Education and Support: Tilting the Scale Toward Exclusive Breastfeeding

2021 ◽  
Vol 12 (2) ◽  
pp. 83-90
Author(s):  
Naomi Pitcock ◽  
Kimberly Pineda ◽  
Natasha Ossinova ◽  
Laura Yoder
Keyword(s):  
Peer Support ◽  
Low Income ◽  
Exclusive Breastfeeding ◽  
Healthcare Providers ◽  
Cost Effective ◽  
The United States ◽  
Peer Counseling ◽  
Culturally Competent ◽  
Breastfeeding Intention ◽  
Quasi Experimental

The Hispanic population in the United States is growing, and healthcare providers are challenged to design targeted, culturally appropriate programs to improve health outcomes related to breastfeeding.ObjectivesThis study was designed to detect the exclusive breastfeeding (EBF) rate among Hispanic women who chose education plus peer support versus peer support only. In addition, this study further evaluates ¡Tengo Leche!, an educational program previously evaluated in the literature.MethodsThe sample (n = 103) consisted of Hispanic pregnant, low-income, and uninsured women. A two-group quasi-experimental design was used to test the educational intervention combined with peer support (n = 35) versus stand-alone peer support (n = 68). The education-plus group (n = 35) voluntarily participated in the education portion. All participants received the inpatient peer counseling. The participants' breastfeeding intention was gathered through chart review.ResultsEBF at discharge was significantly higher (c2 = 4.51, p = .02) among mothers in the education plus peer support group, who were more likely to be exclusively breastfeeding at discharge (46.7%) versus the peer-support-only group (24.6%).ConclusionsThe outcomes of this study may provide guidance for designing culturally competent interventions with a focus on cost-effective and outcome-driven interventions to increase EBF.

Can Nonexperimental Methods Provide Unbiased Estimates of a Breastfeeding Intervention? A Within-Study Comparison of Peer Counseling in Oregon

2019 ◽  
Vol 43 (3-4) ◽  
pp. 152-188
Author(s):  
Onur Altindag ◽  
Theodore J. Joyce ◽  
Julie A. Reeder
Keyword(s):  
United States ◽  
Field Experiment ◽  
Exclusive Breastfeeding ◽  
Low Cost ◽  
The United States ◽  
Peer Counseling ◽  
Counseling Intervention ◽  
Randomized Field Experiment ◽  
Unbiased Estimates ◽  
Supplemental Nutrition Program

Between July 2005 and July 2007, the Oregon Supplemental Nutrition Program for Women, Infants and Children program conducted the largest randomized field experiment (RFE) ever in the United States to assess the effectiveness of a low-cost peer counseling intervention to promote exclusive breastfeeding. We undertook a within-study comparison of the intervention using unique administrative data between July 2005 and July 2010. We found no difference between experimental and nonexperimental estimates but failed to determine correspondence based on more stringent criteria. We show that tests for nonconsent bias in the benchmark RFE might provide an important signal as to confounding in the nonexperimental estimates.

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
Keyword(s):  
United States ◽  
Low Income ◽  
Exclusive Breastfeeding ◽  
Maternity Leave ◽  
The United States ◽  
Breastfeeding Duration ◽  
Breastfeeding Initiation ◽  
White Ethnicity ◽  
Observational Study Design ◽  
The Impact

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.

Home Visiting Effects on Breastfeeding and Bedsharing in a Low-Income Sample

2020 ◽  
pp. 109019812096419
Author(s):  
Joshua P. Mersky ◽  
Colleen E. Janczewski ◽  
ChienTi Plummer Lee ◽  
Ross M. Gilbert ◽  
Cali McAtee ◽  
...  
Keyword(s):  
Low Income ◽  
Home Visiting ◽  
Health Department ◽  
The United States ◽  
Breastfeeding Duration ◽  
Breastfeeding Initiation ◽  
Public Health Department ◽  
Safe Sleep ◽  
Quasi Experimental ◽  
The Impact

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.

