Health Communication Program Plan

Latch On - A Breastfeeding Education and Support Initiative

The benefits of breastfeeding are well recognized and difficult to argue.
Breastfeeding has physical, psychological, economical, and environmental
benefits for both mother and baby.1 Breast milk is the perfect formula that
changes to meet the babys specific needs and provide the perfect nutrition. 1
The World Health Organization (WHO) estimates that millions of infants
contract infectious diseases and malnutrition as a result of formula feeding
as opposed to breastfeeding.2 Even with several prominent health
organizations recommending breastfeeding, many women still choose to use
infant formula.2 This could be a result of misconceptions regarding
breastfeeding, lack of support from family and friends, limitations in work
environments, or pain and difficulties associated with breastfeeding.
The Pender County Health Departments program Latch On would
like to promote breastfeeding in our community by providing persons with a
chance to attend free breastfeeding training and support classes. This Health
Communication Program Plan strives to provide women with the resources
and support they need to make the choice to successfully breastfeed their
child. The program intervention described in this literature review seeks to
increase the proportion of infants who are breastfed through public health
education and encouraging worksite lactation rooms. Health communication
interventions are aimed at breaking the barriers to successful breastfeeding.
The program will provide support and guidance to mothers to increase
initiation and duration of breastfeeding.
Latch On, is partnering with Womens Infants and Children to offer a
group approach to provide women with the tools and support they need to
make the choice to successfully breastfeed their child. This program is
offered to low-income, new and expecting mothers. After launching in
Kansas, a sister program found, various benefits for attendees such as
fewer allergies, enhanced bonding between mother and baby, decrease in
childhood obesity, direct point of contact for breastfeeding mothers, and
businesses response of the benefits of breastfeeding.1
The program will recruit participants through referrals from childbirth
classes, hospitals, physician offices, WIC program, churches, and word-ofmouth. The participants will be invited through to learn about breastfeeding
their child through small group educational classes. At the small group
sessions, women who have successfully breastfed, who the participants can
identify with, will share their experiences to encourage the participants to
breastfeed. In addition, nutritionists and lactation consultants will inspire
expecting or new mothers to make breastfeeding part of their childrens
nutritional plan. When a participant cannot physically breastfeed, the
program will set them up with a WIC nutritionist to get loaner breastpump so
they can still feed their babies breastmilk.

The intervention program will seek to increase breastfeeding through a

variety of means such as education, continuity of care, breastfeeding
equipment, social support, and employer support. The organization of the
review will be broken down into the above intervention categories. The
primary prevention intervention will be education classes to reach out to
mothers before, during, and after birth of their baby. In addition, staff will
work with local employers to provide new mothers with breastfeeding
supplies.
The Breastfeeding Initiation Program strives to provide women with the
resources and support they need to make the choice to successfully
breastfeed their child. Health communication interventions are aimed at
breaking the barriers to successful breastfeeding. The program will provide
support and guidance to mothers to increase initiation and duration of
breastfeeding. The objective for this intervention is as follows: By November
2016, 80% of Pender County WIC participants will have initiated
breastfeeding as measured by questionnaire at end of program or post
partum WIC appointment.
The demographic of the target audience is low-income women with a
low educational attainment. Low income women are more likely to return to
work earlier and be in a job setting that makes it more challenging to
breastfeed than those with a higher income.3 The program will serve women
of multiple-cultures specifically any religion, ethnicity, and family structure.
The program will be equipped to serve English speaking populations. The
physical characteristics for the target audience are females of child bearing
age and breastfeeding mothers. This program looks to target pregnant
women who are interested in breastfeeding.
The health behavior theory used in this intervention plan is the Health
Belief Model HBM). This model helps identity variables that impact individual
perceptions and whether individuals will participate in a particular program.
This intervention incorporates each of the core components -perceived
susceptibility, perceived severity, perceived benefit, perceived barriers, cues
to action, and self-efficacy- to promote and increase the initiation of
breastfeeding in women of low-socioeconomic status. The theory can be
used for the evaluation by assessing how the attitudes and beliefs of
participants regarding the core components change throughout the program.
This information will be evident through the pre and post program
educational and behavior surveys.
Beginning in January, the Latch On program will be offered in several
settings in Pender County, including public centers and faith-based centers.
The participating sites are as follows: Surf City Community Center, Topsail
Baptist Church, Surf City Welcome Center, Hampstead Library, and
Wilmington YMCA. Evening, weekend, and daytime classes will be available.
The Curriculum would be developed with a team of qualified professionals
such as registered dietitians, lactation consultants, and breastfeeding peer
educators. Each class will have a set schedule with instructors teaching
different assigned topics. The program manager would be myself. The major

