Assessing the Efficacy of a Breastfeeding-Friendly Quality Improvement Project in a Large Federally Qualified Health Center Network

Casey Rosen-Carole; Eve Waltermaurer; Monet Goudreault; Allison Larimer; Miriam Pokharel-Wood; Sritha Rajupet; Nafila Kouba

doi:10.1177/0890334415610326

Assessing the Efficacy of a Breastfeeding-Friendly Quality Improvement Project in a Large Federally Qualified Health Center Network

J Hum Lact. 2016 Aug;32(3):489-97. doi: 10.1177/0890334415610326. Epub 2015 Oct 23.

Authors

Casey Rosen-Carole¹, Eve Waltermaurer², Monet Goudreault³, Allison Larimer⁴, Miriam Pokharel-Wood⁵, Sritha Rajupet⁶, Nafila Kouba⁷

Affiliations

¹ University of Rochester School of Medicine and Dentistry, Rochester, NY, USA caseyrosencarole@gmail.com.
² SUNY New Paltz Center for Research, Regional Education and Outreach, New Paltz, NY, USA.
³ Independent Researcher, Lincoln, NE, USA.
⁴ Independent Researcher, Traverse City, MI, USA.
⁵ San Jose State University, San Jose, CA, USA.
⁶ Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁷ Institute for Family Health, Mid-Hudson Family Medicine Residency Program, Kingston, NY, USA.

PMID: 26497362
DOI: 10.1177/0890334415610326

Abstract

Background: Provider attitudes can influence breastfeeding decision making, initiation, and duration, although much of this research has suffered from a "hospital-limited view."

Objectives: This study aimed to evaluate the effect of a Breastfeeding-Friendly Initiative (BFI) on knowledge and attitudes of providers and staff, as well as breastfeeding rates of patients within a large Federally Qualified Health Center network with no lactation consultants on staff.

Methods: We evaluated breastfeeding rates before and throughout the BFI. In addition, surveys of 136 primary care providers and staff before and after they were exposed to a breastfeeding education module were assessed to measure changes in breastfeeding knowledge and attitudes.

Results: Breastfeeding initiation and duration improved over the course of the BFI, with mean breastfeeding duration increasing by nearly 1 month following the education module compared with baseline rates (P = .01). Following participation in the breastfeeding education module, we observed a statistically significant improvement in provider and staff knowledge (P < .01) and attitudes (P < .01). These improvements were consistent across employment type, gender, geography, and personal experience as a parent.

Conclusion: Implementing a BFI in a large multispecialty primary care network was found to improve breastfeeding initiation and duration up to 1 year, with a further increase in breastfeeding duration of 1 month following a 45-minute staff education module. After exposure to this module, health care providers and staff across our network improved in breastfeeding knowledge and attitudes. Given that expectant and new mothers regularly come into contact with staff and providers in primary care, sound knowledge and positive attitudes toward breastfeeding appear to have had a favorable effect on mothers that correlates with improved breastfeeding duration.

Keywords: baby-friendly; breastfeeding; breastfeeding education; breastfeeding rates; community health; federally qualified health center; health care education; infant health; primary care.

Publication types

Evaluation Study

MeSH terms

Adolescent
Adult
Ambulatory Care / methods
Ambulatory Care / standards
Attitude of Health Personnel*
Breast Feeding / statistics & numerical data*
Clinical Competence / statistics & numerical data*
Education, Continuing / methods
Female
Health Promotion / methods
Health Promotion / standards*
Humans
Male
Middle Aged
New York
Primary Health Care / methods
Primary Health Care / standards*
Program Evaluation
Quality Improvement*
Young Adult