Evaluation of an Initiative to Increase Exclusive Breastfeeding Among Rural Hispanic Women

2015 ◽  
Vol 6 (3) ◽  
pp. 98-108
Author(s):  
Naomi Pitcock ◽  
Emily Drake ◽  
Pamela A. Kulbok ◽  
Kimberly Pineda ◽  
Mary Gibson ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Low Income ◽  
Exclusive Breastfeeding ◽  
Hispanic Women ◽  
Statistical Significance ◽  
The Body ◽  
Care Group ◽  
Hispanic Population ◽  
Culturally Competent ◽  
Convenience Sample

Background: There is a growing Hispanic population in the U.S. healthcare providers, and lactation consultants are challenged to design targeted, culturally competent programs to support immigrant populations.Objective: To evaluate a prenatal education program using intercultural communication strategies designed to increase the number of Hispanic women who choose to exclusively breastfeed their newbornsMethods: A 2-group quasi-experimental design was used to test the educational intervention. The sample consisted of 71 Hispanic women who were pregnant, low income, and uninsured. Participation in the class was voluntary and used a convenience sample. Data regarding intention to breastfeed and breastfeeding during hospitalization was gathered through chart review.Results: Reaching statistical significance, 41% of the mothers who attended the educational intervention achieved exclusive breastfeeding at discharge from the hospital, compared to only 3.1% of the usual care group.Conclusions: The outcomes of this program evaluation can add to the body of knowledge on successful breastfeeding interventions in the Hispanic population and may provide a model for others who are designing culturally competent interventions in their communities.

scholarly journals CREATING DEMENTIA-FRIENDLY COMMUNITIES IN CENTRAL FLORIDA IN THE UNITED STATES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S444-S444
Author(s):  
Tracy Wharton ◽  
Daniel Paulson ◽  
Courtney Wagner
Keyword(s):  
Law Enforcement ◽  
Focus Groups ◽  
Task Force ◽  
Healthcare Providers ◽  
The United States ◽  
Culturally Competent ◽  
Social Service Agencies ◽  
Central Florida ◽  
Emergency Personnel ◽  
Training And Support

Abstract The Dementia Care & Cure Initiative in Florida is a statewide movement to advance dementia friendly communities. With 25% of the state over the age of 65, Florida has one of the highest rates of dementia in the nation. The taskforce based in Orlando involves a partnership of representatives from social service agencies, law enforcement, healthcare providers, and research partners, as well as consumers. The task force commissioned a series of five focus groups with 43 consumers. These focus groups produced short and long-term recommendations, identifying such issues as needed training for emergency personnel and law enforcement, improving inter-provider communication, and providing culturally competent programming for a diverse region. The taskforce has been planning with the Mayor’s office and law enforcement to initiate training and support for community engagement, and planning for implementation of these goals. Recommendations from the groups and from the taskforce to community leaders will be discussed.

scholarly journals Lessons learnt from the rapid implementation of reusable personal protective equipment for COVID-19 in Malawi

2021 ◽  
Vol 6 (9) ◽  
pp. e006498
Author(s):  
Fumbani Limani ◽  
David Garley ◽  
Derek Cocker ◽  
Priyanka Patel ◽  
Pratiksha Patel ◽  
...  
Keyword(s):  
Low Income ◽  
Personal Protective Equipment ◽  
Scale Up ◽  
Healthcare Providers ◽  
Cost Effective ◽  
Protective Equipment ◽  
Ongoing Training ◽  
Early Implementation ◽  
Worker Perceptions ◽  
The Cost

The SARS-CoV-2 pandemic has challenged health systems and healthcare workers worldwide. Access to personal protective equipment (PPE) is essential to mitigate the risk of excess mortality in healthcare providers. In Malawi, the cost of PPE represents an additional drain on available resources. In the event of repeated waves of disease over several years, the development of sustainable systems of PPE is essential. We describe the development, early implementation and rapid scale up of a reusable gown service at a tertiary-level hospital in Blantyre, Malawi. Challenges included healthcare worker perceptions around the potential of reduced efficacy of cotton gowns, the need to plan for surge capacity and the need for ongoing training of laundry staff in safety and hygiene procedures. Benefits of the system included increased coverage, decreased cost and reduced waste disposal. The implementation of a reusable cotton gown service is feasible, acceptable and cost-effective in tertiary centres providing specialist COVID-19 care at the height of the pandemic. This innovation could be expanded beyond low-income settings.

