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Developing a Culturally Grounded Breastfeeding Assessment for Low-Income, African American Women

Reno, Rebecca, Reno

Abstract Details

2016, Doctor of Philosophy, Ohio State University, Social Work.
The benefits of breastfeeding for mothers and infants have been well established in the literature, as have pervasive racial disparities in breastfeeding initiation and duration. The American Academy of Pediatrics recommends exclusive breastfeeding to 6 months of age, and Healthy People 2020 aims to have 60.6% of all infants exclusively breastfed to 6 months of age. A review of existing literature revealed a dearth of research focused specifically on the breastfeeding beliefs or behaviors of low-income, African American women. Reported studies are either atheoretical or utilize health behavior theories focusing on individual-level factors. Little attention has been paid to the unique sociocultural context within which this population is situated. Further, many existing breastfeeding interventions were not specifically designed for low-income African American women, and therefore may overlook their unique barriers to breastfeeding. Taken together, critical feminist theory and a social cultural model could provide a more comprehensive, culturally grounded framework from which to understand breastfeeding disparities, and to begin working to address them. Utilizing these two theories, a multi-phase, mixed methods research study was designed to identify breastfeeding barriers and supportive factors for low-income African American women, and to help empower them to meet their breastfeeding goals through the design and testing of a breastfeeding assessment process. Phase 1 utilized a community-based participatory action research methodology called group model building to answer the following research question: How do low-income, pregnant and postpartum African American women describe breastfeeding within their socio-cultural context, including factors that help or hinder breastfeeding? In Phase 2A, the set of statements that emerged from Phase 1 activities were evaluated by breastfeeding scholars and practitioners for inclusion in a set of Q-sort cards. These cards formed the foundation of a Dynamic Breastfeeding Assessment Process (D-BAP). In Phase 2B, the D-BAP was tested with a sample of lactation specialists and pregnant women to answer the research question: What would an assessment process look like if it were informed by the perspectives of the women as captured in the model building process? Finally, in Phase 3 the D-BAP underwent feasibility testing. Mixed methods were used to answer two research questions: 3A. How do pregnant, low-income African American women experience the culturally grounded Dynamic Breastfeeding Assessment Process? 3B. When the Dynamic Breastfeeding Assessment Process is delivered, is there a measurable difference in breastfeeding self-efficacy and intent among pregnant, low-income African American women? Completion of the D-BAP was hypothesized to be associated with increased breastfeeding intent and higher levels of breastfeeding self-efficacy. A pre-post, paired-samples design was utilized in Phase 3. The Phase 1 and 2 activities successfully resulted in a testable Dynamic Breastfeeding Assessment Process. In Phase 3, women who participated in the D-BAP demonstrated a statistically significant increase in breastfeeding self-efficacy, but not in their breastfeeding intent. The qualitative and quantitative findings from this study can inform future research, particularly as it pertains to supporting low-income African American women to meet their breastfeeding goals: a critically important public health and social work goal.
Audrey Begun (Committee Chair)
Dawn Anderson-Butcher (Committee Member)
Olate Rene (Committee Member)
308 p.

Recommended Citations

Citations

  • Reno, Reno, R. (2016). Developing a Culturally Grounded Breastfeeding Assessment for Low-Income, African American Women [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1461292199

    APA Style (7th edition)

  • Reno, Reno, Rebecca. Developing a Culturally Grounded Breastfeeding Assessment for Low-Income, African American Women. 2016. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1461292199.

    MLA Style (8th edition)

  • Reno, Reno, Rebecca. "Developing a Culturally Grounded Breastfeeding Assessment for Low-Income, African American Women." Doctoral dissertation, Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1461292199

    Chicago Manual of Style (17th edition)