Sophie's KISS: Keeping Infants Safe and Secure

According to the Missouri Department of Health, from 2000-2013, there were 15 hyperthermia-related deaths among children aged five years and younger in Missouri (4% of all hyperthermia-related deaths).[1] Hyperthermia-related deaths among this age group most often occur when temperatures are high and children are accidentally left in a vehicle. In 2011, the American Academy of Pediatrics recommended parents keep children in rear-facing car seats until age two.[2] This recommendation increases the probability of unintentional hyperthermia deaths in young children since rear facing seats make it more difficult for parents to see their child while they are driving.

After the tragic loss of a pediatrician’s baby—Sophie—due to hyperthermia, the Sophie’s KISS (Keeping Infants Safe and Secure) initiative was created by safety experts at St. Louis Children’s Hospital. The goal was to promote infant safety by raising parent awareness about the dangers of leaving their child unattended. This initiative is implemented as part of Safety Stop, an evidence based safety program within St. Louis Children’s Hospital, a nationally recognized pediatric hospital, and is funded through the St. Louis Children’s Hospital Foundation.

While at Safety Stop, expectant parents and families with a child under age 2 are told Sophie’s story and receive materials during their car seat consultation by certified child passenger safety technicians. Materials include: 1) a heart-shaped red carabineer with a long yellow ribbon that fits on the car seat and then is intended to be attached to the parent’s key ring while driving as a reminder that their child is in the car and 2) a tips card with ideas for developing safety routines to prevent child hyperthermia. One to two weeks later, participants are sent a survey consisting of ten questions designed to capture program material usefulness, knowledge of educational components, and whether the information was shared with others.

References

1. Data & Statistical Reports | Hyperthermia | Health & Senior Services. Healthmogov. 2017. Available at: http://health.mo.gov/living/healthcondiseases/hyperthermia/data.php. Accessed February 2, 2017.

2. AAP Updates Recommendation on Car Seats. Aaporg. 2017. Available at: https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Updates-Recommendation-on-Car-Seats.aspx. Accessed February 2, 2017.

The goal of Sophie’s KISS is to increase education and awareness among parents regarding hyperthermia to reduce the incidence of children left in cars.

The program is successful in delivering life-saving knowledge and in diffusing the message of Sophie’s KISS through many channels.

The evaluation of Sophie’s KISS is a post-test only, single group design. Responses from 634 participants were collected using electronic and phone survey methods from January 2010 to December 2016. 1458 individuals were exposed to the program, but not all participants responded to the survey (43.5% response rate).

Results since 2010 indicate that the materials developed for the program are considered helpful by parents. 35% (N=215) said the tips card was the most helpful program material, while 18% (N=111) said the reminder carabineer/ribbon was most helpful. 21% (N=130) responded that both were helpful, but this response option wasn’t added until 2012. Only a small proportion of participants since 2010 have responded that neither program material was helpful (8%; N=50).

56% (N=351) of respondents said they have used the reminder carabineer/ribbon, and 22% of all survey respondents (N=137) reported that they use the reminder bracelet either always or most of the time. A quarter of participants also said they were very likely or likely to use the reminder bracelet in the future. Program materials were developed at a low cost, and they act as a helpful reminder to parents. One parent responded to an open ended question that “The memory device is a great reminder for my husband and me to have. We really like the constant reminder of our child in the backseat!”

71% (N=457) of participants said it was likely - ranging from somewhat likely (31%) to very likely (40%) – that Sophie’s story changed their perception of how easy it is to leave their child in the car unintentionally. One participant lamented on the tragedy behind the Sophie’s KISS program in the open ended section of the survey, and said “none of us are immune to simple human errors, and their consequences can be devastating.” Additionally, since 2010, 29% (N=181) said that Sophie’s KISS definitely yes or probably yes helped them remember their child when they might have forgotten.

Results also indicate that the program impacts parental behaviors. 65% (N=417) of parents said they developed a safety routine following exposure to the initiative. 99% (N=634) of participants responded to the question, “How long can you safely leave your child alone in a car?” correctly by answering not even for a minute. Participants overwhelmingly responded that they shared what they learned from Sophie’s KISS with others. Most participants (84%) shared with their spouses, family members, friends, co-workers, or caregivers or a combination of those people.

Since 2010, the Sophie’s KISS program has successfully achieved its goal of helping parents and caregivers to better understand the dangers associated with leaving a child in a car unattended, even for a minute, and to fully appreciate the importance of always remembering when their child is in the backseat. The core elements of Sophie’s KISS (reminder carabineer/ribbon and tips card) can be easily replicated at a low cost and retained by other organizations in pediatric settings to increase the reach of awareness about hyperthermia-related deaths.