title: Innovative use of influential prenatal counseling may improve breastfeeding initiation rates among WIC participants.
abstract: OBJECTIVE
  To determine whether integrating influence strategies (reciprocation, consistency, consensus, feeling liked, authority, and scarcity) throughout Chickasaw Nation Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics (1) changed participants' perception of the WIC experience and (2) affected breastfeeding initiation rates.
  
  
  METHODS
  Two-part, quasi-experimental design.
  
  
  METHODS
  Four WIC clinics.
  
  
  METHODS
  Parents and caregivers of children birth to 3 years.
  
  
  METHODS
  Behavior change intervention based on Social Cognitive Theory using Caildini's Principles of Influence. Traditional-model groups (control) received services prior to the intervention; influence-model groups (experimental) received services after initiation of the intervention.
  
  
  RESULTS
  The preliminary demonstration project surveyed 2 groups to measure changes in their perceptions of the WIC environment. Secondary data analysis measured changes in breastfeeding initiation in 2 groups of postpartum women.
  
  
  METHODS
  Frequency analysis, independent sample t tests, chi-square for independence, step-wise logistic regression.
  
  
  RESULTS
  The demonstration project resulted in 5 improved influence measures (P < .02), aligning with the influence principle of "feeling liked." The model had a small effect (φ = 0.10) in distinguishing breastfeeding initiation; women in the influence model were 1.5 times more likely (95% CI, 1.19-1.86; P < .05) to initiate breastfeeding compared with women in the traditional model, controlling for parity, mother's age, and race.
  
  
  CONCLUSIONS
  Consistent with Social Cognitive Theory, changing the WIC environment by integrating influence principles may positively affect women's infant feeding decisions and behaviors, specifically breastfeeding initiation rates.
authors.affiliation: Department of Nutritional Sciences, College of Human Sciences, Oklahoma State University, Stillwater, OK. Electronic address: deana.hildebrand@okstate.edu.
authors.forename: Deana A
authors.initials: DA
authors.lastname: Hildebrand
authors.affiliation: Pam McCarthy Associates, St. Paul, MN.
authors.forename: Pam
authors.initials: P
authors.lastname: McCarthy
authors.affiliation: Chickasaw Nation Division of Health, Nutrition Services, Ada, OK.
authors.forename: Debi
authors.initials: D
authors.lastname: Tipton
authors.affiliation: Chickasaw Nation Division of Health, Nutrition Services, Ada, OK.
authors.forename: Connie
authors.initials: C
authors.lastname: Merriman
authors.affiliation: Chickasaw Nation Division of Health, Nutrition Services, Ada, OK.
authors.forename: Melody
authors.initials: M
authors.lastname: Schrank
authors.affiliation: Chickasaw Nation Division of Health, Nutrition Services, Ada, OK.
authors.forename: Melinda
authors.initials: M
authors.lastname: Newport
mesh_terms: D001942:Breast Feeding / Q000208:ethnology; D017028:Caregivers / Q000193:education; D053198:Child Nutrition Sciences / Q000193:education*; D065246:Culturally Competent Care / Q000208:ethnology; D005260:Female; D063105:Food Assistance; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D007198:Indians, North American; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018673:Nutrition Policy; D009825:Oklahoma; D010290:Parents / Q000193:education; D010349:Patient Compliance / Q000208:ethnology; D011204:Poverty Areas; D064186:Prenatal Education; D066269:Social Theory
keywords: Chickasaw Nation; breastfeeding; decision theory; low-income population