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Toolkit
Funding
Requested:
$8,080
Project
Duration:
8
week
Intervention,
1
year
data
collection
period
Project
Director:
Julianne
Borba
Address:
68
Corey
Rd,
Aromas,
Ca
95004
Phone:
(831)
809-8570
Email:
jtellesborba@gmail.com
Created
by:
Kern
County
Breastfeeding
Coalition
Potential
Funding
Agency:
Coalition
for
Healthy
Communities
Abstract:
This
intervention
aims
to
increase
the
proportion
of
Hispanic
and
Latino
women
located
in
Kern
County
who
exclusively
breastfeed
for
6
months.
This
will
be
accomplished
through
the
delivery
of
bilingual
breastfeeding
education
classes
to
maternity
ward
staff
currently
working
at
Kern
County
Medical
Center.
A
two-
month
educational
seminar
and
training
program
will
take
place.
Pre
and
post
breastfeeding
knowledge
will
be
evaluated
through
surveys
and
the
in-hospital
breastfeeding
rates
will
be
collected
and
analyzed
for
a
year
following
completion
of
the
program.
These
surveys
will
determine
if
the
educational
program
results
in
increased
knowledge
among
hospital
staff
and
breast-feeding
rates
will
be
compared
to
prior
hospital
data
in
order
to
determine
if
increasing
staff
and
health
care
provider's
knowledge
and
training
has
a
notable
impact
on
patient's
exclusive
breastfeeding
rates.
Needs
Assessment:
Exclusive
breastfeeding
has
the
ability
to
increase
the
well-being
of
mothers,
infants,
children,
and
families.
It
has
been
shown
to
result
in
superior
nutritional,
psychological,
and
economic
benefits.
The
Department
of
Health
and
Human
Services
have
set
a
Healthy
People
objective
of
increasing
the
proportion
of
infants
who
are
breastfed
exclusively
through
the
first
six
months
of
their
lives
from
14.6%
in
2008
to
25.5%
in
20201.
Raising
the
rate
by
nearly
11%
can
not
only
save
money
in
medical
costs
but
it
can
also
improve
both
mothers
and
childrens
nutritional
status.
It
is
estimated
that
the
lives
of
1,000
children
and
$13
billion
a
year
could
be
saved
if
90%
of
babies
in
the
US
are
exclusively
breastfed
for
the
first
6
months
of
their
lives2.
Minority
groups,
a
lack
of
education,
and
low-income
mothers/families
are
all
factors
associated
with
low
exclusive
breastfeeding
rates.
These
risk
factors
are
evident
in
a
large
portion
of
Kern
Countys
population,
making
it
a
high
priority
population
of
interest.3,4
Latinos
are
both
the
largest
and
fastest
growing
minority
in
the
US,
comprising
about
17%
of
the
population6.
In
California,
Latinos
comprise
38.2%
of
the
population
and
in
Kern
County
they
comprise
an
even
higher
percentage.
Latinos
and
Hispanics
comprise
nearly
50%
of
the
Kern
County
population
and
have
been
shown
to
have
a
22.5%
lower
exclusive
breastfeeding
rate
in
hospitals
than
whites
do5.
Due
to
the
high
percentage
of
Latinos
and
Hispanics
and
the
lower
exclusive
breastfeeding
rate
among
them,
increasing
the
exclusive
breastfeeding
rate
among
the
Hispanic
and
Latino
population
in
Kern
county
should
be
a
prominent
public
health
concern.
the
importance
of
increasing
breastfeeding
rates
and
educating
mothers
so
they
can
make
informed
decisions.
In
addition
to
health
benefits,
breastfeeding
also
proves
to
have
a
number
of
economic
benefits.
Commercial
formula
feeding
has
been
shown
to
increase
healthcare
spending
by
$331-$475
per
never
breastfed
infant
during
the
first
year10.
Breastfeeding
mothers
and
families
have
far
fewer
financial
expenses
than
those
who
opt
for
formula
feedings.
Not
only
do
they
save
money
on
the
supplemental
formulas
themselves
but
they
also
save
money
on
medical
bills
associated
with
the
improved
health
benefits
of
breastfeeding.
