{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T19:59:51Z","timestamp":1782503991335,"version":"3.54.5"},"reference-count":25,"publisher":"American Public Health Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:p> Objectives. To evaluate the impact of the Southern Public Health Regions\u2019 (Regions IV and IV) Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality, supported by the US Health Resources and Services Administration. <\/jats:p><jats:p> Methods. We examined pre\u2013post change (2011\u20132014) 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. <\/jats:p><jats:p> Results. For 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. <\/jats:p><jats:p> Conclusions. The 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. <\/jats:p>","DOI":"10.2105\/ajph.2018.304371","type":"journal-article","created":{"date-parts":[[2018,4,19]],"date-time":"2018-04-19T19:58:01Z","timestamp":1524167881000},"page":"815-821","source":"Crossref","is-referenced-by-count":15,"title":["The Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality: An Outcome Evaluation From the US South, 2011 to 2014"],"prefix":"10.2105","volume":"108","author":[{"given":"Ashley H.","family":"Hirai","sequence":"first","affiliation":[{"name":"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."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Sappenfield","sequence":"additional","affiliation":[{"name":"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."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem M.","family":"Ghandour","sequence":"additional","affiliation":[{"name":"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."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Donahue","sequence":"additional","affiliation":[{"name":"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."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Lee","sequence":"additional","affiliation":[{"name":"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."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Lu","sequence":"additional","affiliation":[{"name":"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."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"bib2","volume-title":"The US Infant Mortality Rate: International Comparisons, Underlying Factors, and Federal Programs","author":"Heisler EJ","year":"2012"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2017.303689"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2013.12.006"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-016-2235-2"},{"key":"bib6","volume-title":"The Breakthrough Series: IHI\u2019s Collaborative Model for Achieving Breakthrough Improvement","year":"2003"},{"key":"bib7","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780195304121.001.0001"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2012.01.022"},{"key":"bib10","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.302533"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1177\/003335491513000108"},{"issue":"2","key":"bib14","first-page":"1","volume":"62","author":"Martin JA","year":"2013","journal-title":"Natl Vital Stat Rep"},{"key":"bib15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2006.00016.x"},{"key":"bib16","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-0860"},{"key":"bib17","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-010-0566-y"},{"key":"bib18","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12376"},{"issue":"9","key":"bib21","first-page":"1","volume":"64","author":"Matthews TJ","year":"2015","journal-title":"Natl Vital Stat Rep"},{"key":"bib22","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2013.07.009"},{"key":"bib24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.05.036"},{"key":"bib25","volume-title":"Using Education, Collaboration, and Payment Reform to Reduce Early Elective Deliveries: A Case Study of South Carolina\u2019s Birth Outcomes Initiative","author":"Perelman N","year":"2013"},{"key":"bib26","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6544a2"},{"issue":"5","key":"bib27","volume":"138","author":"American Academy of Pediatrics","year":"2016","journal-title":"Pediatrics"},{"key":"bib29","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.12.011"},{"key":"bib31","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.13381"},{"key":"bib32","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13396"},{"key":"bib33","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2013.166"},{"key":"bib34","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001737"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.2018.304371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T23:24:05Z","timestamp":1652138645000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.2018.304371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.2105\/AJPH.2018.304371"],"URL":"https:\/\/doi.org\/10.2105\/ajph.2018.304371","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6]]}}}