HLTH 630 LIBERTY UNIVERSITY Community_Health_Initiative_2024.pdf

Community Health Initiative

Monica Bagous

HLTH 630: Article Review 4

Liberty University

April 27, 2024

Abstract

Objective: The State of New York was awarded a 1-year grant to create

criteria for the Breastfeeding Friendly Practice Designation. At least five

primary care practice facilities were required to be identified and designated

Start Healthy Future of All Coalition to develop the program. The result was

the New York State Ten Steps to a Breastfeeding Friendly Practice, as well as

an accompanying implementation guide, designation criteria, and model

office policies. On-site training was provided to practice staff and providers,

and they also participated in a virtual learning network. A self-assessment

survey was completed by practice staff at baseline and post-Ten Steps

implementation, as well as the submission of a written office breastfeeding

policy review. Results: Fourteen practices met the criteria for the New York

State Health Commissioner. Conclusion: It is concluded that the number of

practices that have achieved designation as Breastfeeding Friendly far

surpassed the grant objective. Future objectives include an expansion of the

initiative across the State as well as the measurement of the impact of

Breastfeeding Friendly Designation on breastfeeding outcomes.

Key words: breastfeeding, community support, initiatives,

breastfeeding practices.

Introduction

Breastfeeding is the natural way for infants to get food in their earliest

diabetes, diarrhea, among others. It has several benefits for the mother as

well apart from the less likely of attaining breast ovarian cancers and the

possibility of reaching your weight before pregnancy.2 Infants who are wholly

breastfed are feed only breast milk. You are willingly consuming breast milk.

No other food or beverage, including water, is admitted to the baby. Infants

are also not given bottles, rubber nipples, or sucking berries. It is

recommended during the first 6 months of their life and up to 1 year by the

American Academy of Pediatrics, the American Congress of Obstetricians and

Gynecologist, The World Health Organization and the US Department of

Health and Human Services. In 2012, 83.8 percent of healthy newborns in

New York state were feed any breast milk during the birth hospital stay. This

surpassed the goal set by Healthy People 2020 of 82 percent. Just 40.6

percent of healthy newborns were feed only breast milk in 2012, however.

This is far below the stated 2020 national goal of 70 percent.4 The city of

Buffalo/Erie County was the chosen for this grant funded project since it was

inn high need an urban county and racially diverse. It was the county with

the lowest breastfeeding initiation, exclusivity, and duration rates in New

According to the data obtained from the birth certificate and New York state,

67% initiated breastfeeding and 57% exclusively breastfed during their birth

hospitalization. If the infant is not admitted or transferred to neonatal

intensive care unit, out of hospital or in, the infant is considered healthy.