County
are
likely
related
to
the
high
percentage
of
residents
living
below
the
poverty
line.
In
2011,
30.8%
of
the
Latino
and
Hispanic
population
in
Kern
County
were
living
below
the
poverty
line,
about
126,545
people.6,12
Low
socioeconomic
status
may
lead
to
inflexible
work
hours
and
busy
schedules
that
make
exclusive
breast-feeding
extremely
challenging.
Low-income
status
can
also
result
in
lack
of
maternity
leave
depending
on
the
job
situation
as
well
as
poor
lactation
accommodations11,12.
These
mothers
need
programs,
support,
and
resources
to
overcome
these
barriers
in
order
to
increase
breastfeeding
rates.
The
rate
of
babies
breastfed
at
6
months
increased
from
35%
in
2000
to
49%
in
2010.13
Though
weve
seen
increases
in
the
prevalence
of
breast-feeding,
less
than
half
of
these
mothers
were
still
breast-feeding
at
6
months
indicating
the
need
for
some
sort
of
additional
continual
support3.
The
Kern
County
Breastfeeding
Coalition
serves
to
promote,
support,
and
protect
breastfeeding
through
initiatives
like
the
Baby
Friendly
Hospital
Initiative
which
promotes
exclusive
breastfeeding
while
infants
are
in
the
hospital14.
The
annual
California
Breastfeeding
Summit
gathers
to
address
issues
like
workplace
accommodation
laws,
hospital
maternity
policies
and
practices,
and
how
to
bridge
the
gap
between
lactation
services
prior
to
and
post
hospital
experiences15,16.
These
programs
are
playing
a
part
in
the
combined
effort
necessary
to
reach
the
Healthy
People
2020
objective,
though
additional
efforts
need
to
be
made.
Benefits
of
breastfeeding
demonstrate
the
value
of
interventions
that
promote
the
initiation,
exclusivity,
and
duration
of
breastfeeding
rates.
Further
intensive
and
thorough
the
training
among
professionals
the
more
effective
as
far
as
increasing
breastfeeding
knowledge
and
skills
among
personnel
and
better
equipping
maternity
wards
with
a
stronger
breastfeeding
support
system.
Goals
and
Objectives:
knowledge
among
hospital
staff
in
order
to
provide
better
support
for
patients
and
increase
the
prevalence
of
Hispanic
and
Latino
women
in
Kern
County
who
exclusively
breastfeed
for
6
months.
The
educational
seminar
will
include
medical
Spanish
language
instruction,
evaluate
the
effectiveness
of
classroom
learning,
and
will
cover
the
following
topics:
their
work
and
personal
schedules.
They
will
be
given
the
choice
of
attending
either
Wednesday
or
Saturday
seminars
from
12-3pm
for
8
weeks.
These
lessons
will
be
given
by
a
locally
hired
lactation
consultant
and
shall
cover
the
previously
stated
criteria.
-Language
Instruction:
Language
instruction
will
total
12
hours
and
be
provided
to
staff
members
by
a
Spanish
instructor
from
Bakersfield
College.
The
instructor
will
accompany
a
lactation
consultant
with
whom
they
will
collaborate
to
comprise
a
list
of
breastfeeding
terminology
and
phrases
that
will
aid
the
staff.
Pronunciation
exercises
and
classroom
instruction
will
be
the
basis
for
participant
training.
These
Spanish
lessons
will
follow
weekly
breastfeeding
seminars
and
run
from
3-4:30pm
on
Wednesdays
and
Saturdays
(staffs
choice).
Participants:
My
proposed
intervention
will
focus
on
maternity
ward
staff
members
as
participants
(nurses,
nurse
practitioners,
nurse
midwives,
physician
assistants,
and
doctors)
employed
by
Kern
County
Medical
Center.
Training
will
be
required
and
will
take
place
from
October
1st
to
November
31st
of
2014.
Kern
County
Medical
Center
will
make
the
training
program
mandatory
for
relevant
medical
personnel
and
provide
the
location
for
the
lactation
seminars
as
well
as
the
resources
needed
like
projectors,
tables,
desks,
chairs,
ect.
