title: Counseling and motivational videotapes increase duration of breast-feeding in African-American WIC participants who initiate breast-feeding.
abstract: OBJECTIVE
  To evaluate the relative effects introducing motivational videotapes and/or peer counseling in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics serving African-American women have on breast-feeding duration.
  
  
  METHODS
  Experimental intervention study. Pregnant women were enrolled at or before 24 weeks gestation and were followed up until postpartum week 16. Women were interviewed at enrollment, 7 to 10 days, 8 weeks, and 16 weeks postpartum. SUNJECTS/SETTING: One hundred fifteen African-American WIC participants who initiated breast-feeding and who had been enrolled in 1 of 4 clinics.
  
  
  METHODS
  Two-by-two factorial design, in which 4 clinics were randomly assigned to receive either no intervention, a motivational video package intervention, a peer-counseling intervention, or both interventions.
  
  
  METHODS
  Breast-feeding duration in weeks and relative risk ratios for breast-feeding cessation before 16 weeks postpartum.
  
  
  METHODS
  Contingency table analysis, including chi2 tests and log-rank tests; multivariate analysis using Cox proportional hazards regression analysis.
  
  
  RESULTS
  A higher proportion of women were breast-feeding at 8 and 16 weeks postpartum in the intervention clinics than in the control clinic. The proportion of women reporting breast-feeding declined at 8 and 16 weeks postpartum, but the rate of decline was slower in the 3 intervention clinics than in the control clinic. Being younger than 19 years of age or older than 25 years of age, having a male infant, and returning to work or school all negatively affected breastfeeding duration, whereas previous breast-feeding experience positively influenced breast-feeding duration.
  
  
  CONCLUSIONS
  WIC-based peer counselor support and motivational videos can positively affect the duration of breast-feeding among African-American women. WIC nutritionists and other health professionals in contact with this population should expand their efforts toward promoting increased duration of breast-feeding.
authors.affiliation: Department of Maternal and Child Health of The Johns Hopkins University School of Hygiene and Public Health, 615 N Wolfe St, Room 2501, Baltimore, MD 21205, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Gross
authors.forename: L E
authors.initials: LE
authors.lastname: Caulfield
authors.forename: M E
authors.initials: ME
authors.lastname: Bentley
authors.forename: Y
authors.initials: Y
authors.lastname: Bronner
authors.forename: L
authors.initials: L
authors.lastname: Kessler
authors.forename: J
authors.initials: J
authors.lastname: Jensen
authors.forename: V M
authors.initials: VM
authors.lastname: Paige
mesh_terms: D001741:Black or African American / Q000193:education / Q000523:psychology*; D000367:Age Factors; D015142:Baltimore; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D003376:Counseling; D005260:Female; D005522:Food Services; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007223:Infant; D007225:Infant Food; D007231:Infant, Newborn; D008297:Male; D009042:Motivation; D010353:Patient Education as Topic; D010379:Peer Group; D016016:Proportional Hazards Models; D012737:Sex Factors; D013997:Time Factors; D014743:Videotape Recording; D014931:Women, Working