Review a Grant RFP - links and documents provided

Breast is Best RDF

Breast is Best Foundation

1245 Street Name

Bowling Green, KY 42101

Anella Higgins, Grants Management Specialist

Department of Health and Human Services

CDC Procurement and Grants Office

2920 Brandywine Rd, MS E09

Atlanta, GA 30341

To Whom This May Concern,

Our agency is interested in giving children the best, healthiest life possible all the way from the start. We know that the best way to promote a healthy immune system as well as healthy growth and weight in a growing infant is breast feeding. The children of WIC women consistently have the lowest rates of breastfeeding.

This program is a multi-level intervention within Christian County, KY that not only works with the target population directly, but with those in their surrounding environment who frequently work with those on WIC. Breast is Best will implement an educational program to increase awareness of this issue within those community members, will help to increase the perception of importance of this issue within WIC women, and the entire Christian County community itself.

Breast is Best looks to hire on a lactation specialist to work specifically with WIC women to promote breastfeeding within the population. Breast is Best also will help to decrease limitations that WIC women may have with breastfeeding by purchasing an ample number of hospital grade breast pumps to allow these women to have access to these products that they may not financially have been able to prior. Breast is Best will hire on peer counselors to assist these women if they have any questions or need outside support in their decision to breastfeed.

This program works to increase the likelihood of those on WIC to breastfeed their children to their babies can have the best start possible. Breast is Best appreciates your consideration of this grant application, and looks forward to hearing from you.

Sincerely,

Abstract

Program Plan

Brief History

Breastfeeding is considered by the CDC to be the highest level of prevention a mother can take in protecting her infant and keeping him/her healthy. The American Academy of Pediatrics (AAP) states that breastfeeding is the preferred feeding method for all infants for the first six months of life (AAP, 2012). The AAP's policy statement includes that breastfed children benefit in growth, health, development, and multiple other potential outcomes (AAP, 2012). New research is continuously found on the importance and necessity of breastfeeding. With this new research, health care professionals are critical in assisting and supporting women in breastfeeding initiations and the promotion of further longevity of breastfeeding. The breastfeeding benefits the mother and child's health but can also have financial benefits on society as a whole. Concurrent with the Healthy People 2020 objectives, the United States is committed to increasing the proportion of infants who are breastfed to 81.9% in the early postpartum period, 60.6% 6 months postpartum, and 34.1% 1 year postpartum (United States Department of Health and Human Services, 2011). According to the Health People 2020, the United States’ baseline for breastfeeding was 74.0% in early postpartum period, 43.5% 6 months postpartum, and 22.7% 1 year postpartum (United States Department of Health and Human Services, 2011).

Breastfeeding is valuable for mothers, children, families and communities. For children, breastfeeding reduces the risk of contracting a variety of different illnesses. Reduction in the risk of acute otitis media, non-specific gastroenteritis, severe lower respiratory tract infection, atopic dermatitis, asthma, obesity, type 1 and type 2 diabetes, childhood leukemia, sudden infant death syndrome, and necrotizing enterocolitis within breastfed children in developed countries (Ip, Chung, Raman, Chew, Magula, Devine, Trikalinos, & Lau, 2007). With the reductions in sudden infant death syndrome and other potential life-threatening diseases, one can infer that breastfeeding will reduce infant mortality rates. For mothers who chose to breastfeed, there was a reduced risk of type 2 diabetes, breast cancer, and ovarian cancer (Ip et al., 2007).

Kentucky is reported to be one of the lower breastfeeding states in the nation (CDC, 2010). On the CDC's Outcome Indicator for breastfeeding in 2012, Kentucky was at 59.4% for women who have ever breastfed (once or more), 27.3% breastfeeding at 6 months, and 10.8% breastfeeding at 12 months (CDC, 2012). Breastfeeding rates can be affected by several factors such as race and socioeconomic status. Within Kentucky, there is a significant difference between race and breastfeeding rates; for Hispanic women, breastfeeding was 65.8% at initiation, 32.3% 6 months postpartum, and 10.8% 1 year postpartum (CDC, 2010), White, non-Hispanic women, breastfeeding was 54.8% at initiation, 26.1% 6 months postpartum, and 12.7% 1 year postpartum (CDC, 2010), and Black, non-Hispanic women, breastfeeding was 36.4% at initiation, 11.1% 6 months postpartum, and 2.8% 1 year postpartum (CDC, 2010). Women whom were recipients of WIC (Women, Infants and Children) had lower breastfeeding rate at 66.1% than those not on WIC but eligible (76.5%) and those that were not eligible for WIC at (82.2%) (CDC, 2010). Mother's education and age also affect the breastfeeding rates with increase education and age leading to higher rates of breastfeeding at initiation.