Among the participants of the Catholic Charities of Buffalo, Women, Infant,

and Children Special Supplemental Nutrition Program WIC local agency

served, 14% of the participants reported that the infant was exclusively feed

for at least 3 months. The 7% at 6 months as opposed to the target rates

according to Healthy People 2020 which should be 46.2% and 25.5%. The

rates in Erie County were below those of Healthy People 2020. In 2011, the

breastfeeding in Erie County was at the lowest running a rate of 61%. They

were the 57th out of 62 in New York state.4

Method

All the organizations involved in the Coalition had the shared purpose

of enhancing in the health of west New York resident and the health care

system. The grant aim was that of increasing the rate of breastfeeding

among the low-income women residents of the City of Buffalo and Erie

primary care practices. The health care organization defined the practice

that had to work one gigue mad one more of practice. The criterion

developed focused on low-income Medicaid population and any one of the

population prioritizations. Development of Designation Criteria the NYS Ten

Steps to a Breastfeeding Friendly Practice was developed in October 2012 by

NYSDOH staff work group. The criteria were developed from different sources

like the AAP’s Ten Steps to Support Parents’ Choice to Breastfeed Their Baby

and How to Have a Breastfeeding Friendly Practice, and the ABM protocols

that support breastfeeding in primary office setting. The NYS Ten steps of

breastfeeding Friendly Practice and NYS Breastfeeding Friendly Practice

Designation Criteria was developed by the NYSDOH in coalition. They also

developed other materials like the pre-and post-assessment survey that was

finalized as the NYS Breastfeeding Friendly Practice Designation

Assessment.4 Resource Development and Distribution A resource binder

about the AAP policy and ACOG policy and ABM clinical protocol was

published by the Coalition. These binders were distributed to Erie County

practices, and they served as their guide. Memories of the Healthy Your x

Friendly practice was reviewed to all the staff and providers. The assessment

results were reviewed create the press according to the steps. Several

sessions were held to mobilize ideas for implementing initiatives. Seven

other sessions were held to review this calls and implementation process. To

start the system changes, all teach, and all-learn approach was used. The

community lactation expert was involved in training the staff and providers

of practices was held from October 2013 to March 2014. Funds from the CDC

grant was used to pay for the cost. This training was extended to the

hospital’s occupants and practicers. Three sessions of the CLC training were

held in Erie County. The coalition invited all 40 obstetric practices and 50

pediatric practices in Erie County to become Breastfeeding Friendly.

Persuasive approach combinations were practiced. In the last year of the

grant meeting was held. The in-person meting attracted the nearest

practices, and they were taught about the local breastfeeding resources. If

the implemented draft office policy and both the pre-and post-assessment

surveys were submitted by March 29, 2014, practices received an incentive

ranging from $500 to $1000. A higher portion of the Medicaid appreciated

Results

A fulltime community coordination was hired to coordinate training and

recruitment activities. 23 practices facilities were used, five never started the

designation process and 14 received the public health training visits and

became designated. A local lactation expert conducted 12 breastfeeding

education training session. 240 health care staff attended those training.

Seven webinars were conducted in which all practice staff attended. 119

professionals were trained, and 75 percent became CLCS after the three CLC

trainings. A monetary incentive was used to provide to practices that

became designated. It was a portion of the Coalition’s grant and was

$12,000. Five out of the twelve practices that received the incentive served a

high proportion of Medicaid patients. In 2014, ten practices that received the

incentive in 2014 became designated. Four practices did not receive funding

from the grant incentives. These practices included three obstetrics practices

and one pediatric practice.4

Discussion

This is the first state health department-sponsored primary care

Erie County, we had one health system in maternity management which

chose to work with 3 hospital-based obstetric primary care centers and 1

private obstetric practice to become Breastfeeding Friendly. All practices

became designated practices, but only the private obstetric practice was

granted the incentive. Education of the hospital and practices’ staff on the

benefits of breastfeeding for leadership and administrative staff and, with

our support, elimination of formula discharge bags and sponsored materials

for all practices. The cultural change within the primary care and hospital

relationship in a hospital system was witnessed, allowing us to work at the

health- system level which allowed all providers of maternity care to become

engaged in achieving a designated goal. It was a challenge working with

medical practices because they were limited on time, staff resources and

recruiting and maintaining participation in the process was difficult.

Networking was crucial to proceed. We used personal connections of

Coalition staff with staff members who were already breastfeeding advocates

to continue participation from other staff members. At the start of the

process, primary care practices were overwhelmed because they did not

with community partnerships and kept us informed of the NYS Ten Steps

implementation process and helped us prepare for the future support of our

designation practices. It was difficult for many practices to eliminate Step 3

or infant formula; therefore, additional education was given on the formula

marketing rings, direct mail, and how a mother’s perceived endorsement of a

product encourages the continuation of breastfeeding. This education made

a difference as more mothers continued breastfeeding.4 Limitations Pre- and

post-assessment survey data was all self-reported data. Activities such as

coaching calls and virtual learning network webinars served as other data

collection techniques and helped us assess how well our participating

practices were with the actual NYS Ten Steps. We were limited on how we

gathered and assessed related data. Demographic data would have been

ideal for each practice as the process evaluated how likely they were to

achieve the designation. Incomplete data was the only available data we had

about the number of staff who participated in webinars and CLC trainings

and if they successfully passed the tests to become a CLC.4

Conclusion

other NYS communities.4

References