Effectiveness of Workplace Lactation Interventions on Breastfeeding Outcomes in the United States: An Updated Systematic Review

2018 ◽  
Vol 35 (1) ◽  
pp. 100-113 ◽  
Author(s):  
Julia H. Kim ◽  
Jong C. Shin ◽  
Sharon M. Donovan

Background Returning to work is one of the main barriers to breastfeeding duration among working mothers in the United States. However, the impact of workplace lactation programs is unclear. Research Aim The aim of this study was to evaluate the effectiveness of workplace lactation programs in the United States on breastfeeding practices. Methods A systematic search was conducted of seven databases through September 2017. Articles ( N = 10) meeting the inclusion criteria of describing a workplace lactation intervention and evaluation in the United States and measuring initiation, exclusivity, or duration using an experimental or observational study design were critically evaluated. Two reviewers conducted quality assessments and reviewed the full-text articles during the analysis. Results Common services provided were breast pumps, social support, lactation rooms, and breastfeeding classes. Breastfeeding initiation was very high, ranging from 87% to 98%. Several factors were significantly associated with duration of exclusive breastfeeding: (a) receiving a breast pump for one year (8.3 versus 4.7 months), (b) return-to-work consultations (40% versus 17% at 6 months), and (c) telephone support (42% versus 15% at 6 months). Each additional service (except prenatal education) dose-dependently increased exclusively breastfeeding at 6 months. Sociodemographic information including older maternal age, working part-time, longer maternity leave, and white ethnicity were associated with longer breastfeeding duration. Conclusion Workplace lactation interventions increased breastfeeding initiation, duration, and exclusive breastfeeding, with greater changes observed with more available services. More evidence is needed on the impact of workplace support in low-income populations, and the cost-effectiveness of these programs in reducing health care costs.

2020 ◽  
pp. 109019812096419
Author(s):  
Joshua P. Mersky ◽  
Colleen E. Janczewski ◽  
ChienTi Plummer Lee ◽  
Ross M. Gilbert ◽  
Cali McAtee ◽  
...  

Background Research suggests that home visiting interventions can promote breastfeeding initiation, though their effects on breastfeeding continuation are unclear. No known studies have assessed the impact of home visiting on bedsharing. Aims To test the effects of home visiting on breastfeeding and bedsharing in a low-income, urban sample in the United States. Methods During a field trial conducted in Milwaukee, Wisconsin, from April 2014 to March 2017, referrals to a public health department were randomized to a Healthy Families America (HFA) program or a prenatal care and coordination (PNCC) program. Of the 204 women who accepted services, 139 consented to the study and were allocated to the two treatment groups, which were compared with each other and a third quasi-experimental group of 100 women who did not accept services. Data were collected at four time points up to 12 months postpartum. Results Breastfeeding initiation was higher among 72 HFA participants (88.4%; odds ratio [OR] = 2.7) and 67 PNCC participants (88.5%; OR = 2.2) than 100 comparison participants (76.5%). Similar results emerged for breastfeeding duration, though group differences were not statistically significant. Unexpectedly, bedsharing prevalence was higher among HFA participants (56.5%) than PNCC participants (31.1%; OR = 2.9) and comparison group participants (38.8%; OR = 2.0). Discussion Home visiting was linked to increased breastfeeding, while effects on bedsharing varied by program. Progress toward precision home visiting will be advanced by identifying program components that promote breastfeeding and safe sleep. Conclusion Further research is needed to examine whether home visiting reduces disparities in breastfeeding and safe sleep practices.


Elements ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 39-52
Author(s):  
Charlie Power

The debate over the future direction of elementary and secondary education in the United States is fractious and contentious. Many of these are rooted in concerns over disparities in financial circumstances and race. While the full extent of the gaps, in addition to the United States' mediocre education system relative to other industrialized nations, has been a subject of frequent research and heated debate, one crucial component of this divide has yet to be analyzed: summer learning loss. This paper will closely analyze published literature in order to analyze the impact of summer education loss. Additionally, this paper will argue that summer learning varies by socioeconomic status (SES), with low-income populations gradually regressing over the years. This phenomenon has ramifications on students' achievement and explains the disparities that accumulate over a student's educational career. Finally, based on current evidence, this paper will make policy recommendations on how to change the current education system to better address summer's inherent inequities. 