The breastfeeding initiation rate among many counties in the state of Kentucky falls drastically below the 50% mark and in Christian County, Kentucky particularly the initiation rate is at a 39.9% (Bailey, 2012). With this initiation in this county being extremely low compared to other counties in the state, it was decided that the women and infants in this county would benefit greatly from a breast feeding initiation program. Many statistics show that breast feeding is least common among mothers who fall in the lower socio-economic status. Therefore instead of just concentrating on all women in Christian County, Kentucky, we have specifically decided to target women who are accepted and certified into the federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

At the local level, breastfeeding initiation rates are higher in northern and western Kentucky (Bailey, 2012). Within western Kentucky, some counties are below 50% initiation rate. Among these counties includes Christian County at 39.9% initiation rates (Bailey, 2012). Within the WIC participation in Christian County, 14% of WIC mothers fully breastfed their child and 10.9% of WIC mothers partially breastfed their child (USDA, 2013). In Christian County 24.9% of WIC mothers breastfed. WIC mothers in Christian County are the target population for the intervention to increase breastfeeding rates.

Literature Review

Ruowei, Fein, Chen, and Grummer-Strawn conducted a study to focus on the various reasoning of why women to stop breastfeeding and at what point within their infant’s first year of life. Data was collected by administering questionnaires through the mail to roughly 1323 mothers , the questionnaire consisted of 32 reasons for their decision to stop breastfeeding and the participants were asked to rate the importance of each question. The results of the study showed that the number 1 reason the mother stopped breastfeeding was she felt as if the breast milk alone did not satisfy her infant, the 2nd reason indicated in the results showed that the mother ‘s concern for her infant’s nutrition and lactation had increased at the infant’s age of 2 months, and the top 3rd reason indicated in the results that mothers stopped breastfeeding in the third month because they felt their infant began self-weaning including statements such as; the baby lost interest in breastfeeding, or the baby began to bite (Ruowei, Fein, Chen, & Grummer-Strawn, 2008).. The author’s reported that this information is vital to health professionals indicating that there are many perceived barriers for breastfeeding mothers. It is also acknowledged in the text that infants and children who are not breastfed have increased health issues such as hospitalization for respiratory infections, pneumonia, and asthma, they are twice as likely to suffer from diarrhea, increased chances of becoming overweight during their childhood, and have increased chances of developing ear infections. Many factors are associated with breastfeeding rates, such as environmental support, psychological support, and hospital practices (Ruowei, Fein, Chen, & Grummer-Strawn, 2008).

Authors Anderson and colleagues conducted a study to determine the effectiveness of utilizing peer counselors to promote exclusive breastfeeding among low-income and inner city women. Women who live in inner cities and are low income in Hartford, Connecticut are less likely to breastfeed than those who have a higher income and live in a rural or suburban area (Anderson et. al, 2005). The intervention promoted exclusive breastfeeding with the use of peer counselors; there were 3 prenatal home visits, daily perinatal visits, 9 postpartum visits, and telephone counseling as needed (Anderson et. al, 2005. The results of the study indicated that with a well-planned and implemented breastfeeding support program provided at the hospital and with peer counselors are effective and improved the rates of exclusive breastfeeding among women who lived in inner cities and had low incomes (Anderson et. al, 2005). The authors recognize that currently there is quite a bit of literature that supports breastfeeding, as well as education provided by public health professionals, and other health care service, yet the breastfeeding rates remain low among low income women, but more strategies should be developed such as the community based peer counseling intervention to increase the breastfeeding rates. Breastfeeding provides the infant with developmental benefits, decrease likelihood of acute and chronic diseases, and has immunologic benefits, and has social economic and environmental benefits to both the infant and society (Anderson et. al, 2005).

