Improving engagement with services to prevent Sudden Unexpected Death in Infancy (SUDI) in families with children at risk of significant harm: A systematic review of evidence

Abstract

This paper reports part of a wider systematic review commissioned by the English National Safeguarding Panel on Sudden Unexpected Death in Infancy (SUDI). The wider review covered three areas: interventions to improve safer sleep practices in high‐risk families, interventions to improve engagement with services and decision making by parents at high risk of SUDI about infant sleep environments. Here, we report the qualitative and quantitative studies reviewed under the engagement strand. Parental engagement is understood to be a multidimensional task for health and social care professionals comprising attitudinal, relational and behavioural components. Following a PROSPERO registered systematic review synthesizing the three strands outlined, 28 papers were found to be relevant in the review of interventions to improve engagement with services in families with children at risk of significant harm through abuse or neglect. No studies were found that specifically focused on engagement of families at high risk for SUDI, so these wider engagement studies were included. The different types of intervention reported in the included studies are described under two broad themes: Enablers (including parental motivation and working with families) and Barriers. Given the focus in the studies on interventions that support parental engagement, the Enablers theme is more extensive than the Barriers reported although all studies noted well‐understood barriers. The evidence underpinning these interventions and approaches are reviewed in this paper. We conclude that effective engagement is facilitated by experienced professionals given time to develop supportive non‐judgemental relationships with families in their homes, working long‐term, linking with communities and other services. While these conclusions have been drawn from wider studies aimed at reducing child maltreatment, we emphasize lessons to be drawn for SUDI prevention work with families with children at risk of significant harm.

Risk of Postneonatal Infant Mortality Associated With Prior Founded Allegations of Child Abuse

“…While pre-training knowledge of safe sleep recommendations was low among the CPS staff, their knowledge improved significantly post-training which increased their engagement in training other CPS staff. Clinicians also play a role in identifying infants from families with a history of child abuse, and referring at-risk families for appropriate interventions, including linking them with community resources (Garstang et al, 2021), to help reduce the incidence of potentially preventable infant deaths. A recent report from England and Wales recommends a “prevent and protect” practice model that would include multi-agency action to address predisposing risk factors for SUID among high-risk families and targeted support for families with additional needs (The Child Safeguarding Practice Review Panel, 2020).…”

Human rhinovirus and respiratory syncytial virus genotypes in Sudden Unexpected Death in Infancy (SUDI) cases at Tygerberg Hospital, Cape Town, South Africa

“…SUDI is defined as the sudden and unexpected death in an infant with no clinical signs suggesting possible illness up to two days prior to death [54,55]. These cases are mandated to undergo a medico-legal investigation in South Africa to determine the cause of death.…”

Interventions to Improve Safer Sleep Practices in Families With Children Considered to Be at Increased Risk for Sudden Unexpected Death in Infancy: A Systematic Review

“…The second National Child Safeguarding Practice Review (NCSPR) (18) focused on the occurrence of SUDI in families where children were considered to be at risk of abuse or neglect, aiming to identify the most effective methods for professionals to provide effective support to ensure that safer sleep advice can be clearly understood and embedded. As part of their work, the NCSPR Panel commissioned a systematic review in three key areas (19): (1) interventions to improve engagement with support services (20), (2) improving our understanding of parental decision-making processes related to the infant sleep environment (21), and (3) the evidence on interventions for improving the uptake of safer sleep advice, which is the subject of this paper.…”