91̽��

A research team at WMU Homer Stryker M.D. School of Medicine (91̽��) has  demonstrating the value of family interviews in the Fetal and Infant Mortality Review (FIMR) process. 

FIMR provides public health surveillance by analyzing fetal and infant mortality rates, identifying the socio-ecological context and causes of death, and developing strategies and promoting action to prevent new deaths.  

Although there has been strong motivation for incorporating family interviews into the FIMR process, and important potential for expanding it to other types of reviews, there has been limited evidence that family interviews make a difference in review team outcomes. 

Until now. 

The study led by the team from 91̽��, “Family Interviews Improve Health Service Recommendations in Mortality Review Process: A Mixed-Methods Assessment,” provides compelling evidence that family interviews “serve a central function in identifying system gaps and generating community‐informed, practical solutions.” 

“Oftentimes we think, OK, we have medical records; we have (all) the information we need,” said Fernando Ospina, PhD, assistant professor in the Department of Biomedical Sciences at 91̽�� and a co-author of the study “But the family interviews suggest that, no, there's actually missing information, there's important information that we're not getting, and one of the ways that you get that information is through talking to people who have gone through the experience. Quantitative data is not enough. You also need qualitative data so you can have additional context to further understand issues.” 

The study, published in Health Expectations, examined 158 FIMR cases in Kalamazoo County from 2015 to 2023. Of those, 53 cases (33 percent) included a family interview. 

Comparing cases that included a family interview with those that did not, researchers found that family interviews were associated with increased identification of stressors, particularly medical and socioeconomic factors. Moreover, family interviews were associated with a 40 percent increase in recommendations generated, including significantly more recommendations related to medical provider communication and bereavement. 

“FIMR’s greatest impact is that it provides actionable recommendations that lead to policy change and community services improvement, ultimately leading to better maternal, infant/child and family health,” said Rosemary Fournier, former national director of the FIMR program at the National Center for Fatality Review and Prevention and co-author of the study. “The value of the family interviews cannot be understated. It is the voices and stories of the women impacted by infant and fetal death that truly helps providers to understand the root causes of fetal and infant mortality. Stories change hearts and minds where mere statistics may leave matters unchanged.” 

Ultimately, the researchers believe this study has shown the value of family interviews in the FIMR process as something worth supporting, investing in, and even potentially expanding into other types of death review. 

“We want people to see the value in family interviews and then support that effort,” said Ruth Butters, population health research coordinator at 91̽�� and co-author of the study. “People with lived experience should be part of the conversation when making improvements or changes, and that needs to be done in a way that honors the humanity of those individuals.”