Assessing the Efficacy of a Breastfeeding-Friendly Quality Improvement Project in a Large Federally Qualified Health Center Network.
BACKGROUND
Provider attitudes can influence breastfeeding decision making, initiation, and duration, although much of this research has suffered from a "hospital-limited view."


OBJECTIVE
This study aimed to evaluate the effect of a Breastfeeding-Friendly Initiative (BFI) on knowledge and attitudes of providers and staff, as well as breastfeeding rates of patients within a large Federally Qualified Health Center network with no lactation consultants on staff.


METHODS
We evaluated breastfeeding rates before and throughout the BFI. In addition, surveys of 136 primary care providers and staff before and after they were exposed to a breastfeeding education module were assessed to measure changes in breastfeeding knowledge and attitudes.


RESULTS
Breastfeeding initiation and duration improved over the course of the BFI, with mean breastfeeding duration increasing by nearly 1 month following the education module compared with baseline rates (P = .01). Following participation in the breastfeeding education module, we observed a statistically significant improvement in provider and staff knowledge (P < .01) and attitudes (P < .01). These improvements were consistent across employment type, gender, geography, and personal experience as a parent.


CONCLUSIONS
Implementing a BFI in a large multispecialty primary care network was found to improve breastfeeding initiation and duration up to 1 year, with a further increase in breastfeeding duration of 1 month following a 45-minute staff education module. After exposure to this module, health care providers and staff across our network improved in breastfeeding knowledge and attitudes. Given that expectant and new mothers regularly come into contact with staff and providers in primary care, sound knowledge and positive attitudes toward breastfeeding appear to have had a favorable effect on mothers that correlates with improved breastfeeding duration.
University of Rochester School of Medicine and Dentistry, Rochester, NY, USA caseyrosencarole@gmail.com.
Casey
C
Rosen-Carole
SUNY New Paltz Center for Research, Regional Education and Outreach, New Paltz, NY, USA.
Eve
E
Waltermaurer
Independent Researcher, Lincoln, NE, USA.
Monet
M
Goudreault
Independent Researcher, Traverse City, MI, USA.
Allison
A
Larimer
San Jose State University, San Jose, CA, USA.
Miriam
M
Pokharel-Wood
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Sritha
S
Rajupet
Institute for Family Health, Mid-Hudson Family Medicine Residency Program, Kingston, NY, USA.
Nafila
N
Kouba
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000379:methods / Q000592:standards; D001291:Attitude of Health Personnel; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D004496:Education, Continuing / Q000379:methods; D005260:Female; D006293:Health Promotion / Q000379:methods / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D011320:Primary Health Care / Q000379:methods / Q000592:standards*; D015397:Program Evaluation; D058996:Quality Improvement; D055815:Young Adult
baby-friendly; breastfeeding; breastfeeding education; breastfeeding rates; community health; federally qualified health center; health care education; infant health; primary care