Breast is Best Program

This program’s strategy works along with the previously stated AAP guidelines to help in promoting, supporting, and protecting breastfeeding mothers who give birth in Christian County (AAP, 2012). The AAP explains that breastfeeding should be encouraged through education, positive societal outlook, and continued research (AAP, 2012). Our plan for increasing breastfeeding in Christian County for WIC women includes pre-program data collection, programming through peer counselors, hiring of a lactation specialist for the Christian County Health Department specifically for WIC women, and training programs on breastfeeding for healthcare professionals within Jennie Stuart Medical Center, Christian County Health Department WIC staff, and other relevant professionals. This program works to not only educate women in Christian County on the multiple health benefits for mother and child through breast feeding, as well as helping to create a more educated environment around these women to assist in supporting these women in their choice to breastfeed.

The program works to promote breastfeeding in women through raising awareness in the community of the lack of breastfeeding in the population and the need to increase these rates between mother and child. We will do this through public service announcements, and we will also promote our program through this. Community support is a huge factor when it comes to women deciding whether or not they will breastfeed their children. The US Surgeon General in 2011 made a call to action specifically relating towards breastfeeding. In this document, it was stated that only 43% of Americans believed that women should have the right to breastfeed in public places (US, 2011). Helping to show the community that breastfeeding is important for mother and child, as well as working with PSA’s to promote not only the idea of breastfeeding but stressing the importance of it as well.

A preliminary survey will be given to identify Christian County’s specific barriers to and will allow the program to address them head on. Assessing the community helps to know their perspectives on many different levels, as well will survey not only our target community, but those who work directly with this community including doctors and nurses in maternity areas in hospitals, WIC women, WIC staff in the Christian County Health Department, lactation specialists, health educators, and other community members residing in Christian County. This survey will assist in knowing which barriers we will have to prioritize in spearheading in our program. Without the survey, it is unclear whether or not this program would be effectively addressing the most prominent issues within its target community.

The “Breast is Best” will assist in the hiring of a lactation specialist that is specifically designated to work directly with mothers who are currently on WIC. The lactation specialist will be responsible for meeting with the expectant mother on their enrollment into WIC prior to giving birth to discuss the option of breastfeeding. The lactation specialist will then be responsible for meeting with the mother postpartum if the woman has chosen to breastfeed. This is because Christian County does not currently have a lactation specialist that works solely with WIC women, although breastfeeding services are currently being offered through Christian county’s health department for women who seek these services out such as breastfeeding classes, and in person as well as telephone breastfeeding counseling. Having a WIC designated lactation specialist helps with targeting our focus community, and it helps in the respect that the current on-staff lactation specialist is not overwhelmed with the new responsibilities our program will entail.

“Breast is Best” also works with peer counseling of WIC women interested in breastfeeding to help guide and support these new mothers. In the previously stated surgeon general’s Call To Action, it states that “Peer-counseling programs that provide breastfeeding support for low-income women who are enrolled in or eligible for WIC have been found to be effective at both agency and individual levels in improving breastfeeding rates” (US, 2011). Including this peer counseling (consisting of volunteers within the Christian County area that are interested in promoting breastfeeding and assisting new mothers with this process) in our program will assist in answering questions that new mothers may have, and provide an example on a peer level that these new mothers can look up to for support.

The next portion of this program consists of providing hospital grade medical pumps for new WIC mothers who have experienced issues with their baby latching during attempts at feeding their child. In the Surgeon General’s Call To Action it states, “High-quality lactation programs go beyond just providing time and space for breast milk expression, but also provide employees with breastfeeding education, access to lactation consultation, and equipment such as high-grade, electric breast pumps” (US, 2011). If women have trouble with their babies latching and feeding, then they can at least pump milk not only at home, but at work as well to provide their child with essential nutrients. It is shown that, “...in the United States, a majority of mothers have returned to the workplace by the time their infants are six months old” (US, 2011), and if these women are already having trouble with their babies latching, returning to work is likely to lower their levels of self-efficacy towards being able to maintain breastfeeding. Providing pumps to these women can help to extend the time period that their children are breastfeeding, and to help mothers feel that this is indeed doable.