scholarly journals Surgical Technology, Anaesthesia and Pain Medicine, Ambulatory Anaesthesia for Outpatient Surgery

2020 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Outpatient Surgery ◽  
Healthcare Providers ◽  
Cost Effective ◽  
The United States ◽  
Postoperative Management ◽  
Insurance Companies ◽  
Pain Medicine ◽  
Ambulatory Anaesthesia ◽  
Surgical Technology ◽  
Surgical Methods

Owing to burgeoning improvements in surgical technology, anaesthesia and pain medicine, ambulatory anaesthesia for outpatient surgery has become commonplace, with a proportion of 66% in the United States of America, 50% in the United Kingdom, 11%-23% in India and an ambitious 75% in the next decade. Its advent was driven by financial and economic issues which it adequately abates by 25%-75% lesser than an inpatient procedure. Among other benefits to patients, healthcare providers, insurance companies and hospitals, outpatient anaesthesia decreases costs, minimises respiratory failure, enhances early hospital discharge, contributes to the economic growth of the nation, and decreases exposure to nosocomial infections. The growing complexity of surgical methods and number of comorbidities these days have increased the indications for ambulatory anaesthesia. In order for it to be safe and successful, the appropriate selection of patients, surgical and anaesthetic methods as well as postoperative management should be considered simultaneously. Nevertheless, ambulatory anaesthesia is still hindered by limited resources, inadequate expertise, and poor coordination between medical and organisational aspects of care in some countries. This problem can be minimized by providing resources and the training of healthcare providers on better organisation and the use and manipulation of these equipment through seminars and conferences. Furthermore, the global burden of disease study projects an increase in future anaesthesia demands due to the ever rising disease burden worldwide. This can be resolved by adequately managing the challenges of ambulatory anaesthesia and creating more centers either within or without hospitals. By and large, safe and convenient cost-effective methods to ensure patient’s quick return to function and recovery are necessary in ambulatory anaesthesia. Still and all, many challenges are being confronted daily, and numerous barriers have to be broken before ambulatory anaesthesia and surgery can make its concrete place and establishment in the clinical society.

Are Landlords Overcharging Housing Voucher Holders?

2016 ◽  
Vol 15 (2) ◽  
pp. 137-162 ◽  
Author(s):  
Matthew Desmond ◽  
Kristin L. Perkins
Keyword(s):  
Low Income ◽  
Cost Effective ◽  
The United States ◽  
Housing Subsidy ◽  
Housing Assistance ◽  
Data Set ◽  
Administrative Records ◽  
Federal Housing ◽  
Low Income Families ◽  
Rental Markets

The structure of rental markets coupled with the design of the Housing Choice Voucher Program (HCVP), the largest federal housing subsidy for low–income families in the United States, provides the opportunity to overcharge voucher holders. Applying hedonic regression models to a unique data set of Milwaukee renters combined with administrative records, we find that vouchered households are charged between $51 and $68 more in monthly rent than unassisted renters in comparable units and neighborhoods. Overcharging voucher holders costs taxpayers an estimated $3.8 million each year in Milwaukee alone, the equivalent of supplying 620 additional families in that city with housing assistance. These findings suggest that the HCVP could be made more cost–effective—and therefore more expansive—if overcharging were prevented.

