1. The Effect of Message Framing on Human Milk Donation Janice Sneider O’Rourke, MPA, RD PhD Candidate, Lilly School Of Philanthropy April 8, 2014 *Detweiler, et al., 1999

2.  Executive Director of the Indiana Mothers’ Milk Bank  The Milk Bank did not provide any support for this research. Disclosure *Detweiler, et al., 1999

3.  Overview of Framing Theory  Framing Theory and  Public Health  Philanthropy  Breastfeeding  Human Milk Donation  Field Experiment  Preliminary Results  Discussion Overview *Detweiler, et al., 1999

4. Framing Theory  People respond differently to messages depending on how they’re framed (the perspective).  People avoid taking risks when gains are prominent  People are willing to take risks when losses are prominent  Willingness to incur risk in order to promote a desirable outcome or avoid an undesirable outcome changes depending on how the message is framed. *Detweiler, et al., 1999

5.  Disease outbreak expected to kill 600 people  Certainty that Program A will save 200 people  Program B  1/3 probability that 600 people will be saved (72% chose)  2/3 probability that no one will be saved (28% chose)  Majority choice is risk averse  Prospect of saving 200 lives is more attractive *Detweiler, et al., 1999 Framing Experiments

6.  Disease outbreak expected to kill 600 people  Certainty with Program C that 400 people will die  Program D  1/3 probability that none will die (22% chose)  2/3 probability that 600 will die (78% chose)  Majority choice is risk taking  Certain death of 400 less acceptable than 2/3 chance that 600 will die *Detweiler, et al., 1999 Framing Experiments con’t

7.  Use of pictures can increase charitable giving.  Framing of fundraising messages.  Effects of media. Framing and Philanthropy *Detweiler, et al., 1999

8.  Potential gains=advantages or benefits  “Protect yourself from the sun and you will keep yourself healthy”*  “If you limit your soda drinking, you are more likely to avoid tooth decay”**  Potential losses=disadvantages or costs  “Expose yourself to the sun and you will risk becoming sick”*  “If you drink a lot of soda, you are likely to have tooth decay”** Framing and Public Health *Detweiler, et al., 1999; ** Aldridge, 2006.

9.  In a comparison of breastfeeding women, those having received loss-framed materials will be more likely to donate excess breastmilk to a human milk bank than will those receiving gain-framed materials.  In a comparison of breastfeeding women, those having received materials with a negative picture will be more likely to donate excess breastmilk to a human milk bank than will those receiving materials with a positive picture. Hypotheses: Framing and Human Milk Donation *Detweiler, et al., 1999

10. Why Human Milk? Advantages for Baby  Reduces risk of  Ear Infections  Dermatitis  Gastroenteritis  Lower Respiratory Infections  Asthma  SIDS  Necrotizing Enterocolitis Advantages for Mom  Decreased blood loss  Uterus reduces faster  Reduced risk of  Breast Cancer  Ovarian Cancer  Postpartum Depression *Detweiler, et al., 1999

11.  Recommended as the standard infant feeding by:  American Academy of Pediatrics  American Academy Of Family Physicians  American College of Nurse-Midwives  American College of Obstetricians and Gynecologists  American Public Health Association  Academy of Nutrition and Dietetics  World Health Organization  Exclusive for first six months  As part of baby’s diet for at least twelve months Why Human Milk? *Detweiler, et al., 1999

12. Current Breastfeeding Stats HP 2020 Goals  Ever breastfed: 81.9%  Breastfed 6 months: 60.6%  Breastfed 1 year: 34.1% US 2010  Ever breastfed: 76.5%  Breastfed 6 months: 49%  Breastfed 1 year: 27% Indiana 2010  Ever breastfed: 63.6%  Breastfed 6 months: 37.7%  Breastfed 1 year: 16.5% *Detweiler, et al., 1999

13.  Conceptual definition: The concept of breast milk donation is defined as the extent to which women offer their excess breast milk to nonprofit human milk banks for use with infants other than their own. *Detweiler, et al., 1999 Human Milk Donation

14.  Premature and ill infants are 6 to 10 times more likely to acquire life-threatening infections during the critical neonatal period if they are fed infant formula instead of human milk.  Without human milk up to 15 percent of neonatal intensive care patients acquire NEC.  It is standard practice for hospital neonatologists to strongly encourage mothers of premature infants to breastfeed or express their milk for tube-feeding.  Some mothers are unable to provide sufficient milk  American Academy of Pediatrics (AAP) recommends using banked human milk with mom’s own is not available. *Detweiler, et al., 1999 Human Donor Milk

15. Messages *Detweiler, et al., 1999

16. As a mother, you know that breastmilk is best for your baby. But did you know that breast milk can help premature babies? The Indiana Mothers’ Milk Bank believes that human milk is best for all babies. Research has shown that babies that are fed human milk, including donor human milk, have fewer infections. By donating your extra milk, you can save premature babies’ lives. Please consider donating your excess breastmilk to The Indiana Mothers’ Milk Bank Positive Message *Detweiler, et al., 1999

17. As a mother, you know that breastmilk is best for your baby. But did you know that breast milk can help premature babies? The Indiana Mothers’ Milk Bank believes that human milk is best for all babies. Research has shown that babies that are fed human milk, including donor human milk, have fewer infections. The Indiana Mothers’ Milk Bank always needs a good supply of donor milk. If you don’t donate your extra milk, these premature babies could die. Please consider donating your excess breastmilk to The Indiana Mothers’ Milk Bank. Negative Message *Detweiler, et al., 1999

18. Positive Picture-Healthy Baby *Detweiler, et al., 1999

19. Negative Picture – Ill Premature Baby *Detweiler, et al., 1999

21. Frames Positive Message Positive Picture Negative Message Positive Picture Positive Message Negative Picture Negative Message Negative Picture *Detweiler, et al., 1999

22. Demographics - Age *Detweiler, et al., 1999

23. Demographics *Detweiler, et al., 1999

25. Results *Detweiler, et al., 1999

26. Results, con’t *Detweiler, et al., 1999

27. Results, con’t *Detweiler, et al., 1999