Reactions of Low-Income African American Women to Breastfeeding Peer Counselors (original) (raw)
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Maternal and child health journal, 2016
Objectives To explore African American women's breastfeeding thoughts, attitudes, and experiences with healthcare professionals and subsequent influences on their breastfeeding interest and behavior. Insight was also sought about the most effective practices to provide breastfeeding support to African American women. Methods Thirty-eight pregnant or lactating African American women and racially diverse health professionals were recruited and participated in one of six membership specific focus groups in the metro Detroit area. An experienced focus group facilitator who was African American woman served as the primary group facilitator, using a semi-structured guide to discussions. Focus groups explored perceptions of personal and professional roles and behaviors that support African American women's breastfeeding behavior. Discussions were digitally recorded and audiotapes were transcribed. Thematic content analysis was conducted in combination with a review of field notes. ...
BMC Pregnancy and Childbirth
Background One approach for improving breastfeeding support and alleviating breastfeeding disparities is the implementation of a clinic-based peer counselor. Our objective was to assess the “real life” effects of an autonomous peer counselor who provides tailored support to low-income, minority women based on individual needs rather than a pre-determined research protocol. Methods This is a secondary analysis of a prospective cohort study of women receiving publicly funded prenatal care during the 6 months before and after introduction of a peer counselor in a single prenatal clinic. The peer counselor provided one-on-one antenatal and postpartum lactation support. Electronic medical record and survey data were collected. The primary outcome was breastfeeding continuation at 6 weeks postpartum. Secondary outcomes included breastfeeding comfort, confidence, and training satisfaction, any breastfeeding, and total breastfeeding duration. Bivariable and multivariable analyses were perfo...
Women, Infant and Children (WIC) Peer Counselor Contact with First Time Breastfeeding Mothers
Public Health Nursing, 2014
Objective: This study was designed to determine whether singleton women who had not previously breastfed and who had a women, infant and children (WIC) peer counselor were more likely to initiate breastfeeding than women not exposed to the WIC peer counselor. Design and Sample: The retrospective cross-sectional study used data from the 2009 Texas Department of State Health Services (DSHS) WIC Infant Feeding Practices Survey (IFPS) administered through 73 local WIC agencies. Of the 5,427 responses to the 2009 Texas DSHS WIC IFP Survey, 56.6% (N = 3,070) were included in this study. Measures: The Texas DSHS WIC IFPS, a 55-item survey with multiple-choice and two open-ended questions, was used to evaluate breastfeeding beliefs, attitudes, and practices among women receiving WIC services. Results: Women who had peer counselor contact during pregnancy, in the hospital, and after delivery were more likely to initiate breastfeeding than women without such contacts, OR = 1.36, 2.06, 1.85, respectively. Conclusion: Womens decision to initiate breastfeeding is significantly associated with WIC peer counselor contacts. Continued WIC peer counselor program services may increase breastfeeding initiation rates among WIC participants.
Journal of human lactation : official journal of International Lactation Consultant Association, 2015
Whereas breastfeeding initiation rates have risen in all groups throughout the country, rates of breastfeeding duration have changed more slowly. Peer counseling has had some success in sustaining breastfeeding, but with intensive programs and variable effects. We aimed to improve rates of any and exclusive breastfeeding at 1 and 6 months using a low-intensity peer counseling intervention beginning prenatally. We also planned to study the interaction of breastfeeding attitude and self-efficacy with the intervention. One hundred twenty prenatal women underwent stratified randomization based on breastfeeding attitude, measured by the Iowa Infant Feeding Attitude Scale (IIFAS). The peer counselor contacted the intervention group by telephone or in clinic up to 4 months postdelivery. Study groups were compared on breastfeeding outcomes, adjusting for IIFAS strata, and on interactions with self-efficacy. One hundred three women were followed to at least 1 month. Women with positive attit...