Evaluation:
-Summative:
The
lactation
consultant
and
language
instructor
will
observe
and
monitor
participants
level
of
understanding
and
engagement
throughout
the
intervention
in
order
to
determine
what
types
of
improvements
can
be
made
in
order
to
make
the
program
more
successful
in
the
future.
-Formative:
Kern
County
Medical
Center
already
tracks
patients
exclusive
breastfeeding
rates
so
this
data
will
be
collected
from
previous
years
as
well
as
the
2
year
span
following
the
newly
implemented
training
program
in
order
to
determine
the
success
of
the
intervention
on
breastfeeding
rates
among
Hispanic
and
Latino
women
in
Kern
County.
Hospital
staff
participants
will
be
given
a
test
both
before
and
after
the
seminar
to
assess
their
breastfeeding
knowledge
and
bilingual
capabilities.
The
lactation
consultant
and
language
instructor
will
develop
and
perform
these
breastfeeding
tests
to
determine
whether
an
improvement
in
staff
knowledge
has
taken
place.
-Impact:
By
collecting
these
results,
we
will
be
able
to
determine
whether
the
intervention
has
increased
the
breastfeeding
knowledge
among
maternity
ward
staff
members
and,
if
it
did,
whether
the
increased
knowledge
of
the
staff
led
to
an
increase
in
exclusive
breastfeeding
rates
among
Hispanic
and
Latino
women
in
Kern
County.
Sustainability:
This
knowledge
can
benefit
the
hospital
staff
and
caregivers
throughout
their
entire
careers,
allowing
them
to
help
educate
and
counsel
new
mothers
on
breastfeeding.
It
has
the
ability
to
empower
new
mothers
in
making
and
carrying
out
the
decision
to
exclusively
breastfeed
for
the
duration
of
6
months.
Increasing
the
exclusive
breastfeeding
rates
can
help
protect
newborns
from
diseases
and
health
conditions
as
well
as
providing
health
benefits
to
the
new
mothers.
The
knowledge
and
training
attained
by
the
participants
of
this
intervention
can
continue
to
be
passed
to
new
hospital
staff
during
job
training
and
can
be
used
to
make
improvements
to
future
Healthy
Start
Toolkit
programs
in
the
future.
Community
Participants:
Kern County Medical Center: The hospital is enthusiastic about the project
and
has
agreed
to
make
the
program
a
required
part
of
training
for
its
maternity
ward
staff
(including
nurses,
nurse
practitioners,
nurse
midwives,
physician
assistants,
and
doctors)
The
hospital
offered
the
use
of
their
on
site
conference
rooms
and
educational
materials
like
tables,
chairs,
desks,
projectors,
and
white
boards
free
of
charge
for
the
training
sessions.
The
hospital
agreed
to
provide
us
with
the
results
of
the
breastfeeding
rates
they
continually
track.
APPENDIX
I--Budget
Narrative
Direct
Costs:
A. Salaries
and
wages
a. Project
Director:
$28/hr;
9hrs/week;
8
weeks/yr-
Total=
$2,016
b. Lactation
Consultant:
$40/hr;
9hrs/week;
8weeks/yr-
Total=
$2,880
c. Spanish
Instructor:
$35/hr;
3hrs/week
(includes
time
outside
of
class
preparing
lessons
etc);
8weeks/yr-
Total=
$840
i.
Total= $5,736
B.
