to concentrate their efforts in a five-ZIP-code area of Detroit. 

Detroit zip codes with high rates of infant mortality

"When we looked at the ZIP code map, and determined that the sudden, unexplained infant deaths were in specific geographic areas, and then saw that other injuries matched up, it endorsed the fact that these ZIP codes were hot spots," says Moss. 

This revelation now informs the work they do, and the data they will assess moving forward.

Safety is not always intuitive

Focusing specifically on safe sleep education for pregnant mothers, couples, and caregivers, Moss asked state-funded home visiting agencies working in these specific ZIP codes to refer individuals to attend safety training at locations in their communities, like Sinai Grace Hospital, or the Mathis Community Center

"The agencies are identifying the women most in need of our intervention through visual inspection," says Moss. "They go into their homes and determine whether they have infant car seats, or a safe place for baby to sleep, and they refer them to our classes."

Those conducting the home visits can provide injury-prevention knowledge, reinforce safety basics in the home, and offer specific reminders, like the fact that babies should sleep without toys and on its back, and that water heaters should be turned down to avoid scalds. 

"They have a trusted relationship with them and can be safety mentors," says Moss. "In using these home visiting agencies, we are able to carry the message beyond what the families will get in the two or three hours [of training] with us."

Joann Moss giving a presentation on infant safety

As well as child passenger safety, another hot topic for KS4K is fire safety and scald burn prevention. By working in Early Head Start and Head Start programs within these five specific Detroit neighborhoods, safety educators Jennifer Kotas and Renee Zarr train both parents and children. 

Events at Focus: HOPE's Center for Children align perfectly with both organizations' goals, and so far, they've been well attended. About 55 families came to this year's first car seat safety event, which is meant to service primarily low-income families. 

One point of emphasis for the educators is to make sure families feel comfortable. Kotas presents fun lessons to three-, four-, and five-year-old students about avoiding burns and scalds, and the importance of home fire safety. Meanwhile, in another room, parents learn about the importance of setting water heaters no higher than 120 degrees, turning pot handles on the stove away from grabbing hands, and common sense space heater use. 

Kotas and Zarr also gather data on the use of car seats, before and after giving parents instructions. Throughout the initial two-year grant period, the KS4K team will analyze change in knowledge and behavior, and hospital ER data. 

They're looking for a positive, measurable change, but in the meantime, they're experiencing gratitude for their work.

"The response I have received from the agencies and schools has been amazing," says Kotas. "There has been a need, but not a focused program to meet those, and the parents are the biggest advocates for their families. They feel better when they leave because they know their kids are safer."

Innovative teaching tools

Washtenaw Area Council for Children has a mission to protect children from harm caused by maltreatment, abuse, and neglect by strengthening resilience and protective factors in families and communities. They carry out this mission by providing educational outreach programs on safe sleep, sexual abuse, body safety, cyberbullying, sexual predation, and cyber safety. 

For each of the past two years, the Council has provided education and support to more than 10,000 individuals through agencies like Hope Clinic, Corner Health Center, and all Washtenaw County public school districts. But it's with middle school students that they're able to pilot innovative awareness of these issues through the language kids speak best: interactive video games. 

Currently being piloted through peer mentor groups to students, the Digital Decisions games were developed by a former Council employee. Loaded onto Kindle tablets, they guide kids through everyday situations.

"With the interactive game we talk about how we can make it a teaching moment. What went into their decision? Is their decision correct?" says Jyoti Gupta, executive director at Washtenaw Area Council for Children. Overall, the games stimulate plenty of conversations about risky behavior. "Often kids will just say 'I got a random text from someone in another state. What should I do?'"

What may seem to be an obvious risk to an adult isn't always so clear to a youth, especially with regard to threats that go viral across social media, and the connected laws and consequences.

"We are talking about kids who are 10 to 18, and they are not mature enough to distinguish [risks and] feelings. How do we help them make the right decisions?" says Gupta. "There is no organization teaching kids this."

This article is part of "Children of Michigan," a series on the importance of health and wellbeing for Michigan's children. It is made possible with funding from the Children's Hospital of Michigan Foundation.

All photos by Nick Hagen.
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