1. 1 Fatimah Ali-Ferre´ CHES

2. Significance Benefits Health, nutritional, immunologic, developmental, psychological, social, economic, and environmental benefits. 2Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre

3. Lower incidence of infectious diseases, respiratory disease, allergies, obesity, SDS, etc. (Agency for Healthcare Research and Quality). Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre3 Significance

4. Exclusive breastfeeding for 6 months should support optimal growth and development of a child (AAP). Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre4

5. Significance National Goal Healthy People 2010 to increase breastfeeding by 75% at postpartum, 60% at 6 months and 25% at 1 year (CDC). 5Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre Photo: AP / Pat Roque)

6. Study Purpose To find: The disparities in breastfeeding knowledge (K), beliefs/attitudes (A) and behaviors (B). 6Breastfeeding Knowledge, Beliefs and Behaviors. F. Ali-Ferre

7. Theory The Health Belief Model- People’s behavior influenced by their knowledge and beliefs. A woman will (not) breastfeed depends on direct/indirect factors affecting these variables. Breastfeeding Knowledge, Beliefs and Behaviors. F. Ali-Ferre7

8. Delineation Target population Women living in Carbondale, Illinois. Sample 50 respondents from a local OB/GYN office at time of their doctor’s office. 8Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre

9. Delineation Sample Women 18-40 years old. Random sampling. Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre9

10. Method: Instrument Measurement InstrumentItemScale Knowledge12Yes/No Attitudes13Likert scale 1-5 SD Strongly disagree D Disagree IDK I don’t know A Agree SA Strongly agree Behaviors13Likert scale 1 Always (100%) 2 Mostly (75%) 3 Often (50%) 4 Never (0%) Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre 10

11. Method: Data Analysis TestKnowledgeBeliefsBehavior KR200.5-0.89  -0.290.86 Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre11 Reliability

12. Method: Data Analysis Descriptive statistics Excel 2007 Frequency distribution 12 Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre

13. 13 Descriptive Statistics

14. Data Analysis Inferential Statistics Independent t-test for K, A and B scores for difference between groups ( races and education). Correlation analysis between K and A. 14Breastfeeding Knowledge, Beliefs and Behaviors. F. Ali-Ferre

15. Results: Knowledge T-test Results for Knowledge (12 items) Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre15 ItemMaster’s and some high school Associate degree and some college African American and White Expecting and those not expecting Result0.130.320.0020.07

16. Results: Knowledge Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre16 ItemsGroup mean Expecting mothers Item 5 Item 6 Item 7 Proportion incorrect Result6.36.898%92%88% Results for Knowledge (12 items)

17. Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre17 ItemsItem test mean 1. There is an economic benefit of breastfeeding. 4.18 4. Breastfeeding means I have to eat and drink differently. 3.48 7. Breastfeeding is good for me. 3.94 12. I don't think I know enough about breastfeeding. 3.22 Likert scale 1-5 SA=5 A=4 DA=3 SD=2 IDK=1 Results: Attitude

18. Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre18 ItemsItem test mean 5. I would be embarrassed if someone saw me breastfeeding. 2.7 6. Breastfeeding makes the breasts sag. 2.74 9. Breastfeeding is painful.2.9 11. I don't think I know enough about breastfeeding. 2.76 10. Breastfeeding means I can't go back to school or/and work. 1.86 Results: Attitude

19. Correlation coefficient Inverse relation between K and A -0.32 T-test=0.159 (.05); not a significant difference btw African Americans and Whites. Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre 19

20. Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre 20 BehaviorExpecting women Will breastfeed, not sure of duration.11 Exclusively 1 year.1 Exclusively 18 months.1 Bottle feeding2 Thinking of breastfeeding but not sure 2 1 month2 6 months8 Not thinking of breastfeeding, no decision. 1 Total28 Results: Behavior

21. Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre21 Behavior (reasons for not breastfeeding) Respondents Medication, doctor did not recommend. 1 Mother (50%)2 Partner (75%)1 School (50%)1 Results: Behavior

22. Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre22 Results: Behavior

23. Conclusion and Recommendations Disparity in breastfeeding K between African Americans and Whites. Need targeted programming No significant difference in K Educational levels Between expecting mothers and those that are not. 23Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre

24. Conclusion and Recommendations No significant difference in Attitude between races. Average Knowledge (K) test score low Need to increase K. Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre24

25. Conclusion and Recommendations Revise content of breastfeeding information provided through physicians, health departments and hospitals. Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre25

26. Implications Findings could be utilized as part of a pilot study to create a breastfeeding promotion program for the women of Carbondale. Majority on Medicaid implies modest income Need to research further for SES barriers to breastfeeding. 26Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre

27. Implications Focus on WIC program. Apply Stages of Change Theory to learning material to target the “intending but undecided” group. Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre27

28. Limitations and Recommendations Items for attitudes should be revised since the CA was not within an accepted value. A likely response bias may have affected the survey because respondents’ significant others were seated next to them. Participation skewed towards Medicaid recipients. Pilot study needs more research. 28Breastfeeding Knowledge, Attitudes and Behaviors. F. Ali-Ferre