Pēpi-Pod® Program Data Record (AUSTRALIA)
INSTRUCTIONS
This is the online version of the paper form that you use to record Pēpi-Pod® distribution and follow-up information. It supports your agency to monitor and evaluate your Pēpi-Pod® service and show a value to funders for the work. This is a confidential record. Some information from the paper form is not required on this electronic version.
1. DISTRIBUTION: Complete the information below for each Pēpi-Pod® (or other 'in-bed capable' sleep space) given out.
2. FOLLOW-UP: Make follow-up contact when babies are 6-8 weeks (by text, phone or in a face to face session).
ASK
a) Does or did your baby
sleep in the Pēpi-Pod®?
b) Do you want to keep it to use yourself or share with others?
c) How many people have you spoken with so far about safe sleep for babies?
d) Ask the infant protection questions listed.
3. DATA ENTRY: Transfer all required information from paper forms to this online form.
Use the tab key to move to the next response. All fields are required. (Updated 27 June 2022)