The Role of Nutrition in Integrative Preventive Medicine

2017 ◽  
Author(s):  
Walter C. Willett
Keyword(s):  
Low Income ◽  
Healthcare Providers ◽  
Well Being ◽  
The United States ◽  
Fellowship Training ◽  
Dietary Factors ◽  
Low Income Countries ◽  
Noncommunicable Diseases ◽  
Premature Deaths ◽  
Major Illness

Until recently, and still today in low-income countries, undernutrition during pregnancy and early childhood was a major cause of mortality. However, in recent decades, noncommunicable diseases account for the majority of premature deaths both in the United States and globally. Although dietary factors have been identified as the most important causes of this, physicians and other healthcare providers are taught little about nutrition in medical school or fellowship training. In conventional medical practice almost no attention is given to knowing what a patient is eating or providing dietary guidance that has the potential to improve dramatically their long-term health. This chapter describes what we know about the elements of a healthy diet and how these elements can be combined into an overall dietary pattern for the prevention of major illness and promotion of well-being. A brief section considers ways that this knowledge can be integrated into preventive healthcare.

scholarly journals Konseling Sebaya Bagi Ibu Untuk Meningkatkan Praktik Pemberian ASI Eksklusif

2020 ◽  
Vol 11 (4) ◽  
pp. 351
Author(s):  
Dona Sartika ◽  
Agus Setiawan
Keyword(s):  
Social Support ◽  
Peer Support ◽  
Exclusive Breastfeeding ◽  
Quantitative Research ◽  
Positive Impact ◽  
Descriptive Analysis ◽  
Peer Counseling ◽  
Google Scholar ◽  
Literature Study ◽  
Maternal Social Support

Breastfeeding positively impacts both infants and mothers, but the rate of exclusive breastfeeding throughout the world is still low. One of these needs to be improved by implementing peer counseling for nursing mothers. This study aims to determine the benefits of peer counseling to mothers and exclusive breastfeeding. The method used was systematic literature study with descriptive analysis. Articles obtained from online databases namely Emarald insight, EBSCOhost, PubMed, sciencedirect, Wiley and Google scholar with a publication from 2016 to 2020. This study identified 43 articles and 12 met the inclusion criteria. The article consisted of quantitative research, (n = 8), qualitative research, (n = 3) and 1 article was a report article, 10 articles showed the positive impact of peer counseling on exclusive breastfeeding and maternal social support, 1 article was no impact on exclusive breastfeeding, 1 article needed further evaluation. Most research showed the positive impact of peer support on exclusive breastfeeding and maternal social support. This result was one of the important considerations in an effort to increase exclusive breastfeeding and social support for mothers. Keywords: breastfeeding; exclusive breastfeeding; peer counselling; peer support ABSTRAK Menyusui memberikan dampak positif baik bagi bayi maupun ibu, namun angka pemberian ASI eksklusif di seluruh dunia masih rendah. Hal ini perlu ditingkatkan salah satunya dengan menerapkan konseling sebaya untuk ibu menyusui. Studi ini bertujuan untuk mengetahui manfaat konseling sebaya terhadap ibu dan ASI eksklusif. Metode yang digunakan yaitu studi literatur tersistematis dengan analisis deskriptif. Artikel diperoleh dari online database yaitu Emarald insight, EBSCOhost, PubMed, sciencedirect, Wiley dan Google scholar dengan tahun terbit dari 2016 hingga 2020. Studi ini mengidentifikasi 43 artikel dan 12 memenuhi kriteria inklusi. Artikel terdiri dari penelitian kuantitatif, (n=8), penelitian kualitatif, (n=3) dan 1 artikel merupakan report article, 10 artikel menunjukkan dampak positif konseling sebaya terhadap ASI eksklusif dan dukungan sosial ibu, 1 artikel tidak berdampak terhadap ASI eksklusif, 1 artikel perlu evaluasi lebih lanjut. Sebagian besar penelitian menunjukkan dampak positif dukungan sebaya terhadap ASI eksklusif dan dukungan sosial ibu. Hasil ini menjadi salah satu pertimbangan penting dalam upaya meningkatnya pemberian ASI eksklusif serta dukungan sosial bagi ibu. Kata kunci: ASI eksklusif; dukungan sebaya; konseling sebaya; menyusui

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