Research Team
Urmeka Jefferson, PhD, RN, FAWHONN, Principal Investigator
Wrenetha A. Julion, PhD, MPH, RN, FAAN, Mentor
Project Period
7/1/2021 - 6/30/2024
Funding Source
University of California, Davis Betty Irene Moore Fellowship for Nurse Leaders and Innovators
Abstract
Current breastfeeding initiation rates in the U.S. have reached 83%, but drastically decline to 25% for exclusive breastfeeding through six months of age. Significant racial and geographical disparities also persist despite breastfeeding promotion endeavors. Breastfeeding rates have fluctuated over the last six years with African American (AA) mothers consistently having the lowest rates of all mothers. In Illinois, White mothers initiate breastfeeding at a rate of 81% compared to 59% for AA mothers. This gap continues for exclusive breastfeeding through six months with a substantial decline to 21% for White and 10% for AA mothers. The significant decline in breastfeeding rates is in part attributed to mothers not receiving the support needed during the critical time immediately after birth. AA mothers are more likely to return to work within eight weeks after birth to demanding environments unsupportive of breastfeeding needs, lack access to professional breastfeeding services, and experience racially biased care such as lack of education based on the assumption, they prefer formula feeding. While these barriers to breastfeeding are not distinctive to only AA mothers, they are experienced more often at disparate rates compared to other racial groups. Therefore, the goal of this project is to refine the previously developed breastfeeding support app, Mother’s Milk Connection, conduct formal usability testing, and evaluate use with AA mothers. This study will be conducted in 2 phases. Phase 1 will employ a user-centered design to rename and enhance features of the breastfeeding support app ensuring engagement, error tolerance, ease of use, and cultural relevance for AA mothers (Aim 1). In phase 2, an explanatory sequential mixed method study will be conducted to evaluate use of the breastfeeding support app with AA mothers. (Aims 2 & 3). Specific Aim 1: To refine the breastfeeding support app and evaluate usability with AA mothers. Specific Aim 2: To examine feasibility of implementing the breastfeeding support app as a mHealth intervention for AA mothers. Specific Aim 3: To explore AA mothers experiences participating in the mHealth intervention and how exposure to racism has impacted their breastfeeding experiences.