Updating the USDA National Breastfeeding Campaign Workshop Summary (2011) / Chapter Skim
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4 Where Does the Breastfeeding Campaign Go from Here?
4 Where Does the Breastfeeding Campaign Go from Here?
Pages 55-74
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Jay Bernhardt discussed new communication tools that can play a role in engaging mothers and other stakeholders. Cathy Carothers, relying on feedback from seven state programs, suggested several implementation tools needed by local WIC staff to move forward.
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as well as through community support, such as the legislative environment, hospital and physician practice, peer network, and community attitudes. When launched, the Loving Support campaign was based on formative research and then-leading theories in health communications.
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In the years since the campaign began, much has been learned about self-efficacy in breastfeeding, Parvanta said, although she added that she has not yet seen many of these lessons applied. For example, research has shown that women scored higher on breastfeeding self-efficacy scales at 2 days and at 4 weeks postpartum if they had observed breastfeeding role models through videotapes, if they received praise from their partners for breastfeeding, or if their own mothers had significantly higher levels of breastfeeding self-efficacy.
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LOVING SUPPORT 2.0: LEVERAGING NEW MEDIA Presenter: Jay M Bernhardt Since the launch of the Loving Support campaign, a variety of new communications technologies have been developed for creating and sharing, interactivity and engagement, and collaboration.
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Crossing the Digital Divide Bernhardt presented data from the Pew Internet & American Life Project (2010) about communication trends and usage in the United States.
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Reprinted with permission from the Pew Internet & American Life Project. both the opportunity and the challenge to "get the right message to the right audience from the right source at the right time." Bernhardt suggested four steps in determining how to use new media for Loving Support.
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Bernhardt finished by discussing the innovative potential of leveraging mobile technology for offering "digital coaching" about breastfeeding to women in the field during the immediate hours after delivery. IMPLEMENTATION TOOLS NEEDED BY WIC STAFF Presenter: Cathy Carothers When the Loving Support campaign was created in 1997, it used the implementation tools available at that time to address the barriers to breastfeeding.
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Carothers reported that she received the following feedback concerning implementation tools needed in a new campaign: • Recommended target audiences: While mothers should continue to be targeted, respondents suggested that the audience should be broadened to include hospitals, healthcare providers, employers of low-wage earners, and the general public. • Media tools: Television and radio PSAs should continue, but they should be focused on the community support needed, rather than trying to get women to breastfeed.
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, said she wanted to explore further the role that community partners can play in the new Loving Support campaign
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Achieving this goal requires Loving Support to reach the settings, people, and groups that influence infant feeding decisions beyond mothers and their immediate circle of care, such as hospitals and employers. FNS has been a responsive partner in the community, Shealy said, but she recommended that the agency become a more proactive initiator of partnerships and an engaged contributor with "some skin in the game," contributing financial and human resources to partnership activities that go beyond the traditional WIC clinical setting.
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In New York WIC participates in program planning and activities in a CDC-funded obesity program, which ensures consistent messaging and shared resources. And in North Dakota WIC provides local support to coalitions, is involved with the state Business Case of Breastfeeding initiative, and partners closely with the Communities Putting Prevention to Work team.
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66 FIGURE 4-1 Organizations and institutions that affect mother and baby.
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IDENTIFYING RESEARCH GAPS Presenter: Kiran Saluja Saluja returned to the podium to discuss what WIC needs to know about current perceptions of breastfeeding and the need for early support. It is important, she said, to learn not only about a mother's perceptions but also about the perceptions of those around her, including healthcare providers, WIC staff, family, and friends.
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how evaluation and monitoring can be designed to accommodate budget, staffing, and other resources limitations. Identifying Outcomes In reviewing the current goals of Loving Support, Baxter noted that exclusive breastfeeding is not mentioned, although it is something that
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based on the goal to "increase the number of infants born to WIC participants who are breastfed for the recommended period of one year." Whatever specific goal is ultimately decided upon, Baxter advocated thinking through a similar logic model that covers measurable objectives, strategies to reach those objectives, outputs, and both short- and long-term outcomes. Knowing the outputs -- for example, the percentage of participants offered support for breastfeeding or the percentage of healthcare providers given information about WIC's breastfeeding services -- can also help from a process perspective to catalogue what has been done and by whom, what materials were sent out, and who saw them.
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receiving brochures • Offer information, counsel (SMART objective) • % of target WIC participants ing, and support at WIC sites offered information, counsel ing, and support for breast feeding Figure 4-3 • See measures listed above • Use above campaign Increase breastfeeding Increased utilization of WIC Increased breastfeeding strategies • % of target WIC participants duration rates among breastfeeding support services duration rates among WIC who utilize WIC's breast WIC participants among WIC mothers participants (measure: tracking of • Provide WIC breastfeeding feeding support services breastfeeding rates at 1, 3, 6, 9, and support to breastfeeding 12 months for one year prior to mothers campaign and one year after implementation)
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The evaluation must be practical at the local level. This means developing measurable objectives, selecting measures that will work within operational constraints, and developing a system for collecting and tracking data over time; coding data in ways that are easy for staff to understand, track, and analyze; preparing staff for their evaluation role; and aligning new data collection with existing operations (such as a new item on an existing form, rather than a new form)
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• Specific products or services to support: Baxter said that she felt there is some ambiguity about what "support services" are, al though Saluja said that WIC recipients or potential recipients re ceive an explanation from the outset of enrollment. Saluja said that increasing the number of Baby-Friendly Hospitals would make a difference.
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Presented at the Institute of Medicine Workshop on Updating the USDA National Breastfeeding Campaign, Washington, DC, April 26. CDC/DNPAO (Centers for Disease Control and Prevention/Division of Nutrition, Physical Activity, and Obesity)
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