Mobilizing Community Resources to Enhance Postdischarge Support for Breastfeeding in Massachusetts (USA): Results of a Catalyst Grant Approach.
BACKGROUND
The Massachusetts Department of Public Health's (MDPH) Mass in Motion Program (MiM) facilitates the adoption of community-level strategies that promote healthy weight in 52 municipalities. MiM provided the platform for enhancing postdischarge continuity of care for breastfeeding.


OBJECTIVE
This study aimed to improve the continuity of breastfeeding care and support for mothers by enhancing postdischarge care infrastructure and supportive contacts for women and families.


METHODS
The MDPH awarded catalyst grants to community-based organizations (CBOs) that facilitated the formation of teams for improving breastfeeding support. The effort focused on populations that often experience disparities in breastfeeding outcomes such as minority women and women receiving Medicaid. The Added Value Model of Community Coalitions was used to qualitatively assess effect across multiple levels of the socioecological model of influence.


RESULTS
Six communities were awarded grants to enhance or convene Breastfeeding Continuity-of-Care Teams consisting of at least 3 CBOs, including 1 maternity hospital, the local Special Supplemental Nutrition Program for Women, Infants, and Children, and the local MiM representative. Teams implemented customized plans with performance indicators to create and strengthen infrastructure for supportive contacts with breastfeeding mothers. The project included Baby Café pilots in 3 additional MiM communities. Across all grantee communities, there was an average total increase of 491 contacts with mothers per month, an improvement of 8.5% over baseline. The project created 153 added value outcomes of community collaboration at 5 levels in the socioecological framework.


CONCLUSIONS
The project demonstrated how cross-sector, coordinated efforts focused on vulnerable populations can leverage local strengths to establish/enhance breastfeeding support services customized to local needs.
Nutrition Division, Massachusetts Department of Public Health, Boston, MA, USA.
Rachel
R
Colchamiro
Consultant, Massachusetts Department of Public Health, Boston, MA, USA.
Roger A
RA
Edwards
Division of Prevention and Wellness, Massachusetts Department of Public Health, Boston, MA, USA Christina.Nordstrom@state.ma.us.
Christina
C
Nordstrom
Department of Sociology, Northeastern University, Boston, MA, USA.
Jill
J
Eshelman
Nutrition Division, Massachusetts Department of Public Health, Boston, MA, USA.
Kara
K
Ghiringhelli
Nutrition Division, Massachusetts Department of Public Health, Boston, MA, USA.
Julie
J
Forgit
Nutrition Division, Massachusetts Department of Public Health, Boston, MA, USA.
Ellen
E
Tolan
Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA.
Kristen
K
Mainello
Community Health Training Institute, Health Resources in Action, Boston, MA, USA.
Judi
J
Foley
D001942:Breast Feeding; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D005381:Financing, Organized; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration*; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008404:Massachusetts; D011181:Postnatal Care / Q000379:methods / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D036301:Qualitative Research; D012944:Social Support
breastfeeding; breastfeeding support; community collaboration; community wellness; continuity of care; healthy communities; lactation support; obesity prevention; vulnerable populations