Implementing a WIC-Based Intervention to Promote Exclusive Breastfeeding: Challenges, Facilitators, and Adaptive Strategies

Abstract

Implementation was shaped by clinic setting and adaptive strategies. Future WIC interventions may benefit from formal consideration of intervention fit with local clinic setting and allowable adaptations.

Outcome Evaluation of the You Can Do It Initiative to Promote Exclusive Breastfeeding Among Women Enrolled in the New York State WIC Program by Race/Ethnicity

“…3 In addition, studies indicated that provision of BF support within WIC settings may vary by race/ethnicity, and that black women were less likely to be offered lactation support. 25,26 In this study, it was likely that adherence to the study protocol and perceived improvements in staff BF counseling competencies and confidence through learning community training, as reported by participating WIC staff at the end of the intervention, 15 may have led to enhanced opportunities for all participants (in particular non-white women) to receive tailored BF support. On the other hand, the observation of little or no effect among white women, who had a relatively high prevalence of exclusive BF, suggested the potential of a ceiling effect, which can restrict and/or conceal the potential effectiveness of an intervention.…”

“…12 Although a priority of the NYS WIC program is to promote and support BF, this intervention may have been particularly effective in part because the YCDI intervention protocol increased the intensity of BF promotion: for example, by prioritizing BF counseling at each of 3 prenatal WIC visits and concentrating efforts on providing BF support to postpartum women within the first few days immediately after birth. Similarly, it is possible that striving for nutritionist and PC continuity across visits improved rapport between WIC staff and participants, thus supporting continuity of care 15 and improving exclusive BF outcomes. 21 Examination of BF outcomes by race and ethnicity revealed that the impact of the intervention was most profound among black and Hispanic women.…”

“…A detailed description of the YCDI intervention implemented by the NYS WIC program was reported by Eldridge and colleagues. 15 Only a brief explanation of relevant components is described here. A key intervention component was the use of the Breastfeeding Attrition Prediction Tool (BAPT), which is grounded in the Theory of Planned Behavior, 16 to screen participating mothers and inform a tailored BF counseling plan targeting the following 3 domains: attitudes, social/professional support, and confidence.…”

Dukungan Teman Sejawat Di Jejaring Sosial Dalam Pemberian Asi Eksklusif

“…Manfaat kesehatan dari menyusui semakin meningkat ketika pemberian ASI eksklusif dipertahankan selama enam bulan (Charlick, McKellar, Gordon, & Pincombe, 2018;Darwent & Kempenaar, 2014;Eldridge, Hartnett, Lee, Sekhobo, & Edmunds, 2017;S., A.P., & V., 2018;Sriraman, 2017). ASI eksklusif didefinisikan sebagai pemberian ASI saja (termasuk ASI dan obat-obatan) dan tidak termasuk susu buatan bayi, susu nonmanusia, air atau minuman berbasis air, teh atau jus buah (Charlick et al, 2018;De Jager, Broadbent, Fuller-Tyszkiewicz, & Skouteris, 2014).…”

WIC and Breastfeeding

“…[9][10][11] In addition to direct interventions, organizational and staff changes were implemented. [12][13][14] These coordinated strategies reflect the sociological framework upon which WIC operates, while facilitating independent efforts by local and state agencies.…”