Our program will also train those who work directly with Christian County’s WIC mothers, such as doctors, nurses, WIC staff, and the health department to be able to assist with women who have questions about breastfeeding. The Surgeon General’s Call to Action to Breastfeeding states, “hospitals, clinicians in the community, and community organizations typically lack systems to help connect mothers to skilled persons who can offer support for breastfeeding” (US, 2011), and through the training of those who work with WIC women on many different levels helps to ensure that there are multiple people that can offer support for those who are breastfeeding. Doing this also helps to promote breastfeeding itself, and it helps in relation towards stressing the importance of breastfeeding for the health of the child. If these health professionals aren’t prioritizing breastfeeding in their minds to know how to answer questions of mothers needing to know how to breastfeed their child, it may make a statement to these patients that breastfeeding really isn’t that essential in the health of the child.

Our training of these individuals includes both in-house trainings at their place of employment, as well as outside training that is provided through take home materials that those being trained will look over and study, and then be tested on at a later time. This allows for training that goes further than what can be squeezed into a typical work day, and takes on the Red Cross’ training ideas that allow for both in person training as well as at home training too. Having multiple different training methods being implemented allows for those with different learning styles to absorb the material in a way that best fits the way they learn, and allows for there to be a more all-encompassing training program.

Summary of Activities

The Christian County Breastfeeding initiation program among WIC participants is composed of several phases. It is important to note that the overall goal of the breast feeding initiation, is to improve infant health (morbidity and mortality), through breast feeding and increase the support and encouragement of breast feeding among CCHD WIC staff, health educators, lactation specialist, community members, and hospital staff. The initial phase of the initiation will begin with the issuing of surveys for WIC participants and for the nurses who work within the maternity department in the hospital. The purpose of the surveys, interviews, and focus groups that are given to the WIC participants, is to gain a clear understanding of how WIC participants perceive breast feeding (positive or negative), identify their perceived barriers, identify and understand their current knowledge and education concerning breastfeeding, and to learn about past their past experiences with breast feeding if any. The primary purpose of the surveys and interviews given to the WIC and maternity nursing staff is to identify their prospective on breast feeding and the promotion of breastfeeding within their professional environment and determine areas of weakness, barriers, and the needs for the professional environment, considering they have much interaction with the patients.

Mothers who intend on breast feeding their child many times in the initial stage have great difficulty in properly breast feeding (or having their infant latch on to the breast), therefore the program is designed for the CCHD to employ a well-trained Lactation Specialist. This Lactation Specialist (LS) is exclusively for WIC participants. It is the responsibility of the LS to assist women who are on WIC within twelve hours of delivery, the LS is required to stay in the room with the mother for two entire feeding sessions or until the mother is comfortable with doing it without assistance. The WIC appointed LS will also be required to attend follow-up WIC appointments to address questions and concerns that the mother may have about breast feeding. During the follow-up appointment, this will be the opportunity for the LS to give the mother positive reinforcement concerning her decision to breastfeed and reassuring her of the benefits that breastfeeding will have for her child.

The third component of the breast feeding initiation will be peer counseling by the CCHD within the program. The health educators have the responsibility of providing information classes regarding breastfeeding promotion and awareness to WIC expectant or lactating mothers. Health educators will be the facilitators of the peer-counseling meeting and the actual peer counselors will consist of volunteer women, who has successfully breastfed in the past and is willing to provide positive feedback and support to the mothers who may have some doubts about breast feeding or those mothers who would like to have social support from someone who has made it through their current situation. The peer counselors will be able to relate to similar barriers that the women are currently facing and help them overcome them learn how to overcome in different ways. Considering that peer counseling is a crucial part of initiation and success of the program, care recruiting and consideration will be taken in selecting the peer counselors. It is the goal recruit peer-counselors who were successful in their breastfeeding and have a passion for getting other women to breastfeed. The breastfeeding peer counselor volunteer position will be posted on the CCHD website and applications will be available, there will be interviews conducted to decide which peer-counselors that will be involved in the program.

