Impact of Rural Habitus on First-Time Mothers' Feeding Choices

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Project Summary/Abstract Rural U.S. mothers, especially those of lower socioeconomic status (SES), are more reluctant to breastfeed than urban mothers of comparable SES. The question is whether the experience of living in a rural area is influencing a rural woman’s decision on how to feed her infant. An understanding of the contextual factors existing in a community that are influencing infant feeding choices is needed to guide future nursing breastfeeding research The purpose of this study is to qualitatively explore rural habitus, or the community influence on rural mothers’ decisions on how they feed their infants. The specific aims of this study are: 1) To explore rural mothers’ intentions and decision-making around infant feeding their first child, including their unique habitus, and other key community influencing factors; 2) To describe rural mothers’ perceptions of how the rural community influenced their infant feeding decisions; and 3) To explore rural mothers’ priorities for interventions to support breastfeeding, including needs for information, support, and resources. The recruitment of participants will take place through rural Missouri WIC clinics as well as rural Federally Qualified Health Centers (FQHCs) with obstetrical or pediatric services. The concepts of habitus and rurality will guide this study, utilizing a qualitative descriptive approach to allow themes from the rural women’s own voices to be generated regarding factors that formed their decision on how to feed their newborn. The findings will be utilized in a post-doctoral fellowship to develop a quantitative instrument to survey a larger rural population of women to further test how habitus influences breastfeeding. The applicant’s long-term goal will be to design an effective nursing intervention to boost breastfeeding rates in underserved rural communities. A key strength of this study is the research team the applicant has assembled. Drs. Bullock, Everett and Bloom have a long history of research collaboration studying health disparities in rural Missouri. Dr. Bullock will provide senior mentorship for the research team, as well as data collected with rural Missouri perinatal women that can be explored for the concept of habitus. Dr. Everett’s current research has a strong overlap with the goal of this study and can provide hands-on training for the applicant. Dr. Bloom has extensive research experience and publications using qualitative methodology and will provide crucial mentoring in this area. Lastly, the team will be complete with the support of a senior interdisciplinary scientist, Dr. Beth Olson, who has extensive research experience in rural communities and in breastfeeding research. Overall, this proposal has multiple strengths: 1) It is taking a unique approach of exploring habitus in addressing an aged old problem of increasing breastfeeding, 2) It is addressing one of the nation’s most vulnerable and understudied populations, rural women who have increased health disparities and few resources, and 3) It is highly responsive to NINR’s strategic goals of enhancing wellness and developing culturally tailored interventions intended for families and underrepresented communities.40