Knowledge and Usage of Lactation using Education and Advice from Support Network (KULEA-NET)

项目摘要/摘要 未按建议的6个月时间开始母乳喂养(BF)和纯母乳喂养(EBF)； 可能导致母亲及其婴儿的长期发病率。非裔美国人/黑人(AA/B) 在美国所有种族中，最低的BF启动率和EBF比率。AA/B婴儿有 死亡率高得不成比例，儿童哮喘和婴儿猝死的发生率也很高 死亡综合征(SID)，而AA/B母亲患慢性疾病的风险很高，如肥胖、糖尿病和 心血管疾病。这些健康差距使美国花费了超过91亿美元的医疗费用 每年，但可以通过提高EBF利率来减少。然而，AA/B女性在多个方面遇到障碍 水平到开始、持续BF和维持EBF(通过停止BF或引入补充剂 BF和其他食物)。A/B的智能手机拥有率和数字内容消费率较高 对于女性，拟议的mHealth干预措施有很大潜力增加BF的启动和维持EBF 在AA/B女性中使用，并已在之前完成的 可行性研究。建议的SBIR直接第二阶段应用、哺乳知识和用法 来自支持网络的教育和建议(Kulea-Net)解决了对循证医学的未得到满足的需求 移动APP，提供全面的高炉支持，解决相互关联和复杂的高炉障碍 AA/B级母亲的经历跨越了社会生态层面。 Kulea-Net将提供全面的BF支持，以培养和支持AA/B妇女在BF开始和 EBF，并包括以下创新特征：a)促进社会营销和健康品牌 EBF作为一种社会可取的行为；b)微型学习教育内容，以改善获得 与EBF相关的知识和技能；c)支持利用异步的网络通信工具 沟通，允许母亲与她的BF支持者、同龄人和哺乳专业人员进行沟通 支持；d)情景感知交付框架，将利用用户信息，如日期 交付、喂食和尿布日志数据以及位置变量，以提供及时的反馈、内容和指导； E)一个虚拟社区支助网络，将AA/B母亲及其配偶/家庭聚集在一起 成员，并培养一个相互支持的社区。 我们假设Kulea-Net将提高知识、BF自我效能和对BF的意图，并最终 在AA/B母亲中，在6个月时实现更高的BF启动率、BF持续时间和EBF比率，因此， 改善孕产妇和婴儿的健康状况。

PROJECT SUMMARY/ABSTRACT Failure to initiate breastfeeding (BF) and exclusively breastfeed (EBF) for the recommended 6-month duration, can result in long-term morbidity among both mothers and their infants. African Americans/Blacks (AA/B) have the lowest BF initiation and EBF rates among all racial ethnicities in the US. AA/B infants have disproportionately high rates of mortality, and children have a high incidence of asthma and sudden infant death syndrome (SIDS) while AA/B mothers are at high risk for chronic illnesses like obesity, diabetes, and cardiovascular diseases. These health disparities cost the US more than $9.1 billion in medical treatment annually but can be reduced by increasing EBF rates. However, AA/B women experience barriers on multiple levels to initiating, continuing BF, and maintaining EBF (either by discontinuing BF or introducing supplements BF with other foods). With high rates of smartphone ownership and consumption of digital content in AA/B women, the proposed mHealth intervention has great potential to increase BF initiation and maintain EBF among AA/B women and has demonstrated feasibility (user satisfaction and use) in our prior completed feasibility study. The proposed SBIR Direct Phase II application, Knowledge and Usage of Lactation using Education and Advice from Support Network (KULEA-NET) addresses an unmet need for an evidence-based mobile app, providing comprehensive BF support and addresses the interrelated and complex BF barriers AA/B mothers experience across the socio-ecological layers. KULEA-NET will provide comprehensive BF support to nurture and support AA/B women in BF initiation and EBF, and include the following innovative features: a) Social marketing and health branding to promote EBF as a socially desirable behavior; b) Micro-learning educational content to improve the acquisition of knowledge and skills related to EBF; c) Support network communication tools leveraging asynchronous communication that allow mothers to communicate with her BF supporters, peers, and lactation professional supports; d) Context-aware delivery framework that will capitalize on user information such as date of delivery, feeding and diaper log data, and location variables to provide timely feedback, content, and guidance; and e) a Virtual community support network bringing together AA/B mothers and their spouse/family members, and fostering a community of mutual support. We hypothesize that KULEA-NET will improve knowledge, BF self-efficacy, and intentions to BF, and ultimately achieve increased BF initiation, BF duration, and EBF rates at 6 months among AA/B mothers and, as a result, improved maternal and infant health outcomes.