The fourth and final stage of the breast feeding initiation is to make available hospital grade breast pumps for the mothers who have attempted to breastfeed their infant with no success, but still has the desire to keep her child on breast milk. The breast pumps are not given to the mothers but loaned to them and must be returned at the child’s first birthday. In order to insure the efficiency of the breast pump, the mother will be required to bring her breast pump to her follow up WIC appointments. Although the initiation supports and encourages the mother’s to work at getting their child to latch there are some cases, where it just doesn’t work, which is why it the breast pump is considered the last result. The mothers who wish to receive a breast pump must have a recommendation from the WIC LS, which will verify that this mother has taken every action possible to breastfeed and has reached out to the LS on several attempts for assistance.

In order for the breast feeding program to be successful, it is important that we have the support and encouragement of all the medical professionals that have direct contact with our WIC participants. A hospital breast feeding initiation will be implemented to prepare and train staff members on multiple levels to assist in the success and efficiency of the breast feeding initiation program. The program will mandate the training of physicians, nurses, WIC staff, and the CCHD staff to increase their ability to educate the public and on the benefits of breast feeding when given the opportunity. Requiring this training will refresh the health professionals and staff on the importance of breastfeeding and give them the ability to answer various questions related to breastfeeding on all different levels. Educating the health professionals and staff on the barriers that many women face while breast feeding will help them develop a better understanding on their patients and give them the opportunity to respond accordingly.

There will be a training process for the health educators, which will involve an in-house and education seminar delivered by a certified breastfeeding educator who will work face-to-face with the trainees. Materials for the training will be available online and in paper for those who are required to go to the program and who must successfully complete the exam. The fact that many health professionals obtain prior health education knowledge and training having the opportunity to complete the certification online and on their own time will be just as effective to what is being taught and tested on in a class. Mandating breast feeding training and certifications of health professionals will ensure that the WIC women that give birth in Christian County will have will have multiple resources in obtaining information regarding breast feeding and support.

Requirement 1: Have a written breastfeeding policy that is communicated to all healthcare staff.

Requirement 2: Train all healthcare staff in the skills necessary to implement this policy.

Requirements 3: Inform all pregnant women about the benefits and management of breastfeeding.

Requirement 4: Help mothers initiate breastfeeding within one hour of birth.

Requirement 5: Show mothers how to breastfeed and how to maintain lactation even if they are separated from their infants.

Requirement 6: Give infants no food or drink other than breastmilk unless medically indicated.

Requirement 7: Practice rooming in – allow mothers and infants to remain together twenty-four hours a day.

Requirement 8: Encourage breastfeeding on demand.

Requirement 9: Give no pacifiers or artificial nipples to breastfeeding infants.

Requirement 10: Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.

Program Evaluation Plan

The Evaluation Process will be broken into three phases:

Process Evaluation—Outcome Evaluation--- Impact Evaluation

1. Process Evaluation

The Process evaluation phase we will analyze the program from beginning to end, this phase will allow us to gain understanding and determine if the “Breast is Best” program was successfully implemented according to the way it was planned. If the program was not implemented the way it was designed, we will have gathered information that will help us to identify what actually happened and create improvements and adjustments where they are needed. The process evaluation will allow us to look at the quality of the implementation phase in the program; meaning did the services, resources, and incentives effectively reach our WIC participants, and if not tell us why and what happened. This phase in the evaluation gives us the opportunity to help us identify if any outside factors played a role in the effectiveness or deterioration of the breast feeding initiative. From the process evaluation phase we will have gathered information that will help us determine if the Breast is Best program is something that is effective and should be continued, possibly expanded, improved, or ineffective.

1. Outcome Evaluation

The Outcome evaluation will focus on the assessment of the short-term/proximal outcomes that have been previously set for the “Breast is Best” program objectives. Utilizing outcome evaluation, we will be able to determine if there has been an actual adjustment made in the participant’s behavior or health status, which was brought on by the influence or the implementation of the “Breast is Best” initiative.

1. Impact Evaluation

The Impact evaluation of the Christian County Breast feeding initiative, will allow us to identify the long-term/distal outcomes brought on by implementation of the program. Impact evaluation not allows one to identify if the program long-term goal was met, but identify the possible wide-range impact that the program may have had on the participants, their families, and maybe other community members.

