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Sarah Lundli, Amanda Martelli, Sarah Martin, Stacey Martin,

B. R. E. A. S. T.- Friends Behavioral Reinforcement and Education through Awareness, Support, and Training. Sarah Lundli, Amanda Martelli, Sarah Martin, Stacey Martin, Erin Paschall , & Cara Skillingstead. Introduction. Total population of women in U.S. 156,964,212

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Sarah Lundli, Amanda Martelli, Sarah Martin, Stacey Martin,

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  1. B. R. E. A. S. T.- FriendsBehavioral Reinforcement and Education through Awareness, Support, and Training Sarah Lundli, Amanda Martelli, Sarah Martin, Stacey Martin, Erin Paschall, & Cara Skillingstead

  2. Introduction • Total population of women in U.S. • 156,964,212 • Top five causes of mortality for women • Heart disease, cancer, stroke, chronic lower respiratory diseases, and Alzheimer's disease

  3. Introduction

  4. Introduction

  5. Introduction • Total number of pregnant women between ages 20-29 • 21,038,081 • Top 5 leading causes of mortalityfor pregnant women • Cardiovascular disease, cardiomyopathy, hemorrhage, non-cardiovascular diseases, and hypertensive disorders of pregnancy

  6. Health Problem World Health Organization Types of breastfeeding

  7. Health Problem

  8. Health Problem • Health benefits of breastfeeding to mother • Decrease of diabetes risk • Lower rates of postpartum depression • Lower rates of breast and ovarian cancer • Lower rates of obesity, metabolic syndrome, and cardiovascular disease

  9. Health Problem • Health benefits to infant • Nutrients and vitamins • Lower rates of infectious and noninfectious diseases • Less risk of childhood illness

  10. Health Problem • Emotional benefits to mother • Sense of fulfillment • Sense of nurturing • Sense of attachment • Psychological and social benefits to child • Fewer difficulties • More mature

  11. Health Problem • Costs to mothers • Infant illness • Absenteeism • Formula vs. breast pump • Costs to society • Potential to save $13 billion dollars a year • Health care costs

  12. Healthy People 2020 Objectives MICH-21: Increase the proportion of infants who are ever breastfed  MICH-22: Increase the proportion of employers that have worksite lactation support programs MICH-23: Reduce the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life MICH-24: Increase the proportion of live births that occur in facilities that provide recommended care for lactating mothers and their babies

  13. Contributing Factors • Socioeconomic status • Race and Ethnicity • Postpartum Depression • Self-efficacy • Attitudes/Perceptions • Support network

  14. Contributing Factors • Contraindications • Parity • Policies • WIC • Clinical Care • Supplementation

  15. Effective Programs Breastfeeding self-efficacy intervention program Maternal breastfeeding self-efficacy workshop Family practice breastfeeding education program

  16. Effective Programs Ten steps for the protection, promotion, and support of breastfeeding West Tennessee peer counseling program Breastfeeding duration, cost, and benefits of a support program for low-income breastfeeding women

  17. Focus of Intervention Social marketing campaign Educational sessions and follow-ups Policy change and advocacy efforts Recruitment of participants

  18. Program Goals The primary goal of B.R.E.A.S.T.-Friends is to increase the initiation of breastfeeding among mothers age 20-29. The secondary goal of B.R.E.A.S.T.-Friends is to increase the duration of breastfeeding among mothers age 20-29.

  19. Administrative/Process Objectives Five months prior to program implementation, educational materials for all sessions will be finalized Four months prior to program implementation, receive permission from two local OBGYNs to implement the program in their offices Three months prior to program implementation, 10 lactation consultants will complete a two-week training program on peer health education

  20. Behavioral Objectives • Four weeks prior to birth, 95% of participants will report at least one conversation with her partner about her breastfeeding decision • At 1 week postpartum, 75% of women will have breastfed exclusively as a feeding method • By 6 months postpartum, 25% of participants will report having utilized at least one community resource recommended by the program

  21. Environmental Objectives • By 2015, there will be a 25% increase in the number of bi-monthly peer breastfeeding support groups offered in the community • By 2020, 95% community hospitals will not distribute formula to mothers who have previously stated an intention to exclusively breastfeed • By 2020, there will be a 15% increase in community safe-space breastfeeding areas

  22. Program/Health Objectives • At 6 months postpartum, 95% of mothers who participated in the B.R.E.A.S.T.-Friends program will have ever breastfed • At 6 months postpartum, 55% of mothers who participated in the B.R.E.A.S.T.-Friends program will still be breastfeeding • By 2020, there will be a 50% decrease in the rate of breastfeeding cessation before 6 months postpartum among mothers age 20-29

  23. Educational Plan Session 1: Meeting Your B.R.E.A.S.T.-Friend Session 2: Healthy Baby and Healthy You! Session 3: Overcoming Obstacles Session 4: Making a Plan Session 5: Bringing Baby Home

  24. Process Evaluation • Feedback and observations • Prenatal education and follow up sessions

  25. Impact Evaluation • In-person follow-ups • 1 month, 3 months, 6 months • Telephone follow-up • 1 year postpartum

  26. Outcome Evaluation • Health departments • Local and state • Hospitals, clinics, and birthing centers

  27. Questions?

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