Objective To describe the use of social media during the antepartum and postpartum periods among first-time African American mothers and their support persons. Design A qualitative critical ethnographic research design within the contexts of Family Life Course Development Theory and Black Feminist Theory. Setting Participants were recruited from community-based, public health, and home visiting programs. Participants A purposive sample was recruited, consisting of 14 pregnant African American women and eight support persons. Methods Pregnant and postpartum African American women and their support persons were interviewed separately during the antepartum and postpartum periods. Data were analyzed thematically. Results Participants frequently used social media for educational and social support and searched the internet for perinatal and parenting information. Most participants reported using at least one mobile application during their pregnancies and after giving birth. Social media were typically accessed through smartphones and/or computers using different websites and applications. While participants gleaned considerable information about infant development from these applications, they had difficulty finding and recalling information about infant feeding. Conclusion Social media are an important vehicle to disseminate infant feeding information; however, they are not currently being used to full potential. Our findings suggest that future interventions geared towards African American mothers and their support persons should include social media approaches. The way individuals gather, receive, and interpret information is dynamic. The increasing popularity and use of social media platforms offers the opportunity to create more innovative, targeted mobile health interventions for infant feeding and breastfeeding promotion.

Background While breast milk is considered the gold standard of infant feeding, a majority of African American mothers are not exclusively breastfeeding their newborn infants. Purpose The overall goal of this critical ethnographic research study was to describe infant feeding perceptions and experiences of African American mothers and their support persons. Methods Twenty-two participants (14 pregnant women and eight support persons) were recruited from public health programs and community based organizations in northern California. Data were collected through field observations, demographic questionnaires, and multiple in-person interviews. Thematic analysis was used to identify key themes. Results Half of the mothers noted an intention to exclusively breastfeed during the antepartum period. However, few mothers exclusively breastfed during the postpartum period. Many participants expressed guilt and shame for not being able to accomplish their antepartum goals. Life experiences and stressors, lack of breastfeeding role models, limited experiences with breastfeeding and lactation, and changes to the family dynamic played a major role in the infant feeding decision making process and breastfeeding duration. Conclusion Our observations suggest that while exclusivity goals were not being met, a considerable proportion of African American women were breastfeeding. Future interventions geared towards this population should include social media interventions, messaging around combination feeding, and increased education for identified social support persons. Public health measures aimed at reducing the current infant feeding inequities would benefit by also incorporating more culturally inclusive messaging around breastfeeding and lactation.

In health disparities research, studying the vulnerabilities of African Americans should be balanced by research on resources and strengths that influence health. One resource is spirituality, yet few tools have been developed and tested in diverse populations. This study evaluated the psychometric characteristics of the Spiritual Perspective Scale (SPS) in 102 pregnant African American women. Internal consistency reliability was high and evidence of construct validity was provided. The SPS correlated as hypothesized with church attendance, religiosity, and self-reported spirituality. In addition, the SPS correlated negatively with depression, anxiety, and stress. Factor analysis revealed a two-factor solution. The SPS performed well suggesting that it is an appropriate tool to use as a measure of spirituality in pregnant African American women. ß

These findings provide further evidence that tobacco use, number of prenatal visits, and discrimination adversely affects birth outcomes. By continuing to explore the social and personal experiences of African American women, important insights can be gained on factors that contribute to the pervasive racial disparities in perinatal health and contribute to interventions to improve the quality of healthcare for all women.