Anticipated Outcomes

The three evaluations used in the Breast is Best program: Process, Impact, and Outcome, the following outcomes are anticipated.

Process Evaluation:

4. By the end of March 2015, the WIC staff will have begun administering surveys to the qualified WIC participants.

6. By the end of June 2015, Peer counselors will have received their education and training and will be available to counsel WIC participants.

7. By the end of June 2015, 10 hospital-grade breast pumps will be available for loan to participants in the "Breast is Best" program.

Outcome Evaluation:

1. By the end of December 2017, the Breast is Best program will have increased the promotion of breastfeeding, knowledge and awareness to medical professionals, health educators, and WIC Staff by 30 percent.

Impact Outcome Evaluation:

1. By the end of December 2017, the “Breast is Best” program will have influenced at least 25 percent of the program participants to breastfeed their child to at least 12 months.

How the Evaluation will be utilized:

After completion of the “Breast is Best” program evaluation, the information that is gathered will be used to identify areas of both strengths and weaknesses within the program and potential barriers the participants may have faced during the program. With the data and information collected identified problems can be addressed with the appropriate personnel within the programs. Identified barriers will allow us to determine if other necessary components should be added to the program or possibly adjusted to meet the need of the target. The key findings that the evaluation will tell us are:

· Did the Breast is Best program reach the intended target population (WIC participants).

· Did the intended target population receive the intended amount of intervention that was planned.

· If the program met the goals and objectives that were set during the development of the program.

· Do the participants feel as if the “Breast is Best” program was effective and would they be willing to continue participation.

Mission

“Breast is Best” program has been created to support and encourage WIC participants to initiate breastfeeding and continue at least until the age of one; Increase breastfeeding-benefits, knowledge, and awareness among WIC participants; Change knowledge attitude and perspective of breastfeeding within the Christian County community; Have medical and health professionals increase their knowledge and skills on breastfeeding and promote/encourage WIC participants to initiate breast feeding.

Goals and Objectives

1. The “Breast is Best” program will select and hire two well-experienced Public Health Lactation Specialist.

Partnerships and Collaboration

Christian County Health Department. A well-received partnership with the Christian County Health Department is critical for the success of the program. Currently the Christian County Health Department does not have Lactation Specialist specifically for WIC mothers, however services are offered regarding breastfeeding; free breastfeeding classes at the health department, available to all pregnant and lactating mothers, one-on-one breastfeeding counseling information, and telephones counseling for women who are unable to make it into the clinic. The breastfeeding initiative program that is being implemented will require that the health department in Christian County employ its own Lactation Specialist that will be assigned to WIC participants that are expecting mothers. “Breast is Best” will also be educating the WIC staff within WIC staff in the health department. Our program staff and the managerial staff of Christian County Health Department must work together to assist each other to make sure the “Breast is Best” program is efficient and effective.

Jennie Stuart Medical Center. “Breast is Best” will be assisting in the education of the maternity staff and implementation of the program within the Maternity Department in Jennie Stuart Medical Center. Jennie Stuart Medical Center is the only hospital in Christian County therefore it is critical a working relationship is established between our program and Jennie Stuart Medical Center.

Christian County Community Churches and Organization. Recruitment processes into the “Breast is Best” program must be completed not only inside the Christian County Health Department but within the Christian County Community. “Breast is Best” will create relationships with churches and organizations around Christian County to recruit peer counselors and participants into the program.

An itemized listing of both timelines for tasks and program evaluation are listed in the appendices, the task timeline being appendix A on page 24, and the program evaluation timeline being Appendix B on page 28.

“Breast is Best” evaluation plan can be found in Appendix B. The plan utilized multiple surveys that can be combined and used together to determine the effectiveness of the program. Personnel measures include interview process of lactation specialist, interview process of peer counselors, Lactation Specialist Evaluation of Peer Counselors and Staff Entering and Exiting survey. Participants measures include Appointment WIC Surveys, Postpartum Initiation WIC Survey, Postpartum 3 Month WIC Survey, Postpartum 6 Month WIC Survey, and Postpartum 12 Month WIC Survey.

