240604 Association of Women, Infant, and Children (WIC) Peer Counselor Interventions with Breastfeeding in Texas

Monday, October 31, 2011: 5:06 PM

Lisa Ann Campbell, DNP-PHN, RN GNP-BC , Primary Care/Public Health, University of Tennessee Health Science Center, Memphis, TN
Patricia M. Speck, DNSc, FNP-BC, FAAN , Primary Care/Public Health, University of Tennessee Health Science Center College of Nursing, Memphis, TN
Jim Wan, PhD , Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
Marion Donohoe, DNP CPNP , College of Nursing, University of Tennessee Health Science Center, Memphis, TN
Gita Mirchandani, PhD, MPH , Office of Program Decision Support, Texas Department of State Health Services, Austin, TX
Margaret T. Hartig, PhD, FNP-BC , Department of Primary Care and Public Health, University of Tennessee Health Science Center College of Nursing, Memphis, TN
Background: Breastfeeding rates in the United States are lower than national goals particularly in low-income women, women with less than a high school education, and women from minority populations. Utilization of peer counselors among populations with the greatest disparities has been shown to increase breastfeeding rates. Breastfeeding rates in Texas WIC mothers are well below the national WIC breastfeeding rates. The 2009 Texas WIC Infant Feeding Practices Survey, reported that 73.4% of mothers initiated breastfeeding, 29.3% reported breastfeeding for six months or longer, and 11.3% breastfed for twelve months or longer. Purpose: The purpose of the study is to determine which WIC peer counselor interventions influence mothers to breastfeed in Texas.

Methods: The study uses a cross-sectional design to determine which Texas WIC peer counselor interventions were associated with mothers' decisions to breastfeed. Analysis of de-identified data was restricted to mothers who have not breastfed before or are first time mothers. Odds ratios with associated confidence intervals and P values were calculated for each of the seven possible peer counselor intervention combinations.

Results: A total of 57.8% of the surveys (n=3,173) met the study inclusion criteria. Of the seven possible peer counselor interventions five were associated with increased breastfeeding, OR (1.28-1.93) and P values (.000-.002). The peer counselor interventions that were associated with the mothers being more likely to breastfeed were; during pregnancy, hospitalization, after delivery and in combination were; during pregnancy, hospitalization, and after delivery, and during pregnancy and after delivery. Discussion/Recommendations: Peer counseling implemented during the prenatal and perinatal period is a viable activity shown to increase breastfeeding rates in women who are vulnerable due to income, education, and race. Comprehensive examination of WIC's data may support evidence based interventions, additional areas of program effectiveness and improve program funding.

Learning Areas:
Public health or related nursing
Public health or related research

Learning Objectives:
Identify 3 out of the 5 WIC peer counselor interventions that increase breastfeeding rates among enrolled mothers.

Keywords: Breast Feeding, Infant Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator for this project. I have taught nursing and medical students, given several presentations at conferences, and authored several articles. Recently I have been selected to be an interdisciplinary team member for the UTHSC Memphis Clarion Case Competition in April.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.