Materials
and
Supplies
a. paper,
notebooks,
pens,
pencils,
printing
pamphlets
&
instructional
materials
b. total=
$350
C. Indirect
Costs
a. hospital
staff
time
(required
part
of
training)
b. conference
room
and
materials
(donated
by
hospital)
D. Total
Direct
Costs
(Items
A
and
B):
Total=
$6,086
Total
Direct
Costs
and
Indirect
Costs=$6,086
APPENDIX
II-
Time
Frame
Task
Time
to
Complete
Contact
Kern
County
Medical
Center
and
Community
College
Spanish
departments
Conduct
interviews
and
hire
the
lactation
consultant
and
Spanish
instructor
Email/notify
hospital
staff
about
the
mandatory
training
Enroll
staff
in
one
of
two
training
schedules
(staffs
choice)
Create
PowerPoint
lectures,
and
classroom
activities
Obtain
classroom
materials:
pens,
paper,
pencils,
etc
3 months prior to
Personnel
Responsible
Program
director
intervention
2
months
prior
to
Program director
intervention
1
day
Program director
1 week
Program director
2 weeks
2 day
Program
director,
Lactation
consultant,
and
Spanish
instructor
Classroom training
2 months
intervention
Program
director,
Lactation
consultant,
and
Spanish
instructor
Pre/post
classroom
2
days
(1st
and
last
day
of
intervention
tests
intervention)
Assess
data
and
1
week
after
the
1
year
evaluations
data
collection
period
References
1.
Healthy
People
2020
breastfeeding
objectives.
Healthy
People
Web
site.
www.HealthyPeople.gov.
(search
MICH-21)
Accessed
April
11,
2014.
2.
Breastfeeding
report
card
-
United
States.
Centers
for
Disease
Control
and
Prevention
(CDC)
Web
site.
http://www.cdc.gov/breastfeeding/data/reportcard.htm.
2011.
Accessed
April
12,
2014.
3.
Healthy
People
2020
breastfeeding
objectives.
Healthy
People
Web
site.
www.HealthyPeople.gov.
(search
Kern
County)
Accessed
April
11,
2014.
4.
Chapman
DJ,
Perez-Escamilla
R.
US
national
breastfeeding
monitoring
and
surveillance:
current
status
and
recommendations.
J
Hum
Lact.
2009;25:13950.
Accessed
April
13,
2014
5.
AAP
(American
Academy
of
Pediatrics):
Breastfeeding
and
the
use
of
human
milk:
policy
statement.
6.
Petrova
A,
Ayers
C,
Stechna
S,
Gerling
JA,
Mehta
R.
Effectiveness
of
exclusive
breastfeeding
promotion
in
low-income
mothers:
a
randomized
controlled
study.
Breastfeed
Med.
2009;4:639.
Accessed
April
13,
2014
7.
The
Baby-Friendly
Hospital
Initiative
guidelines
and
evaluation
criteria
for
facilities
seeking
Baby-Friendly
Designation.
Baby-Friendly
USA
Web
site.
http://www.babyfriendlyusa.org/eng/docs/2010_Guidelines_Criteria_Rev%2011_2
8_11.pdf.
2010.
Accessed
April
12,
2014.
8.
Forster
DA,
Mclachlan
HL.
Breastfeeding
initiation
and
birth
setting
practices:
a
review
of
the
literature.
J
Midwifery
Womens
Health.
2007;52(3):273-280.
9.
Apostolakis-kyrus
K,
Valentine
C,
Defranco
E.
Factors
associated
with
breastfeeding
initiation
in
adolescent
mothers.
J
Pediatr.
2013;163(5):1489-1494.
10.
Myers
JA.
Improve
breastfeeding
rates
by
increasing
health
care
providers
knowledge
and
attitude.
Ky
Nurse.
2013;61(1):5.
11.
Vittoz
JP,
Labarere
J,
Castell
M,
Durand
M,
Pons
JC.
Effect
of
a
training
program
for
maternity
ward
professionals
on
duration
of
breastfeeding.
Birth.
2004;31(4):302-307.
12.
Whaley
SE,
Koleilat
M,
Jiang
L.
WIC
infant
food
package
issuance
data
are
a
valid
measure
of
infant
feeding
practices.
J
Hum
Lact.
2012;28(2):134-138.
13.
Digirolamo
AM,
Grummer-strawn
LM,
Fein
SB.
Do
perceived
attitudes
of
physicians
and
hospital
staff
affect
breastfeeding
decisions?.
Birth.
2003;30(2):94-
100.
14.
Ward
KN,
Byrne
JP.
A
critical
review
of
the
impact
of
continuing
breastfeeding
education
provided
to
nurses
and
midwives.
J
Hum
Lact.
2011;27(4):381-393.