Program Director (Creator):

This full-time position would be designated for the person who runs over the program managers to make sure the program runs smoothly and facilitates their potential needs. They would be paid $20 an hour due to management responsibilities (will be hired before program begins in January 2015).

Responsibilities:

· Overseeing assessments

· Overseeing PSA’s to be sent into the community through free radio time as well as billboard advertisements and new briefings, organization of materials, as well as personnel for education programs

· Being the spokesperson of the program

· Working directly with stakeholders in the program to address any and all issues

· Ensuring that all parts are running smoothly together.

Program Managers (x2):

There are two program managers, both to be paid $17 an hour due to supervisory responsibilities (both will be hired in the month of February 2015, after the recruitment of our stakeholders to discuss best potential candidates).

·Lactation specialist/Breast Pump loan program management

o*The reason for pairing up the responsibilities of a manager of the breast pump loaning program with the needs of the lactation specialist is that the lactation specialist works closely with those who are going to be on the breast pump loaning program and will be able to voice the needs of those utilizing that program as well

-WIC related education/evaluation of surveys management

o* These two responsibilities were paired within this one position because these both involve evaluating materials, and while the education of those who are involved in the WIC program.

WIC Designated Lactation Specialist (x2):

This full-time position will be designated to aid in the lactation needs of new mothers in Christian county who are currently enrolled in the WIC program. $15 an hour due to being an educator and a lactation specialist (will be hired in the month of January 2015).

Responsibilities:

· Working directly with new WIC mothers

· Assessing their potential needs

· Working to promote breastfeeding within these mothers

· Working at the hospital to assist in new mothers’ needs

Health Educator (x3):

This part time position is designated for the professionals who will administer the education materials to those who work with WIC members. $13 an hour due to the current starting wage of a health educator (will be hired in the month of March 2015 to all for time to hire on and train the individual).

Responsibilities:

· Assessing those who work directly with WIC members’ readiness in working with mothers to promote breastfeeding

· Showing these workers how to use breast pumps

· Showing these workers proper breastfeeding techniques

· Training these individuals how to properly answer a new mother’s breastfeeding questions

· Finding these workers information they may need in case their training doesn’t give them the information necessary to answer their question.

Peer Counselors (x20):

These peer workers will be hired on and certified through our program to peer counsel others who are currently on WIC and are interested in breastfeeding. $9.50 an hour, but $50 a month stipend for telecommunication costs. (*These telecommunication costs are covered to ensure that these counselors can be reached in times of emergency and/or when the new mothers in the program need to reach out for support at different hours)

Responsibilities:

· Discussing the many benefits they saw through breastfeeding their children

· Providing social and emotional support to these new mothers

· Allowing these new mothers to communicate with them via the provided telecommunication device

Budget

Our budget for the 3 years starting in 2015 calendar year totals at $999,836.25. This is due to the fact that this program not only needs to have an ample number of breast pumps available to rent out to each person in our program, this program has staff members that will be paid for full and part time positions and have different levels of income based on management requirements and responsibilities, and the program’s budget accounts for incentives and other costs such as telecommunications for our peer counselors, travel costs for those traveling to aid in the distribution and collection of assessments, and the program’s promotional materials such as billboard costs have been accounted for as well. The following is an itemized list of personnel and individual item costs, as well as justifications for pricing each item in the way that it was priced.

This budget was based off of comparable pricings of similar items to what we would be purchasing for our program. If an exact item match could not be made, a comparable item that functioned in the same way as our item would, but may not match the exact needs as what we would be purchasing, was found in its place. For example, if our item was an educational booklet and we could not find a specific educational booklet for breastfeeding, we found an educational booklet that was similar in formatting to what we would purchase but may not have the correct content. This was to ensure accurate pricing of materials if an exact match couldn’t be found.

Personnel Budget

Itemized Budget

Appendices

Appendix A: Task Timeline

Appendix B: Timeline of Program and Evaluation

Appendix C: Works Cited

Ahluwalia, I.B., Tessaro, I., Grummer-Strawn, L.M., MacGowan, C., & Benton-Davis, S. (2000). Georgia's Breastfeeding Promotion Program for Low-Income Women. Pediatrics, 105(85): 1 - 6.