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What works to promote breastfeeding policies in hospitals, community clinics, worksites, child care settings and at the state-level?
Methods: We used a mixed methods approach to collect and analyze data from a) interviews with key informants in policy processes at community clinics (including WIC), hospitals, child care, worksites, breastfeeding coalitions, and state policymaking, b) policy process documents, and c) media coverage. The Advocacy Policy Framework, Geenhalgh’s Diffusion of Innovations Framework, and Berkeley’s Messaging Frames guide the analysis. We collected data on specific evidence-based policies and practices (baby-friendly, 10 Steps).
Results: We conducted 130 interviews and collected documents and media across sectors. An average of 9.0, 7.94, 7, and 7.87 of the 10 steps are implemented across hospitals, clinics, worksites and child care settings, respectively. Facilitators of breastfeeding policies include leadership support, champions, alignment with mission and values, and economic benefits. Personal beliefs and experience with breastfeeding have a strong influence on policy processes. Norms and messaging around personal choice and rights, individual responsibility, government regulation, limited resources, and formula marketing were identified as key barriers.
Conclusions: MCH leaders can use these findings to improve policies, practices, and environments as part of comprehensive approaches to increasing breastfeeding rates and reducing disparities.
Learning Areas:
Advocacy for health and health educationImplementation of health education strategies, interventions and programs
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Public health or related public policy
Learning Objectives:
Identify evidence-based practices and policies to support breastfeeding in hospitals, community clinics, worksites, child care settings and at the state-level (legislation and administrative codes).
Describe several theoretical frameworks (Advocacy Coalition Framework, Greenhalgh’s Diffusion of Innovations, Berkeley’s Messaging Frames around Breastfeeding).
Compare factors that support and hinder the adoption and implementation of evidence-based breastfeeding practices and policies within and across sectors.
Compare factors that support and hinder the adoption and implementation of evidence-based breastfeeding practices and policies by demographics of interview respondents and population served by each organization.
Identify strategies that your community can use to promote the development, adoptions, implementation and maintenance of breastfeeding policies and practices.
Keyword(s): Breastfeeding, Public Health Policy
Qualified on the content I am responsible for because: I have been involved with this specific research project as a research assistant and research coordinator since Sept 2014, which included conducting interviews, managing data storage, coding and analyzing data, and writing reports. My research interests include nutrition, implementation and dissemination, organizational policies to promote health, and early care and education.
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.