Black Fathers’ Views on Breastfeeding Facilitators, Barriers, and Support Services: Insights From a Qualitative Community-Based Participatory Research Study , 2024
Despite the persistence of breastfeeding racial and ethnic disparities in the United States, little is known about Black fathers' perceptions of breastfeeding and breastfeeding support services (e.g., maternity hospital-based care and lactation management care). This qualitative, community-based participatory research study reports Black fathers' perceptions of barriers and facilitators to breastfeeding, including the provision of breastfeeding support services in Connecticut. A focus group guide was co-developed with community partners and adapted from the Barrier Analysis Tool to identify breastfeeding facilitators, barriers, and service improvement areas. Four focus groups were conducted with 30 Black fathers who were Connecticut residents with a child under 3 years old. Qualitative data were analyzed using rapid template analysis involving deductive and inductive coding. We identified factors influencing breastfeeding and fathers' ability to support breastfeeding across all levels of the Socio-Ecological Model. Facilitators included high paternal breastfeeding knowledge, paternal breastfeeding involvement, parents' shared decision-making, extensive maternity hospital discharge support, ongoing breastfeeding support into the postnatal period, availability of community breastfeeding resources, and designated spaces for public breastfeeding. Barriers included low paternal breastfeeding knowledge, familial discouragement, insufficient prenatal breastfeeding education, exclusion of the father from breastfeeding support services, and stigma against breastfeeding in public. Understanding breastfeeding perceptions among members of a mother's support network, including their partners, is key for developing effective person-and family-centered breastfeeding education and counseling services that are well coordinated from the prenatal to postnatal periods with strong direct engagement from fathers. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Journal of Critical Dietetics, 2021
Background. UNICEF & The World Health Organization (WHO) recommend exclusive breastfeeding for the first 6 months of life (UNICEF & WHO, 2017). Research has reported reduced risk for all selected pediatric diseases with breastfeeding durations meeting this recommendation. Despite the proven benefits, breastfeeding rates for low-income African American mothers remain far below the guidelines established by Healthy People 2030. Purpose. The purpose of this research study was to explore the socio-cultural barriers and assets of breastfeeding experienced by African American mothers. The study was designed to elicit responses focused on barriers and facilitators of breastfeeding, specifically focusing on race as a key upstream determinant for both positive and negative experiences. Background. UNICEF & The World Health Organization (WHO) recommend exclusive breastfeeding for the first 6 months of life (UNICEF & WHO, 2017). Research has reported reduced risk for all selected pediatric diseases with breastfeeding durations meeting this recommendation. Despite the proven benefits, breastfeeding rates for low-income African American mothers remain far below the guidelines established by Healthy People 2030. Purpose. The purpose of this research study was to explore the socio-cultural barriers and assets of breastfeeding experienced by African American mothers. The study was designed to elicit responses focused on barriers and facilitators of breastfeeding, specifically focusing on race as a key upstream determinant for both positive and negative experiences. Methods. In this study, a hermeneutic phenomenological qualitative approach was used conducting focus groups and in-depth interviews. Eight African American WIC eligible mothers consented to participate in the study. Results. Data was analyzed using two coders, who looked for themes within the text derived from participants’ experiences. Four main themes emerged from the experiences of the participants: (a) Healthcare provider bias, (b) Distrust/Fear, (c) Agency/Control, and (d) Support Networks. Conclusion. This study offers a novel approach to examining disparities in breastfeeding rates, duration, and exclusivity through directly engaging low-income African American mothers. This study suggests culturally appropriate training for providers, increasing the diversity of providers, providing peer coaches, and support groups for African American women would be beneficial for African American WIC eligible women wanting to be successful at breastfeeding. Keywords: African American, Breastfeeding, Social Determinants of Health (SODH), Socioecological Model, Racial/ ethnic DisparitiesMethods. In this study, a hermeneutic phenomenological qualitative approach was used conducting focus groups and in-depth interviews. Eight African American WIC eligible mothers consented to participate in...
Impact of Education and Training on Type of Care Provided by Breastfeeding Peer Counselors
Journal of The American Dietetic Association, 2010
Background: Studies using community-based breastfeeding counselors (CBBCs) have repeatedly shown positive impact on breastfeeding initiation, exclusivity and duration, particularly among low-income mothers. To date, there has not been a comprehensive study to determine the impact of CBBC attributes such as educational background and training, on the type of care that CBBCs provide. Methods: This was a cross-sectional study of a convenience sample of CBBCs to ascertain the influence of counselor education and type of training on type of support and proficiency of CBBCs in communities across the United States. Invitations to participate in this online survey of CBBCs were e-mailed to program coordinators of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), La Leche League, and other community-based health organizations, who in turn invited and encouraged their CBBCs to participate. Descriptive analysis was used to describe participants (N = 847), while bivariate analysis using χ 2 test was used to examine the differences between CBBC education, training received and breastfeeding support skills used. Multivariate logistic regression was used to assess the independent determinants of specific breastfeeding support skills. Results: The major findings from the research indicate that overall, educational attainment of CBBCs is not a significant predictor for the curriculum used in their training and type of support skills used during counseling sessions, but initial training duration was positively associated with the use of many breastfeeding support skills. Another major influence of counselor support to clients is the type of continuing education they receive after their initial training, with higher likelihood of use of desirable support skills associated with counselors continuing their breastfeeding education at conferences or trainings away from their job sites. Conclusions: Our results show that different programs use different training curricula to train their CBBCs varying in duration and content. Counselor education is not a significant predictor of the type of training they receive. Continuing breastfeeding education is a significant determinant of type of counseling techniques used with clients. Further research is therefore needed to critically examine the content of the various training curricula of CBBC programs. This may show a need for a standardized training curriculum for all CBBC programs worldwide to make CBBCs more proficient and efficient, ensuring successful and optimum breastfeeding experiences for mothers and their newborns.
Reflections of Black Women Who Choose to Breastfeed: Influences, Challenges and Supports
Maternal and child health journal, 2015
Black women continue to have the lowest rates of breastfeeding. Of those who choose to breastfeed up to half cease nursing within the first few days or months postpartum. This study identified factors that influence and challenge Black women who choose to breastfeed, and supportive strategies that facilitate successful breastfeeding experiences. Four focus groups were conducted in 2013 with 16 self-identified Black women aged 21-46 (M = 31.35 years), with 11-18 (M = 14.94) years of education, and were either pregnant or had given birth to an infant within the prior 5 years (range of pregnancies 1-7; M = 2.44). A standard set of questions guided discussions. Data saturation occurred after three groups. All discussions were audiotaped and transcribed. Qualitative methods were used to identify categories and subthemes. Reviewers met periodically to resolve ambiguities and coding discrepancies. Member checking was conducted. Four major categories emerged: Balancing the influences: Peopl...