Lessons from designing a campaign to address infant mortality among urban American Indians and Alaska Natives

Background: The majority of American Indians and Alaska Natives (AI/ANs) reside in urban areas and experience disproportionate risks to maternal and child health (MCH) compared to the general population, as well as high rates of infant mortality (IM). The Seattle Indian Health Board's Urban Indian Health Institute, with funding from the Office of Minority Health, is developing a pilot campaign to address IM among urban AI/ANs. Methods: Project activities include: 1) Review of IM data, including causes and risk factors, previous prevention efforts, and communication campaigns for AI/ANs; 2) Discussions with young AI/AN parents at urban Indian health organizations (UIHO) about keeping babies healthy and safe, and 3) Development, piloting and evaluation of communication materials based on initial project findings. Results: Urban AI/ANs have unique experiences with regard to healthcare access, cultural identity and support systems, which closely correlate with MCH outcomes. Our study findings suggest a lack of social support as a significant barrier to keeping babies healthy and safe. Findings additionally point to identification with native culture as a facilitating factor for healthy behaviors. Based on these findings, we created a short video to help increase awareness of IM rates and MCH needs among urban AI/ANs and UIHO as native-specific resources for support and community connection. Conclusions: Critical formative research identified themes relevant to urban AI/ANs in addressing IM. A short video was created as a campaign tool, which incorporates these themes. Future efforts will examine the salience of the messages with AI/ANs in different settings nationwide.