Abstract
Welcoming Remarks
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Abstract
Development and Validation of a Self-efficacy Theory-based Instrument to Measure Prenatal Breastfeeding Self-efficacy and Breastfeeding Intention among Pregnant Women
Erin McKinley, PhD, RD, LD, CLC, CHES, Linda Knol, PhD, RD, Lori Turner, PhD, RD, Joy Burnham, PhD, Kristine Graettinger, MD, Maria Hernandez-Reif, PhD and James Leeper, PhD
The University of Alabama, Tuscaloosa, AL
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Breastfeeding offers tremendous benefits to both the infant and mother. Individuals choose tasks they feel are within the boundaries of ability. The choice to engage in breastfeeding may be related to the level of self-efficacy a woman has to complete the task. Theoretical constructs have been operationalized to measure perceived self-efficacy for breastfeeding in pregnant populations; however, a guideline based, self-efficacy theory driven, valid, and reliable instrument is lacking. The purposes of this study were to create, test, and validate a new scale to measure prenatal breastfeeding self-efficacy, test the reliability of the scale, determine the correlation between prenatal breastfeeding self-efficacy and breastfeeding intention, and assess the differences in prenatal breastfeeding self-efficacy by the sociodemographic factors. One-hundred and twenty-four pregnant women, 18 years or older, participated in this cross-sectional survey. Confirmatory factor analysis did not confirm the proposed model; therefore, an exploratory factor analysis was conducted to examine the construct validity using maximum likelihood factor analysis with varimax rotation. This revealed a valid (α=.980) and reliable (r=0.920) four factor questionnaire for total prenatal breastfeeding self-efficacy – The Prenatal Rating of Efficacy in Preparation to Breastfeed (PREP to BF) Scale. Total PREP to BF score was significantly correlated to breastfeeding intention (r=.615; P<.001). Women who had at least some college education (P=.003), were currently married (P=.027), had breastfed previously (P=.035), and planned to deliver vaginally (P=.043) had significantly greater PREP to BF scores than their counterparts. Measuring the level of breastfeeding self-efficacy at the prenatal stage could alert prenatal women and health professionals to particular individual skill sets needed to successfully initiate breastfeeding after birth. A strong understanding of which pregnant women may or may not be at risk for non-initiation of breastfeeding may help healthcare professionals create and provide the most appropriate support to their patients.
Assessment of individual and community needs for health education Planning of health education strategies, interventions, and programs Provision of health care to the public Public health or related nursing Social and behavioral sciences
Abstract
Q&A
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Abstract
A Phenomenological Study of the Inhibitor Factors to Breastfeeding for African American WIC Participants
Francoise Knox-Kazimierczuk, PhD, RD, CSSD, LD, ATC, CSCS1, Meredith Shockley-Smith, Ph.D.2, Crystal Summers, M.S.3 and Suk-hee Kim, Ph.D., M.S.W.3
(1)University of Cincinnati, Cincinnati, OH, (2)Cincinnati Children's Hospital Medical Center, Cincinnati, OH, (3)Northern Kentucky University, NEWPORT, KY
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Barticket al.in a meta-analysis of nine pediatric and five maternal diseases reported positive relationships between all disease processes and breast feeding. Research has reported reduced risk for all of the selected pediatric diseases with breastfeeding duration's meeting the recommendation of the World Health Organization (six months exclusive breastfeeding). Despite the proven benefits, breastfeeding rates for low-income African American mothers remain far below the guidelines established by Healthy People 2020.The purpose of this qualitative research study was to explore the socio-cultural barriers and assets of breastfeeding experienced by African American mothers. In this study a phenomenological qualitative approach was used conducting focus groups and in-depth interviews. Eight African American mothers consented to participate in the study. Participants' were provided several times and locations in close proximity to their residents for focus groups and interviews. Sessions were conducted from April 2017-June 2017. Focus group and interviews used a semi-structured format and lasted for approximately 60-90 minutes.Data was analyzed using two researchers, both looked for themes within the text and the participants’ experiences relating to the salient themes were described. Participants all had experienced racial bias and micro-aggression from their healthcare providers during various stages of pregnancy and post-partum. Half of the women had experienced a traumatic birthing experience, and reported the avoidance of the healthcare system subsequently. Four main themes emerged from the experiences of the participants: (a) Healthcare provider bias, (b) Distrust/Fear, (c) Agency/Control, and (d) Support Networks. This study offers a novel approach to examining disparities in breastfeeding rates,
duration, and exclusivity through directly engaging low-income
African American mothers. Based on this qualitative data, culturally appropriate training for providers, increase in diverse providers, peer coaches, and support groups for African American women would be beneficial for African American WIC eligible women wanting to be successful at breastfeeding.
