Provider Training and Breastfeeding: Impact of the Carolina Child Care Ten Steps and job-aids

Background: An innovative approach to training providers to support breastfeeding was presented at APHA last year. It includes one hour of discussion of myths, attitudes, and concerns, followed by one hour on the use of materials for parents and for the centers. This approach has now been assessed for impact. Methods: Baseline and follow-up surveys were used to assess the change in knowledge, attitudes and practices. The survey and the training were built around the Carolina Ten Steps and the related materials developed for provider and parents. In addition, a follow-up visit was made to the Child Care center to assess change using an instrument designed for this purpose. All data were entered into Epi-info and then downloaded to Stata for descriptive and comparative analyses. The impact of early trainings is compared to the impact of later trainings. Findings: Final analyses, which will include about 225 per group, will be presented. Preliminary analyses of the training found universal improvements from pre-to post test in knowledge and attitudes. KAP data on about 200 per group found significant improvements in intervention group responses regarding: 1) feeding cereal in bottles; 2) need to wear gloves when handling formula ; 3) need to wear gloves when handling mother's milk; and 4) whether the mother needs a good diet to breastfeed. These suggest a significant impact of the training and materials. Conclusions: The training developed for the Carolina Ten Step approach resulted in increased knowledge and changes in practices at the Child Care Centers.