A S S O C I A T I O N O F S T A T E P U B L I C H E A L T H N U T R I T I O N I S T S A S S O C I A T I O N O F S T A T E P U B L I C H E A L T H N U T R I T I O N I S T S
Children’s Healthy Weight CoIIN Wednesday, July 17, 2019 A S S O C I A T I O N O F S T A T E P U B L I C H E A L T H N U T R I T I O N I S T S
Breastfeeding Workstream Projects Arkansas California Iowa Louisiana Nevada North Dakota Wisconsin A S S O C I A T I O N O F S T A T E P U B L I C H E A L T H N U T R I T I O N I S T S
Arkansas's Children’s Healthy Weight CoIIN
Project Background According to the Surgeon Generals Call to Action Report, 75% of US mother will start • out motherhood breastfeeding with 13% of babies being only breastfed by 6 months of age. These rates are drastically lower in African American babies. The purpose of Arkansas's Children’s Healthy Weight CoIIN project is to support • breastfeeding mothers who have limited access to health care by conducting lactation accommodation training for up to 10 organizations in Arkansas’s Southeast/ Delta region and other at-risk communities so that employers and communities learn, engage, and practice the support lactating women and change procedures/ policies to provide accommodations. Arkansas aims to increase the duration and exclusivity of breastfeeding in • intervention sites by allowing adequate space and time to pump, breastfeed, and store milk in the workplace. These advancements will begin to initiate a change in perception in culture and in communities where breastfeeding has not traditionally been accepted as a social norm. Objectives 1. Create up to 10 breastfeeding Rooms/Nooks in early childcare centers (ECE) in the • delta region of Arkansas 2. Create Policy, System and Environmental changes in up to 10 breastfeeding • rooms/nooks in early childcare centers in the delta region of the state. 3. Train ECE staff on Arkansas laws protecting a woman’s right to breastfeed/express •
Successes Before After **testimonial**
Challenges • Gaining entrée into communities • Arranging time for pre/post CDC Scorecard
Key Lessons Learned • Identify ‘champions’ as early in the process as possible • Trust the process
Reducing Breastfeeding Disparities in California Through Lactation Accommodation
Project Background The CoIIN was an extended effort • to support our existing statewide low-wage lactation accommodation work group. Several strategies were selected • to advance lactation accommodation including: webinars, social media campaign, conference presentations and an issue brief.
Successes Interest in learning about or • improving lactation accommodation was evident in: – Webinar attendance – Social media skills building – Conference workshop attendance – Partnership with multiple organizations to address lactation accommodation outside the scope of the CoIIN
Challenges • State and federal lactation laws can be confusing. Lots of learning opportunities are needed to understand the laws, including for lactation experts. • Personal inexperience, or disallowance by employers, of breastfeeding experts to use various social media • Webinar technicalities for analytics
Key Lessons Learned Employ multiple strategies to • engage a wide audience. Each strategy fits into a long- • range plan to improve systems and policies. Educational opportunities are • needed to support more use of social media by breastfeeding experts. For educational events allow lots • of time for discussion and provide case management examples. Building partnership with diverse • organizations fortifies the strategies.
Iowa CHILDREN’S HEALTHY WEIGHT COIIN
Project Background u Reviving the MCH/WIC partnership was desired u Breastfeeding rates can always improve u Iowa has a very high rate of moms returning to work after having a baby u Health equity focus at Iowa Department of Public Health
Successes u Developed an infographic and poster regarding workplace breastfeeding rights for WIC and Title V Programs u Sponsored Breastfeeding Basics for Childcare Providers train-the-trainer for Child Care Nurse Consultants to improve breastfeeding support for in childcare u Supported 3 minority women to attend Certified Lactation Counselor/Specialist training u Developed an breastfeeding-friendly, statewide WIC breast pump issuance policy to be rolled out in Oct 2019 u In process of enhancing a referral process for utilizing Title V billing codes for extended breastfeeding education/support between WIC and MCH
Challenges u Lack of funding for staff time u Scheduling team meetings/busy schedules u Timeline for changes- Government shutdown delayed WIC pump policy pilot u Finding minority women with time available/interest for extended breastfeeding training
Key Lessons Learned u Be open to change/willing to adapt u Planning far in advance is beneficial for group work u Utilize your available resources u Change takes time
Louisiana
Project Background 2012 Kellogg 2014 Well- funding – focus Ahead included Est. 2007 in few on New Orleans, communities BF as WellSpot but planned for benchmark spread
Successes
Challenges • Diversification of our Lactation Accommodations Statewide Work Group • Team capacity
Key Lessons Learned • Start small • Be patient • Be persistent • Partnerships are key
State of Nevada WIC Program Breastfeeding Partner Support Project July 2019
Project Background Substantial evidence demonstrates the importance of partner support when women determine whether to initiate or to continue breastfeeding. To protect and support breastfeeding, work to include partners in breastfeeding education to improve rates statewide. Nevada WIC is incorporating partner support into education materials, the WIC clinic setting, and the community as a whole.
Successes § Held a pilot Father’s Day event to gather information from the community. § Follow-up event planned in August. § Received Nurturing Father’s Training July 10-12, 2019 to gain information on how to better engage partners. § Working towards making clinics more inclusive of partners, dads, grandparents, etc.
Challenges • Unexpected loss of team members over course of project. • Reaching dads, fathers groups to promote efforts and participate.
• Weekdays worked better for outreach. • Need for father groups, information on WIC benefits/eligibility , child care, education, etc. • Promote events through father-centered agencies, community partners. • Incentives helpful to get partners to the clinic to participate.
Thank you! Jacquelyn Bonde, MPH, CLE Team Lead Nevada WIC E: jbonde@health.nv.gov P: (775) 684-3473
North Dakota
Project Background
Successes • 2017-2018: Key stakeholder meeting with four of the five tribal communities and two of the three ND communities with urban American Indian populations engaged. • 2018-2019: Five grants awarded to four communities to establish new policies or practices addressing barriers to breastfeeding in American Indian communities.
Challenges • Too narrow of a focus in the beginning of the CoIIN (Indigenous Breastfeeding Counselor Training) without input/needs assessment from the communities. • Did not define role of CoIIN and how best this fit in American Indian communities to help them meet their goals.
Key Lessons Learned • Relationship building is key and takes time. • Be clear and define up front mutual expectations.
Wisconsin Breastfeeding
Project Background 2018 – Need for funding to support the creation of lactation spaces. • 10 mini grants to improve lactation services and policies within workplaces and to address disparities in lactation support offered to women of various backgrounds and experiences. – Launched this initiative during Breastfeeding Week. The mini grant application asked applicants to describe how the project would promote and/or support breastfeeding among employees, especially among groups of women who may be less likely to breastfeed their infants. • Examples included: creating/improving a dedicated lactation room (space, chair, table, artwork, printed materials, lock changes), and developing/ providing educational materials in multiple languages. – A lactation policy was a requirement of the project. • The applicant was required to be working with a local or tribal health department for support with the lactation policy and creation of the lactation space or support materials.
Project Background 2019 • Expanded the number of mini grants offered to 12 at the same funding level of $250. – Based on results from our PDSA cycles, we strengthened language within the application to ensure that the mini grants would benefit populations that typically have breastfeeding disparities. • Questions addressed by current PDSA cycles – Does adding information on demographic disparities in breastfeeding rates to mini grant application increase the number of underserved populations identified as targeted in the applications? – Does offering more time for 2019 mini grant application promotion and completion result in more eligible applications being submitted?
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