{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T19:53:43Z","timestamp":1794599623277,"version":"4.9.1"},"reference-count":24,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>We sought to implement and determine the efficacy of Cradle Cincinnati\u2014a county-level collective impact collaborative established to reduce the infant mortality rate (IMR) of Hamilton County, Ohio. We hypothesized that the reduction in the IMR of Hamilton County was attributable to the work of Cradle Cincinnati.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Cradle Cincinnati, conceptualized in the early 2000s and iteratively implemented in the ensuing decades, emphasizes stakeholder engagement, data-driven learning, and community-led strategies to address infant mortality. To determine efficacy, we employed augmented synthetic control methodology to create a synthetic Hamilton County unexposed to Cradle Cincinnati using county-level data from Ohio in the years 2007 to 2023, with change in county-level IMR in the real Hamilton County compared to a synthetic unexposed Hamilton County as the outcome of interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Hamilton County IMR decreased from 11.1 (per 1000 livebirths) in 2008 to 5.5 in 2023. Real Hamilton County IMR progressively decreased over time compared to that of a synthetic Hamilton County unexposed to Cradle Cincinnati, reaching statistical significance in 2021 and 2023 (change in deaths per 1000 live births: \u22122.5 [95% CI: \u22125.1 to \u22120.3] and \u22124.4 [95% CI: \u22126.6 to \u22122.0], respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Cradle Cincinnati significantly reduced infant mortality in a large urban Ohio county, with the greatest improvements emerging nearly a decade after implementation. A county-level focus offers potential to reduce the disproportionately high and racially disparate IMR in the United States.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2026-077116","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:02:36Z","timestamp":1789603356000},"source":"Crossref","is-referenced-by-count":1,"title":["A County-Level Collaboration to Reduce Infant Mortality: Cradle Cincinnati"],"prefix":"10.1542","volume":"158","author":[{"given":"John","family":"Feister","sequence":"first","affiliation":[{"name":"1University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, Ohio"},{"name":"2Cincinnati Children\u2019s Hospital Medical Center, Perinatal Institute, Division of Neonatology and Pulmonary Biology, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shixuan","family":"Wang","sequence":"additional","affiliation":[{"name":"3University of Cincinnati, Department of Mathematical Sciences, Division of Statistics and Data Science, Cincinnati, Ohio"},{"name":"4Cincinnati Children\u2019s Hospital Medical Center, Division of Biostatistics and Epidemiology, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Walker","sequence":"additional","affiliation":[{"name":"2Cincinnati Children\u2019s Hospital Medical Center, Perinatal Institute, Division of Neonatology and Pulmonary Biology, Cincinnati, Ohio"},{"name":"5Cradle Cincinnati, Cincinnati Children\u2019s Hospital Medical Center, Perinatal Institute, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Webken","sequence":"additional","affiliation":[{"name":"2Cincinnati Children\u2019s Hospital Medical Center, Perinatal Institute, Division of Neonatology and Pulmonary Biology, Cincinnati, Ohio"},{"name":"5Cradle Cincinnati, Cincinnati Children\u2019s Hospital Medical Center, Perinatal Institute, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Huang","sequence":"additional","affiliation":[{"name":"1University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, Ohio"},{"name":"3University of Cincinnati, Department of Mathematical Sciences, Division of Statistics and Data Science, Cincinnati, Ohio"},{"name":"4Cincinnati Children\u2019s Hospital Medical Center, Division of Biostatistics and Epidemiology, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Kelly","sequence":"additional","affiliation":[{"name":"2Cincinnati Children\u2019s Hospital Medical Center, Perinatal Institute, Division of Neonatology and Pulmonary Biology, Cincinnati, Ohio"},{"name":"5Cradle Cincinnati, Cincinnati Children\u2019s Hospital Medical Center, Perinatal Institute, Cincinnati, Ohio"},{"name":"6University of Cincinnati College of Medicine, Department of Obstetrics and Gynecology, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"1University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, Ohio"},{"name":"2Cincinnati Children\u2019s Hospital Medical Center, Perinatal Institute, Division of Neonatology and Pulmonary Biology, Cincinnati, Ohio"},{"name":"5Cradle Cincinnati, Cincinnati Children\u2019s Hospital Medical Center, Perinatal Institute, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"2026100508163126600_r1","volume-title":"Leading Health Indicators 2030: Advancing Health, Equity, and Well-Being","author":"National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Informing the Selection of Health Indicators for Healthy 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