2012 ◽  
Vol 69 (3) ◽  
pp. 351-365 ◽  
Author(s):  
Patricia Pittman ◽  
Carolina Herrera ◽  
Joanne Spetz ◽  
Catherine R. Davis

More than 8% of employed RNs licensed since 2004 in the United States were educated overseas, yet little is known about the conditions of their recruitment or the impact of that experience on health care practice. This study assessed whether the labor rights of foreign-educated nurses were at risk during the latest period of high international recruitment: 2003 to 2007. Using consensus-based standards contained in the Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Health Professionals to the United States, this study found 50% of actively recruited foreign-educated nurses experienced a negative recruitment practice. The study also found that nurses educated in low-income countries and nurses with high contract breach fees, were significantly more likely to report such problems. If, as experts believe may occur, the nursing shortage in the United States returns around 2014, oversight of international recruitment will become critically important to delivering high-quality health care to Americans.


PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 182-188
Author(s):  
Sandra Scarr ◽  
Deborah Phillips ◽  
Kathleen McCartney ◽  
Martha Abbott-Shim

The quality of child care services in the United States should be understood within a context of child care policy at the federal and state levels. Similarly, child care policy needs to be examined within the larger context of family-support policies that do or do not include parental leaves to care for infants (and other dependent family members) and family allowances that spread the financial burdens of parenthood. Maynard and McGinnis1 presented a comprehensive look at the current and predictable policies that, at federal and state levels, affect working families and their children. They note the many problems in our "patchwork" system of child care—problems of insufficient attention to quality and insufficient supply for low-income families. Recent legislation is a step toward improving the ability of low-income families to pay for child care (by subsidizing that part of the cost of such care which exceeds 15% rather than 20% of the family income) and some steps toward training caregivers and improving regulations. They note the seeming political impasse over parental leaves, even unpaid leaves, and the impact of this lack of policy on the unmet need for early infant care. We should step back from the current morass of family and child care policies in the United States and look at what other nations have done and continue to do for their working families. By comparison with other industrialized countries in the world, the United States neglects essential provisions that make it possible for parents in other countries to afford to rear children and to find and afford quality child care for their children.


Author(s):  
Betsy Kalin

The documentary East LA Interchange (2015) has extraordinary potential to be used to increase awareness about our diverse, multicultural society and the specific challenges facing low-income communities of color. These communities’ residents are especially vulnerable to gentrification and displacement, and across the United States, we are currently seeing the impact of gentrification on our neighborhoods. One of the most important aspects of a documentary is what happens after the film is completed. We are in the process of creating a multiplatform strategic outreach campaign designed to engage youth and mobilize advocates around the issues addressed in the film. Our outreach and engagement goals are varied yet complementary to the themes in East LA Interchange. We believe that East LA Interchange’s message of empowerment through community action is one that can greatly benefit youth and adults in rapidly changing communities. Because Boyle Heights is one of the United States’ great places of diversity, inclusion, and tolerance, we would like the film to create momentum around social justice issues depicted in the film such as acceptance and appreciation of diversity, immigrant rights, environmental and transportation justice, urban development, and effective political representation.


2018 ◽  
Vol 10 (9) ◽  
pp. 2988 ◽  
Author(s):  
Alana Siegner ◽  
Jennifer Sowerwine ◽  
Charisma Acey

The aim of our review is to critically analyze the urban agriculture and urban food systems literature in order to understand the impact of urban-produced foods on community food security. We examine the role of city planning, food policy, and civic engagement in creating spaces for urban agriculture in cities across the United States, and whether (and how) these spaces promote food justice and food security. Bringing together multidisciplinary literature on access to urban agriculture and the distribution of urban-produced foods in a thematic, systematic review, we point out gaps in the academic research that would benefit from further study. The review integrates academic literature generated from Web of Science searches with gray literature identified through Google Alerts. We find that while there is a strong focus on elucidating the multiple benefits of urban agriculture, there are few studies that robustly measure the impact of urban farms on improving food security in low-income communities. Much of the literature is theoretical, focused on the production potential of urban agriculture, while more work is needed to understand and overcome barriers to access and distribution among communities in need. We conclude with a set of recommendations for researchers, practitioners, and policymakers who seek to create spaces in cities for food justice, equity, access, and sovereignty.


