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Running head: Signature assignment: Breastfeeding Promotion 1

Signature assignment: Breastfeeding Promotion 9

Signature Assignment: Breastfeeding Promotion

Table of Contents Signature Assignment: Breastfeeding Promotion 3 Introduction & Needs Assessment 4 References 11 Footnotes Error! Bookmark not defined. Tables Error! Bookmark not defined. Figures Error! Bookmark not defined.

Signature Assignment: Breastfeeding Promotion

The benefits of breast feeding to infants, children and mothers have been extensively reported. Some examples are lowering a mother’s risk of high blood pressure, type 2 diabetes, ovarian cancer and breast cancer. In addition, infants who are breastfed have reduced risks of asthma, obesity, type 1 diabetes, severe lower respiratory disease, acute otitis media, sudden infant death syndrome and gastrointestinal infections. Both the American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend infants are exclusively breastfed for about the first 6 months with continued breastfeeding while introducing complementary foods for at least 1 year (CDC, 2020).

Although pregnant women and new mothers are eager to learn about breast feeding, as evidenced by a multi-billion dollar breastfeeding accessory market in the United States, breastfeeding initiation and establishment is not as easy as anticipated. This explains why breastfeeding rates are below the current recommendations by CDC, particularly within certain subgroups of mothers, including mothers 29 and younger, mothers of color, and mothers who need to return to the workplace. According to the CDC, in 2017, only 58.3% of 6 month old babies and only 35.3% of 12 month of babies were breastfed.

Programs such as the World Health Organization’s Baby Friendly Hospital Initiative have ensured that breastfeeding is encouraged and supported in maternity settings. Most women return to the workplace after having a child, yet only 51% of employers have worksite lactation support programs, according to the Society for Human Resource Management (2019, SHRS). Creating supporting and save environments for women who choose to breastfeed is vital in the process of increasing rates of breastfeeding.

Introduction & Needs Assessment

Public Health Problem

The CDC reports that low rates of breastfeeding add more than $3 billion a year to medical costs for the mother and child in the United States.

Target Population

The target population is women 29 and younger who plan to return to the workplace.

Program Planning Model. The PRECEDE-PROCEED model was selected because it is very robust with hundreds of published papers citing evidence of its usefulness in improving health outcomes. PRECEDE-PROCEDE is composed of eight phases. The underlying approach of this model is to begin by identifying the desired outcome, to determine what causes it, and finally to design an intervention aimed at reaching the desired outcome (McKenzie, Neiger & Thackeray, 2017).

In Phase 1: Social Assessment and Situational Analysis (page 48). subjectively define the quality of life (problems and priorities) of those in the priority population while involving individuals in the priority population in an assessment of their own needs and aspirations.

In Phase 2: Epidemiological Assessment, we use data to identify and rank the health goals or problems that may contribute to or interact with problems identified in phase 1. Once identified, make 2x2 table consistent with description on page 49.

In Phase 3: Educational and Ecological Assessment, various factors that have the potential to influence a given behavior are identified and classified into three categories: predisposing, reinforcing and enabling. Predisposing factors include the knowledge, attitudes, values, beliefs and perceptions of the mother were identified. Reinforcing factors include different types of feedback and rewards that those in the priority population receive after behavior change, which can be delivered by family, friends, peers, teachers, self and other who control rewards. Enabling factors include access to healthcare facilities or other health-related services, availability of resources, referrals to appropriate providers, transportation, negotiation and problem-solving skills.

Phase 4: (1) Intervention Alignment: match appropriate strategies and interventions with projected changes and outcomes identified in early phases.

(2) Administrative and policy assessment: Determine if the capabilities and resources of existing personnel and participating organizations are available to develop and implement the program.

Phase 5: Implementation

Phase 6: Process Evaluation

Phase 7: Impact Evaluation

Phase 8: Outcome Evaluation

Relevant Primary Data Source. Text begin…

Relevant Secondary Data. Text begin…

Needs Assessment. In a study concentrating on the decision-making process in breastfeeding mothers, four categories were identified influencing maternal decision making: (a) infant nutritional benefits, (b) maternal benefits, (c) knowledge about infant feeding, and (d) personal and professional support (Radzyminski, S., & Callister, C., C., 2019). Based on the findings, interventions that increase knowledge about infant nutritional benefits, increase knowledge about maternal benefits, provide information about how to breastfeed and personal and professional support, especially strategies to cope when difficulties arise.

Genetic Risk Factors: Flat and inverted nipples, structural abnormalities with baby’s mouth can make it difficult for baby to latch on comfortably.

