A Collaborative Effort with a Big Payoff : Southwest-Central Ontario Infant Feeding Survey

Authors Alanna Leffley, Grey Bruce Health Unit Catherine Bingle, Simcoe County District Health Unit Brenda Coleman, Elgin-St. Thomas Health Unit Iris Gutmanis, Southwest Region Health Intelligence Partnership (SRHIP) Lorna Larsen, Oxford County Health Unit Rolf Puchtinger, Huron County Health Unit April Rietdyk, Chatham-Kent Health Unit

Overview l Purpose and Background l Process Survey Content Methodological Issues l What Worked... l Lessons Learned

Purpose and Background

MHPSG - Child Health goal: To increase to 50% the percentage of infants breast-fed up to six months by the year 2010.

But where is the data? l Canadian Community Health Survey (CCHS) problems with questions problems with level of geography l Rapid Risk Factor Surveillance Survey (RRFSS) $$$ time to get sufficient data l Health Unit surveys & routine data collection validity problems

Early Childhood Development Funding l Announced to public health units by Ontario Ministry of Health & LTC mid- December, 2001 l Funding initiatives including the Perinatal and Child Health Survey Strategies Project Goal: to address info needs in support of Early Childhood Development related to maternal, pregnancy, infant and child health (0-6 years)

Perinatal and Child Health Survey Strategies Initiative l Late Dec/01, SRHIP hosted a teleconference for SWO health units to discuss ECD fund plans & explore opportunities for collaborative projects Several decided to join RRFSS Six rural hu’s expressed interest in developing a survey to look at breastfeeding initiation and duration

Process (or Under Construction)

Infant Feeding Survey Participants

Who was involved? Working Group l 4 epidemiologists l 2 program managers l 1 program evaluator l 1 public health nurse l SRHIP director Consultants l nutritionists & dietitians l lactation consultants l dental hygienists & dental educators l public health managers l public health nurses l survey company staff

How did we do it? l Met via teleconferences & all-day, face- to-face meetings, s (Dec/01 through Sept/02) l Survey companies - quotes from 3 places CATI systems in place deliver reports including basic analyses cost savings for the group l SRHIP’s role

General Structure l About 500 new mothers per health unit to be interviewed by telephone l Survey length about 12 minutes each time l Each participant contacted at 2-3 times: 6 week/3 months 2 hu’s also surveyed at 6 months 9 months postpartum

Survey Topics - 3 Months l Demographics Prenatal, perinatal, postpartum: l Exposure to & evaluation of information sources about infant feeding l Decision making, early experiences, supports and difficulties l Breastfeeding initiation rates

Survey Topics - 9 Months l Breastfeeding status, experiences, supports, satisfaction l Use of formula l Introduction to solid foods l Plans to go back to work/school l Postpartum depression l Infant oral care l Breastfeeding duration rates

Methodological Issues In Common l Survey company l Instructions to interviewers & referral resources l Core content l Analyses & report structure Individually l Contracts l Sample size & consent l Timing of surveys l Timelines l Optional & HU specific content

What Worked...

l Diverse group-varied experiences & expertise l Shared experiences, expertise, resources, workload produced a better product l Synergy (whole greater than the sum of its parts) l Learning & capacity building l Shared goals, objectives, consensus decision- making

What Worked... l Cost-savings l SRHIP coordination l Good communications l Comprehensive scope of project l Flexible content l Potential for future collaborations

Lessons Learned

l Designate a Project Leader l Create a schedule of critical dates, deadlines at the start l Identify report specifications early on l Have an Integration Process for new members

Lessons Learned l Beware of Workload Issues within project & externally l Remember to give yourselves enough Time to do the work, get consensus, get feedback l It’s very hard to Keep the Momentum Going over such a long time frame

Would We Do It Again? You Bet Ya!

Thank You!