source of funding would be from grants. The grant will need to be set and
approved in order for the program to begin with start up costs such as
printed material, minimal room rentals, and staff salary. The estimated cost
of each session would be $650. We would hope to host at least 8 sessions
per year.
Most of the costs of this intervention are variable and dependent on
the number of participants that enrolled in the educational class. If more
participants enroll we would need more printed material. Measuring the costs
associated with WIC staff activities will be difficult. There are no out of pocket
expenses for the demonstration but it is time taken away from other WIC
activities. The WIC nutritionists will have to spend about 30 seconds in each
interview documenting whether or not the participant attended the class and
if they continue to breastfeed.
Projection Costs
1. Overhead- all community centers and public buildings agree to
use of the building for free or reduced cost of $30. $50 x 6
sessions= $180
2. Printing materials: $260 pages x $0.05 per page = $13.00
3. Breast pump loaner program: funded by WIC- $0
4. Salary for staff- 3 staff members x $20 per class x 6 classes =
$360
5. Miscellaneous contingency: $97
TOTAL: $650 per session
The first evaluation question is: Did breastfeeding knowledge increase
among participants in the latch on program? The method of data collection
will be a pre-test given at the beginning of the first educational class and an
identical post-test given at the end of the last class or next WIC appointment
if participant does not complete course. This questionnaire will consist of 10
simple questions regarding breastfeeding practices, initiation, and duration.
The information collected from the pre and post-tests will be analyzed to
determine if participants showed an increase in breastfeeding knowledge.
The second evaluation question is: Has a change in breastfeeding
behaviors or attitudes occurred as a result of participation? This information
will be gathered through an initial behavior survey attached to the
knowledge pre-test. The three behavior questions will be as follows: Do you
intend to initiate breastfeeding after birth?, Will you continue to breastfeed
after you return to work?, and How many months do you intend to continue
to breastfeed?. The same three behavior questions will be given at the
completion of the program to evaluate behavior and attitude changes
towards breastfeeding.
The data collected will be used to create a final report at the end of the
program. The program instructors will determine if the program should be

continued based on the conclusions in the final report. If the program is

successful, the report will be used to lobby for grants and financial support
through the health department. If the program is not successful, the
instructors will use the feedback to improve the program where there are
deficiencies. Each participant will be asked to provide an optional end of
course satisfaction survey to provide program feedback and suggestions for
improvement. This information will only be used for program refinement.
The resources for the educational classes will be minimal and will
include printed educational pamphlets and the pre and post educational and
behavioral surveys. The instructors are responsible for printing all necessary
materials for the participants. The pre and post educational and behavioral
surveys will be given during the class times.
The program will be promoted through flyers given to each WIC client
at the Pender County Health Department. A press release will be released in
the Star Newspaper, New Hanover Regional Medical Center Magazine, and
Wilmington Family. In addition a 30-second audio PSA will be ran on the local
radio station, 104.5 WILT.
The American Academy of Pediatrics recommends that mothers
exclusively breastfeed for the first six months of life followed by continuous
breastfeeding until the infant is one while introducing age appropriate
foods.2,5 The current research shows that women of low socioeconomic
status have the lowest rates of breastfeeding. 2,3,4, A breastfeeding
intervention aimed at this population would be justified.
Research shows that early termination of breastfeeding is associated
with lack of prenatal education, returning to work, lacks of social support,
lack of timely postpartum follow-up care, and school responsibilities.2,3 The
interventions discussed in this literature review are aimed at breastfeeding
factors that are modifiable. These interventions intend to provide guidance
and support, boost a mothers confidence and self-esteem to inspire her to
initiate breastfeeding.
References
1. Office of the Surgeon General (US); Centers for Disease Control and
Prevention (US);
Office on Women's Health (US). The Surgeon General's Call to Action to
Support Breastfeeding. Rockville (MD): Office of the Surgeon General
(US); 2011. The Importance of Breastfeeding. Available at

http://www.ncbi.nlm.nih.gov/books/NBK52687/. Accessed on December

13, 2015.
2. Jacobson L, Wetta R. Breastfeeding interventions in Kansas: A qualitative
process
evaluation of program goals and objectives. Evaluation and Program
Planning. 2014; 46: 87-93. doi: 10.1016/j.evalprogplan.2014.05.006.
3. Shealy KR, Li R, Benton-Davis S, Grummer-Strawn LM. The CDC Guide to
Breastfeeding
Interventions. The U.S. Department of Health and Human Services,
Centers for Disease Control and Prevention. Available at
http://www.cdc.gov/breastfeeding/pdf/breastfeeding_interventions.pdf.
Accessed on December 13, 2015.
4. Flacking R, Nyqvist K, Ewald U. Effects of socioeconomic status on
breastfeeding duration
in mothers of preterm and term infants. European Journal of Public
Health. 2007; 17(6): 579-584. doi: 10.1093/eurpub/ckm019.
5. Vaaler M, Castrucci B, Parks S, Clark J, Stagg J, Erickson T. Mens Attitudes
Toward
Breastfeeding: Findings from the 2007 Texas Behavioral Risk Factor
Surveillance System. Maternal Child Health Journal. 2011; 15: 148-157.
doi: 10.1007/s10995-010-0605-8.