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

项目总结/摘要 未能开始母乳喂养（BF）和纯母乳喂养（EBF），持续推荐的6个月时间， 可导致母亲及其婴儿长期患病。非裔美国人/黑人（AA/B） 在美国所有种族中，BF启动率和EBF率最低。AA/B婴儿有 不成比例的高死亡率，儿童哮喘和婴儿猝死的发病率很高 死亡综合征（SIDS），而AA/B母亲患肥胖、糖尿病等慢性疾病的风险较高， 心血管疾病这些健康差异使美国在医疗方面花费了超过91亿美元 但可以通过提高EBF利率来减少。然而，AA/B妇女在多个方面遇到障碍， 开始、继续BF和维持EBF（通过停止BF或引入补充剂）的水平 BF与其他食物）。AA/B中智能手机拥有率和数字内容消费率较高 女性，拟议的移动健康干预有很大的潜力，以增加BF启动和维持EBF 在AA/B女性中，并在我们之前完成的研究中证明了可行性（用户满意度和使用） 可行性研究拟议的SBIR直接第二阶段的应用，知识和使用哺乳使用 来自支持网络的教育和咨询（KULEA-NET）解决了一个未得到满足的需求， 移动的应用程序，提供全面的BF支持，并解决相互关联和复杂的BF障碍 AA/B母亲的经验跨越社会生态层。 KULEA-NET将提供全面的BF支持，以培养和支持AA/B妇女开始BF， EBF，并包括以下创新功能：a）社会营销和健康品牌，以促进 EBF作为一种社会可取的行为; B）微学习教育内容，以提高获得 与EBF相关的知识和技能; c）支持利用异步 沟通，让母亲与她的BF支持者，同行和哺乳专业人士沟通 （d）将利用用户信息（例如， 分娩、喂养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; 以及e）虚拟社区支援网络，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自我效能感和BF意图，并最终 在AA/B母亲中，6个月时BF开始、BF持续时间和EBF率增加，因此， 改善母婴健康成果。

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.