241053 Accentuating the positive: Community solutions to breastfeeding in New Orleans

Wednesday, November 2, 2011

Ashley Martin, MPH , Mary Amelia Douglas-Whited Community Women's Health Education Center, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
Lauren Futrell Dunaway, MPH, RD , Mary Amelia Douglas-Whited Community Women's Health Education Center, Tulane University, New Orleans, LA
Stacey C. Cunningham, MS , School of Public Health, Community Health Sciences, Tulane University, New Orleans, LA
Katherine P. Theall, PhD , Global Community Health and Behavioral Sciences, Tulane University School of Public Health, New Orleans, LA
Jeanette H. Magnus, MD, PhD , Community Health Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
In Louisiana only 56.6% of infants are ever breastfed, well below the national average of 75%1. Less than a third of African-American women in LA initiate breastfeeding2. Rates of infants still being breastfed at 6 months are even lower1. Risk factors for not breastfeeding include being a recipient of WIC or having low education or SES levels2. Researchers often focus on the barriers to breastfeeding but what can be learned from mothers who are overcoming them? Why are their behaviors different? Positive deviants are those who, despite being at risk, engage in beneficial practices and experience better outcomes than their neighbors with similar risks3. The positive deviance approach offers an alternative to needs-based approaches by looking at local solutions to overcoming barriers. The Mary Amelia Women's Health Education Center initiated a project to explore the use of surveys to identify positive deviants (PDs) for breastfeeding among a population at high risk for not initiating or continuing breastfeeding. We created and tested a survey tool to identify women who reported breastfeeding. Women at two pre-postnatal sites serving the uninsured, urban population in New Orleans were surveyed using our tool. We have successfully identified women who breastfeed despite risk factors. These women will participate in our Positive Deviance Inquiry (PDI) to identify coping mechanisms and behaviors that enable them to breastfeed. Findings from the project will be used to develop culturally appropriate breastfeeding programs.

Learning Areas:
Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
1. Discuss the benefits of a positive deviance approach to breastfeeding. 2. Define Positive Deviance Inquiry (PDI). 3. Identify three challenges of developing and implementing a culturally appropriate survey tool that successfully identifies individuals with positive deviant behaviors.

Keywords: Breastfeeding, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee such programs as training grants, breastfeeding projects, and conduct research on various women's health topics.
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.