2021 ◽  
Vol 10 (6) ◽  
pp. 387
Author(s):  
Lingbo Liu ◽  
Tao Hu ◽  
Shuming Bao ◽  
Hao Wu ◽  
Zhenghong Peng ◽  
...  

(1) Background: Human mobility between geographic units is an important way in which COVID-19 is spread across regions. Due to the pressure of epidemic control and economic recovery, states in the United States have adopted different policies for mobility limitations. Assessing the impact of these policies on the spatiotemporal interaction of COVID-19 transmission among counties in each state is critical to formulating epidemic policies. (2) Methods: We utilized Moran’s I index and K-means clustering to investigate the time-varying spatial autocorrelation effect of 49 states (excluding the District of Colombia) with daily new cases at the county level from 22 January 2020 to 20 August 2020. Based on the dynamic spatial lag model (SLM) and the SIR model with unreported infection rate (SIRu), the integrated SLM-SIRu model was constructed to estimate the inter-county spatiotemporal interaction coefficient of daily new cases in each state, which was further explored by Pearson correlation test and stepwise OLS regression with socioeconomic factors. (3) Results: The K-means clustering divided the time-varying spatial autocorrelation curves of the 49 states into four types: continuous increasing, fluctuating increasing, weak positive, and weak negative. The Pearson correlation analysis showed that the spatiotemporal interaction coefficients in each state estimated by SLM-SIRu were significantly positively correlated with the variables of median age, population density, and proportions of international immigrants and highly educated population, but negatively correlated with the birth rate. Further stepwise OLS regression retained only three positive correlated variables: poverty rate, population density, and highly educated population proportion. (4) Conclusions: This result suggests that various state policies in the U.S. have imposed different impacts on COVID-19 transmission among counties. All states should provide more protection and support for the low-income population; high-density populated states need to strengthen regional mobility restrictions; and the highly educated population should reduce unnecessary regional movement and strengthen self-protection.


2012 ◽  
Vol 37 (1) ◽  
pp. 113-116 ◽  
Author(s):  
HB Waldman ◽  
D Cannella ◽  
SP Perlman

The proportion and numbers of children living in low income families and without health insurance continues to increase. The magnitude of these problems is considered at localized levels in terms of the impact on the use of dental services.


Author(s):  
Kumar Ramanathan

Abstract Family and medical leave policy in the United States is often noted for its lack of wage compensation, but is also distinctive in its gender neutrality and its broad coverage of several types of leave (combining pregnancy leave with medical, parental, and caregiving leave). This article argues that the distinctive design of leave policy in the United States is explained by its origins in contestation over the civil rights policy regime that emerged in the 1960s. In the early 1970s, women's movement advocates creatively and strategically formulated demands for maternity leave provision that fit an interpretation of this new policy regime's antidiscrimination logic. Because of this decision to advance an antidiscrimination claim, advocates became committed to pursuing a leave guarantee on gender-neutral grounds, which in turn enabled the broad-coverage leave design. This case study suggests that scholars of social policy and American political development should pay greater attention to the impact of civil rights on social policy. This article also contributes to the study of policy development by providing an example of how political actors cross boundaries between policy domains during the policy making process and by presenting a reconceptualization of “policy regimes.”


Water ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 247
Author(s):  
Laura Medwid ◽  
Elizabeth A. Mack

Research analyzing perceptions of water services has focused on water quality, water safety, and the propensity to consume water from different sources. It has not assessed perceptions of water costs. To address this knowledge gap, this study collected nationally representative survey data from households in the United States about water issues and incorporated these data into logistic regression models. In doing so, our study advances the water and public policy literature in three ways. One, it addresses the need for household resolution information about water issues given the absence of data at this scale in the United States. Two, it creates and utilizes one-of-a-kind survey data to understand the perceptions of household water bills and the drivers of these perceptions. Three, we assess the impact of proposed solutions to improve water affordability on household perceptions of water costs. Model results indicate low-income and households in underrepresented groups were more likely to perceive their water bills to be too high. The perception of water costs also varied geographically. From a policy perspective, model results indicate utilities can positively affect perceptions of water bills via the frequency of water billing and provision of payment assistance programs.


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