Community-based participatory research (CBPR) approach to understanding and addressing breastfeeding support among African American women

Background: Lack of support for breastfeeding mothers has been consistently identified in the literature as a barrier for breastfeeding across racial and ethnic groups. Through funding provided by NIH, Academic and community-based partners conducted an iterative process to assess barriers, facilitators and potential mediating interventions for breastfeeding in the African-American community in Durham, NC.

Methods: Following a literature review and assessment of existing data, eight focus groups were conducted with African-American mothers, fathers and grandmothers. Researchers transcribed and coded each focus group and analyzed using Atlas ti. 5.2. Patterns and themes that emerged informed the development of key informant interviews; 41 were conducted with community stakeholders. These findings informed the development of the support group pilot. The pilot support groups were evaluated for acceptability and for increase in knowledge of attendees.

Findings: Focus groups and key informant interviews indicate that African-Americans may disproportionately experience inadequate support for breastfeeding. This lack of support was reported in the home, the workplace, among peers, and from health care providers. A pilot intervention of support groups for breastfeeding African-American women emerged as the preferred intervention among community partners. The findings from the support groups will be presented and will serve as a foundation for continued community-based partnership in identifying resources for sustaining programs to support breastfeeding among African-American women.

Discussion and Conclusions: There is increasing recognition of the value of CBPR in solving public health challenges. MCH providers seeking to increase breastfeeding would likely benefit from learning of community-identified strategies for increasing breastfeeding.