Advocacy for health and health education Assessment of individual and community needs for health education Diversity and culture
Abstract
Q&A
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Abstract
RISE: Lactation Training Model (Reclaiming, Improving and Sustaining Equity)
Catherine Sullivan, MPH, RD, LDN, IBCLC, FAND1, Stacy Davis, BS, IBCLC2, Abigail Smetana, MSN, RN, IBCLC1, Katie Wouk, MS, IBCLC3, Daina Huntley, MPH, CHES4 and Aunchalee Palmquist, PhD, MA, IBCLC5
(1)University of North Carolina at Chapel Hill, Chapel Hill, NC, (2)National Association of Professional and Peer Lactation Supporters of Color, Hockessin, DE, (3)University of North Carolina at Chapel Hill, Chapel Hill, (4)UNC Chapel Hill, Chapel Hill, NC, (5)University of North Carolina Chapel Hill- Gillings School of Public Health, Chapel Hill, NC
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
The RISE Lactation Training Model aims to solve the lack of accredited lactation consultant training programs established using an equity lens. Existing programs, led by privileged institutions, striving to provide equal access lack of attention to equity. Supporting the development of self-sustaining lactation consultant training programs at universities and colleges serving communities of color, RISE works to improve the medical lactation workforce reducing health disparities by increasing the number of IBCLCs of color.
Across three years, RISE aims to assist up to six self-sustaining programs with implementation of a Pathway 2 (P2) Training Program. A dominant culture institution with an existing accredited P2 program collaborated with a leading association supporting lactation professionals of color to provide direct technical assistance and program development. RISE programs will be adequately prepared for accreditation as a part of this model. Accreditation is a means of ensuring long-term sustainability. Additionally, partners will work with each institution’s job placement coordinator to create demand for new IBCLCs in the community, improving job placement and increasing economic growth.
By targeting the healthcare infrastructure and elevating the IBCLC profession, RISE will affect all aspects of the community. This model empowers lactation leaders to better support families with shared, lived experiences to reclaim breastfeeding practices, undermined due to racial oppression. Programs in communities of color have the ability to enhance job training and didactic education enabling the lactation workforce to provide care in their communities of origin supporting equity.
Diversity and culture Implementation of health education strategies, interventions and programs Other professions or practice related to public health Provision of health care to the public Public health or related education
Abstract
Q&A
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Abstract
Promoting and Supporting Breastfeeding in the Hospital: Factors Associated with Breastfeeding Cessation at One Month among WIC ParticipantsPromoting and Supporting Breastfeeding in the Hospital: Factors Associated with Breastfeeding Cessation at One Month among WIC Participants
Alexis Barr, PhD, MS1, Taylor Livingston, PhD, IBCLC2, Ellen Schafer, PhD, MPH, MCHES3, Regina Roig-Romero, MPH, MCHES, IBCLC2, Maret Wachira, IBCLC4 and Stephanie Marhefka, PhD2
(1)Carolina Global Breastfeeding Institute, Tampa, FL, (2)University of South Florida, College of Public Health, Tampa, FL, (3)Boise State University, Boise, ID, (4)Florida Department of Health in Citrus County, Lecanto, FL
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Introduction: Among low-income U.S. women, low breastfeeding initiation and duration rates are a public health concern. Despite policies to address the economic, social, and political systems that facilitate continued breastfeeding, many women stop breastfeeding before one month postpartum. This study examines modifiable factors in these systems, particularly those that may affect 1-month breastfeeding outcomes among WIC participants and determine whether factors vary by race/ethnicity.
Methods: Data from WIC Infant and Toddler Feeding Practices Study II, a longitudinal study collected 2013 to 2015, were analyzed using multivariable logistic regression.
Results: Among 1,104 Black/African-American women, factors associated with breastfeeding cessation at one month include: perception of delayed onset of Lactogenesis II (PDOL-II) (aOR=2.11, 95%CI:1.08-4.11) and formula supplementation before hospital discharge (aOR=22.2, 95%CI:5.14-95.9). Among 2,566 White women, factors associated with breastfeeding cessation at one month include: PDOL-II (aOR=2.09, 95%CI:1.19-3.65), hospital gift packs with formula (aOR=2.44, 95%CI:1.31-4.52) and formula supplementation before hospital discharge (aOR=4.49, 95%CI:2.18-9.28). Among 1,653 Hispanic/Latina women, factors associated with breastfeeding cessation at one month include: breastfeeding problems in hospital (aOR=1.36, 95%CI:1.01-1.84) and formula supplementation before hospital discharge (aOR=5.14, 95%CI:3.60-7.30).
Discussion: This study suggests possible modifiable factors and priority populations to address in breastfeeding interventions. For all women, interventions should examine why breastfed infants are receiving formula prior to leaving the hospital. This is particularly crucial for Black/African-American women, who are 22 times more likely to stop breastfeeding if formula supplementation occurred before hospital discharge. Also, Black/African-American and White women should be educated on human milk production. Policies are needed to mandate that hospitals uphold the WHO International Code of Marketing of Breastmilk Substitutes or face repercussions. Findings suggest a need for high quality and culturally appropriate breastfeeding assistance in hospitals for continued breastfeeding. Efforts to improve duration should not take a one-size-fits-all approach, but should be tailored for each priority population.
Advocacy for health and health education Assessment of individual and community needs for health education Planning of health education strategies, interventions, and programs Public health or related education Public health or related organizational policy, standards, or other guidelines Social and behavioral sciences
Abstract
Q&A
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Abstract
Discussion
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)