Behavioral Risk factors: Breast Implants, stress, not drinking enough water, not eating enough, not pumping or putting baby to breast every 3 hours leads to low supply.

Environmental Risk factors: Returning to work, stressors

Conclusion/Program Focus. The target population new mothers age 29 and younger who plan to return to the workplace.

Program Planning

Goal Statement

Mothers ages 29 and younger, who plan to return to the workplace, will increase increase initiation, duration and exclusivity of breastfeeding as a result of a breastfeeding promotion program which combines pre- and post-natal interventions.

Process Objectives

Begin reading page 136. Daily tasks, activities, and work plans that lead to the accomplishment of all other levels of objectives. Focus on all program inputs/resources, implementation activities, and stakeholder reactions. See box 6.5, page 143. Use SMART guidelines.

Activities & Strategies for Reaching Process Objectives. Start writing here. continue following descriptions from process objectives above.

Impact Objective: Learning Objective.

Awareness Objectives:

Knowledge:

· Mothers will increase knowledge about physical factors that could hinder their ability to successfully breastfeed, such as structural issues with baby’s mouth, and what should be done (e.g., follow up with pediatrician, lactation specialist, etc…).

· Mothers will learn to recognize signs and symptoms of post-partum depression, how the condition can affect feelings about breastfeeding and behavior, and how to get appropraite help.

· Mothers will increase knowledge about their rights under the Patient Protection and Affordable Care Act, that requires most employers, with few exceptions, to offer a breastfeeding employee reasonable break times to pump for up to 1 year after her baby is born and a place other than a bathroom to comfortably, safely, and privately express breastmilk.

Attitude:

· Mothers will develop a positive attitude towards breastfeeding and requesting appropriate accommodations to breastfeed in the work place.

Skill development objectives:

· Working with a lactation specialist, mothers will engage in role play activities to practice requesting from employers an appropriate place and time to pump breastmilk.

Activities & Strategies for Reaching Learning Objective. Professionals, including doctors, nurses, midwives, nurse practitioners, nutritionists, lactations concultants and other healthcare professionals will be recruited and appropriately selected to provide face to face support and information to mothers regarding problem solving and asserting their rights to breastfeed.

Impact Objective: Behavioral Objective. Page 138. Describe the behaviors or action in which the priority population will engage that will resolve the health problem and move you toward achieving the program goal. Commonly written about adherence, compliance, consumption patterns, coping, preventive actions, self-care, and utilization. As many as 90% of new moms have some nipple soreness, according to the American Pregnancy Association (APA, 2021).

· Mothers will select and implement appropriate remedies to cope with discomfort associated with breastfeeding including, including sore and/or cracked nipples, breast engorgement, clogged milk ducts, etc…

·

Activities and Strategies for Reaching Behavioral Objective.

Impact Objective: Environmental Objective. Follow SMART guidelines. Nonbehavioral causes of a behavior. page 138. causes of non-breastfeeding that are present in the social (social support), physical, psychological, economic (affordability, incentives, disincentives), service, and or political environments. Government programs regarding breastfeeding.

· write 1 or 2

·

Activities and Strategies for Reaching Environmental Objective. Write about how to achieve these objectives.

Outcome Objective. Follow SMART template. Page 138. the ultimate objectives of the program. aimed at changes in health status, social benefits, risk factors, or quality of life. Commonly written as the reduction of risk, physiologic indicators, quality of life measures, etc…

· write at least 1 or 2

·

Health Promotion/Education Materials. Chapter 10

Marketing. Chapter 11

Timeline. Chapter 12?

Jan.

Feb.

Mar.

Apr.

May

June

July

Aug.

Sept.

Oct.

Nov.

Dec.

Phase 1

Phase 2

Phase 3

Phase 4

Phase 5

Phase 6

Phase 7

Phase 8

----- = planned time frame

----- = completed

(page 326)

Program Evaluation

Activities

Measure/Data

Learning Objectie Activities & Data.

Behavioral Objective Activities & Data.

Environmental Object Activities & Data.

Design.

Measure/Data.

Reporting.

References

https://www.cdc.gov/breastfeeding/data/reportcard.htm

https://shrm.org/hr-today/trends-and-forecasting/research-and-surveys/Pages/Benefits19.aspx?_ga=2.87795729.800167855.1593173959-888074358.1591795577

Gonzalez-Darias, D. (2020). “Supporting a first-time mother”: Assessment of success of a breastfeeding promotion programme. Midwifery, 85, 102687–102687. https://doi.org/10.1016/j.midw.2020.102687

https://americanpregnancy.org/healthy-pregnancy/breastfeeding/nipple-pain-remedies-12015/