Multi-modal Intervention for Lactation Care (MILC) will be a mHealth platform to increase

哺乳期护理多模式干预 (MILC) 将成为一个移动医疗平台，以提高

• 批准号: 10401171
• 负责人: Tony Xuyen Ma
• 金额: $ 31.35万
• 依托单位: BENTEN TECHNOLOGIES, INC.
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-18 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10401171
• 关键词: Academy; Address; African American; American; Asthma; Behavior; Belief; Breast Feeding; Businesses; Caring; Centers for Disease Control and Prevention (U.S.); Child; Chronic Disease; Clinical; Collaborations; Communication; Communication Tools; Complementary Feeding; Control Groups; Development; Diabetes Mellitus; Diarrhea; Drops; Education; Exclusive Breastfeeding; Face; Felis catus; Gastroenteritis; Health Benefit; Healthcare Systems; Hispanics; Hospitals; Hour; Human Milk; Hypertension; Incentives; Infant; Infant formula; Insurance; International; Intervention; Interview; Lactation; Lactation consultant; Life; Low income; Medicaid; Methodology; Minority Groups; Mobile Health Application; Modality; Mothers; Nipples; Not Hispanic or Latino; Obesity; Participant; Pediatrics; Perception; Periodicity; Phase; Population; Precede-Proceed Model; Principal Investigator; Privacy; Professional counselor; Randomized; Reporting; Research; Respiratory Tract Infections; Risk; Savings; Scheme; Secure; Small Business Innovation Research Grant; Social support; Structure; Sudden infant death syndrome; System; Testing; Time; United States; University Hospitals; Weaning; Woman; Work; base; care providers; chatbot; commercialization; control trial; design; encryption; ethnic disparity; feeding; group intervention; improved; individual patient; innovation; interest; mHealth; multi-component intervention; peer; peer support; premature; programs; prototype; racial and ethnic; support network; telehealth; usability; user centered design; virtual

PROJECT SUMMARY/ABSTRACT The 2017 Centers for Disease Control and Prevention’s (CDC) Breastfeeding Report Card reported that despite a high breastfeeding (BF) initiation of approximately 80% among the Hispanic population in the United States (US), less than 25% of infants were exclusively breastfed (EBF) through 6 months, further perpetuating ethnic disparities in chronic diseases such as diabetes, obesity, and hypertension. Hispanic women are more likely to supplement feeding with formula, than non-Hispanic or African American (AA) mothers. Research has reported that barriers such as insufficient BF education, lack of BF technical support (i.e. latching issues, sore nipples), returning to work, easy access to free or discounted formula milk from Women Infants and Children (WIC), lack of social support, perceived inconvenience, cultural belief that both formula and breastmilk (los- dos) is best for the babies, perception that the infant is not satiated, and embarrassment associated with breastfeeding result in premature weaning off BF among low-income Hispanic mothers. Therefore, increasing the duration of EBF and continuous BF among low-income Hispanic women would require an innovative and comprehensive approach that addresses the diverse range of barriers listed above. The proposed Fast-track proposal titled Multi-modal Intervention for Lactation Care (MILC) will be a mHealth platform that consists of the following innovative components: 1) Chat bot system to provide virtual peer counselor support; 2) Use of escalating magnitude of incentives contingent on remotely observed breastfeeding; 3) Asynchronous and synchronous communication tools to facilitate lactation and social support; and 4) Virtual peer mother to mother support network. We propose the following aims for the Phase I: 1) Conduct formative research with a) low-income Hispanic mothers, b) Certified and international board- certified lactation consultants (CLCs/IBCLCs) and c) in-depth Interviews (IDI)s with WIC staffs/primary care providers (PCPs). 2) Conduct pilot testing of MILC prototype with 20 low-income Hispanic BF mothers who delivered their babies at TUH and 5 CLC/IBCLCs working at TUH to demonstrate feasibility (usability and acceptance). We propose the following aims for the Phase II: 1) Modify Phase I MILC prototype for commercialization and; 2) Conduct a randomized control trial (RCT) with 178 participants from TUH and Christiana Care Health System (CCHS) and 20 CLCs/IBCLCs on MILC to assess MILC’s efficacy to significantly improve EBF rates at 6 months including increasing rates of any BF at month 1, month 3 and month 6. In the long term, the impact of MILC will increase the rates of EBF up to 6 months along with increasing rates of any BF up to 12 months.

项目总结/摘要 2017年疾病控制和预防中心（CDC）的母乳喂养报告卡报告说， 尽管在美国的西班牙裔人口中，母乳喂养（BF）的开始率约为80%， 在美国，不到25%的婴儿在6个月内完全母乳喂养（EBF），进一步延续了 糖尿病、肥胖症和高血压等慢性病的种族差异。西班牙裔女性更多 与非西班牙裔或非裔美国人（AA）母亲相比，研究 报告说，障碍，如BF教育不足，缺乏BF技术支持（即闭锁问题，疼痛， 乳头），重返工作岗位，容易获得免费或折扣的配方奶粉，从妇女婴儿和儿童 (WIC)、缺乏社会支持、感知到不便、认为配方奶粉和母乳都是母乳的文化信仰（洛斯- dos）对婴儿来说是最好的，婴儿没有吃饱的感觉，以及与之相关的尴尬。 母乳喂养导致低收入西班牙裔母亲过早断奶。因此提高 低收入西班牙裔妇女的EBF和连续BF的持续时间将需要一个创新的， 采取综合办法，解决上述各种障碍。拟议的快速通道 一项名为“哺乳护理多模式干预”（MILC）的提案将是一个移动健康平台，包括 以下创新组件：1）聊天机器人系统，提供虚拟同伴辅导员支持; 2）使用 激励措施的规模不断扩大，取决于远程观察到的母乳喂养; 3）异步和 同步通信工具，以促进哺乳和社会支持;和4）虚拟同龄母亲， 母亲支持网我们建议第一阶段的目标如下： 1)与a）低收入西班牙裔母亲，B）认证和国际委员会进行形成性研究- 认证的哺乳顾问（CLC/IBCLC）和c）与WIC工作人员/初级保健的深入访谈（IDI） 供应商（PCP）。 2)对20名低收入西班牙裔分娩母亲进行MILC原型的试点测试 在TUH和5个CLC/IBCLC在TUH工作，以证明可行性（可用性和验收）。 我们建议第二阶段的目标如下： 1)为商业化修改第一阶段MILC原型; 2)对来自TUH和Christiana Care Health的178名参与者进行随机对照试验（RCT） 系统（CCHS）和20个关于MILC的CLC/IBCLC，以评估MILC在显著提高EBF率方面的功效， 6个月，包括第1个月、第3个月和第6个月时任何BF的增加率。 从长远来看，MILC的影响将使EBF的利率最多增加6个月， 任何BF长达12个月。