Women who participated in this study breastfed for longer durations than the national average for African Americans. Findings can inform practice and research efforts to improve breastfeeding rates in this population using lessons learned from successful women.
Background
African-American women have the lowest breastfeeding rates among all racial/ethnic groups in the United States. Peer counseling is an effective intervention in improving breastfeeding in this population. However, little is known on peer counselors’ perceptions of breastfeeding in African-American women.
Objectives
As part of a larger qualitative study, the goal of this study was to understand the contextual factors influencing breastfeeding decisions of low-income African-American women from the perspective of breastfeeding peer counselors (PCs).
Methods
Three focus groups were conducted with 23 PCs from the WIC program in a Southeastern state. All focus group discussions were audio-recorded, professionally transcribed, and analyzed using thematic analysis. Bronfenbrenner’s socio-ecological model was used to group categories into themes.
Results
Of the sample, 48% were African-American, 78.2% were married, 56.5% had some college education. Five main themes emerged to describe factors at multiple-levels influencing breastfeeding in PCs’ low-income African-American clients: Individual, Microsystem, Exosystem, Macrosystem, and Chronosystem. Novel findings included 1) having breast-pumps may give African-American women a “sense of security”, 2) cultural pressures to be a “strong black woman” can impede breastfeeding support, and 3) breastfeeding “generational gaps” have resulted from American “slavery” and when formula was “a sign of wealth”.
Conclusions
As PCs described, low-income African-American women breastfeeding decisions are impacted by numerous contextual factors. Findings from this study suggest a need to broaden public health approach to breastfeeding promotion in this population by moving beyond individual characteristics to examining historical and socio-cultural factors underlying breastfeeding practices in African-American women.
Pastors shared their major concerns for congregant health status and the African-American community. Health interventions focusing on African-Americans in church settings should include pastor involvement and should incorporate holistic approaches to address health risks.
Successful interventions at community colleges should include several components to increase convenience as well as utilize interactive methods to promote HPV vaccine awareness.
Objective
To examine the association between mother-child communication about sex, sexually transmitted diseases (STDs), and contraception/condoms and HPV vaccine uptake by gender.
Methods
Women (n=1372) with ≥1 child aged 9-17 years receiving care in reproductive health clinics in Southeast Texas were asked to complete a self-administered questionnaire between September 2011 and October 2013.
Results
The majority of mothers with ≥1 eligible daughter (n = 886) reported having talked about ‘sex’ (77.7%), ‘STDs’ (76.6%) and ‘contraception’ (73.2%) with their daughter. The respective figures for mothers with ≥1 son (n = 836) were 68.8%, 69.0% and 65.3%. Mothers who discussed sex, STDs, or contraception with their daughters compared to those who did not were more likely to report that their daughter initiated (≥1 dose) HPV vaccination after adjusting for confounders (all p<.05). Similarly, mother-son discussions about STDs or condoms, but not sex, were associated with HPV vaccine initiation for their sons compared to those who did not discuss these topics. These associations were not significant with regard to HPV vaccine completion (3 doses) for neither daughters nor sons.
Conclusion
Mother-child communication on STDs and contraception/condoms is associated with HPV vaccine initiation, but not completion, among both daughters and sons.
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