Community Participation Research of Breastfeeding Disparities in African American

非裔美国人母乳喂养差异的社区参与研究

• 批准号: 7427414
• 负责人: Tamar Ringel-Kulka
• 金额: $ 17.35万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7427414
• 关键词: Academia; Address; African American; Age; Area; Attitude; Behavior; Belief; Breast Feeding; Budgets; Businesses; Case-Control Studies; Cessation of life; Child; Child Care; Child health care; Childhood; Childhood Leukemia; Clinic; Communities; Community Participation; County; Data; Data Collection; Databases; Diarrhea; Disease; Economics; Eczema; Education; Ensure; Evidence based intervention; Exanthema; Exclusive Breastfeeding; Feeling; Female; Focus Groups; Foundations; Future; Goals; Grant; Guidelines; Health; Health Personnel; Healthy People 2010; Hispanics; Hospitals; Human; Human Resources; Individual; Infant; Infant Health; Intervention; Investments; Knowledge; Literature; Lower Respiratory Tract Infection; Medical; Methods; Minority; Modeling; Mothers; Movement; Names; Nature; Needs Assessment; North Carolina; Not Hispanic or Latino; Obesity; Outcome; Pattern; Persons; Pilot Projects; Population; Postpartum Period; Pregnant Women; Principal Investigator; Process; Public Health; Publishing; Purpose; Rate; Recommendation; Recording of previous events; Research; Research Personnel; Review Literature; Rural; Series; Services; Shapes; Staging; Sudden Death; Surveys; Syndrome; United States Agency for Healthcare Research and Quality; United States Dept. of Health and Human Services; Universities; Urban Population; Woman; Work; Writing; base; community based participatory research; community organizations; data management; day; demographics; design; ear infection; experience; grandparent; health disparity; improved; member; minority health; mortality; outreach; pediatrician; prenatal; programs; reproductive; social; statistics; type I and type II diabetes

DESCRIPTION (provided by applicant): Community Participation Research of Breastfeeding Disparities in African American Women Objective: To use an iterative, Community-Based Participatory Research (CBPR) approach to engage representatives of academic and community-based partners including community organizations, business and lay persons in partnering and collaborating to assess, address and improve breast feeding among African American women in Durham County. Methods: This pilot study is focusing on breastfeeding in African American women of Durham County, a community chosen due to previous collaborative work and contacts with Durham County Health Department and other community programs as well as the foundation of collaborative work within the community itself. Facilitating factors include the large population of African-American women, existence of health disparities, rural/urban population mix and close proximity to the university. The existing collaborative includes representatives from health and human service organizations, academia, community-based organizations and civic organizations. Over a series of nine meetings, the collaborative identified gaps in current service delivery, developed a theme and formed sub-committees to collectively develop the research application, including the budget, specific aims, literature review, methods, dissemination plan and key personnel. Upon acquisition of the grant, the first step of the planned process is to expand the existing collaborative to include additional community partners so we benefit from involvement of all aspects medical, social, economic, cultural, historical, faith-based, and political. To familiarize and educate past and new members in the background of the initiative and bring everyone to a common start base, two half-day long meetings will take place in the beginning of the study period. In these two meetings, we will form sub-committees such as: outreach, data management, survey, focus groups, pilot study, dissemination, and writing. At least one representative from the community and one representative from academia will be in each sub-committee. The community and university Principal Investigators will share equal responsibility on overseeing the execution of this project and will meet on a weekly basis. The second step of the planned process is to develop sets of variables that will be used to assess breastfeeding patterns and potential factors that can influence these patterns. The latter will address the following domains: Mothers' knowledge, attitudes, beliefs, feelings, barriers, needs and available services in Durham County. These variables will initially be identified by a comprehensive review of the published literature on these topics and a review of breastfeeding guidelines, recommendations, and evidence-based interventions. Data collection will include the use of secondary/existing databases for general demographics and breastfeeding patterns in Durham County as well as primary data collected via focus groups with and surveys of African American pregnant women, African American women of reproductive age, partners of African American females of reproductive age, grandparents, and other groups in the community that may have an influence on breastfeeding choices (e.g. employers, child care directors, parishioners, health care providers). The third and final step of the planned process is to work with community-based agencies, organizations and individuals, to implement a pilot intervention, analyze the results, interpret the implications, disseminate the results, and plan for future full scale, community-wide effort to increase breastfeeding initiation and duration among African American women of Durham County. PUBLIC HEALTH RELEVANCE: AHRQ review of the evidence on the effects of breastfeeding on short- and long-term infant health outcomes from April 2007 show that children who are not breastfed suffer increased health problems such as ear infections, lower respiratory tract infections, skin rashes similar to eczema, asthmatic episodes, type I and type II diabetes, episodes of infant diarrhea, and incidents of childhood leukemia and sudden death syndrome. Also, exclusive breastfeeding for more than 6 months has been shown to be associated with leaner body shape at age five, and many reviews and case-control studies have shown the protective impact of breastfeeding against childhood obesity. North Carolina State Center for Health Statistics and NC CHAMPS 2005 show that in North Carolina, minority infants, who are less likely to be breastfed and when they do breastfeed, it is for significantly shorter durations on average, experience a disproportionate mortality from the same illnesses that are known to be reduced if one breastfeeds. Therefore, improved breastfeeding rates and duration could have a profound impact on death and disease in North Carolina's African American population. We created the } Durham B.E.S.T (Breastfeeding, Education & Support Team) Alliance for Babies} and propose to conduct community participation research of breastfeeding disparities in African American women in Durham County, North Carolina.

描述（由申请人提供）：非裔美国妇女母乳喂养差异的社区参与研究目标：采用迭代的、基于社区的参与性研究（CBPR）方法，让学术界和社区合作伙伴（包括社区组织、企业和非专业人士）的代表参与合作，评估、解决和改善达勒姆县非裔美国妇女的母乳喂养问题。方法：本试点研究的重点是达勒姆县非裔美国妇女的母乳喂养，该社区的选择是由于之前的合作工作和与达勒姆县卫生局和其他社区项目的联系，以及社区内部合作工作的基础。促进因素包括非洲裔美国妇女人口众多、存在健康差距、城乡人口混合以及靠近大学。现有的协作包括来自卫生和人类服务组织、学术界、社区组织和民间组织的代表。在一系列的9次会议中，协作小组确定了当前服务提供方面的差距，制定了一个主题，并成立了小组委员会，共同制定研究申请，包括预算、具体目标、文献综述、方法、传播计划和关键人员。在获得赠款后，计划进程的第一步是扩大现有的合作，包括更多的社区合作伙伴，以便我们从医疗、社会、经济、文化、历史、信仰和政治等各个方面的参与中受益。为了在项目背景下熟悉和教育新老成员，并使每个人都有一个共同的起点，在学习期开始时将举行两次半天的会议。在这两次会议中，我们将成立外联、数据管理、调查、焦点小组、试点研究、传播和写作等小组委员会。每个小组委员会至少有一名社区代表和一名学术界代表。社区和大学的首席研究员将分担监督项目执行的同等责任，并将每周会面一次。计划进程的第二步是制定一系列变量，用于评估母乳喂养模式和可能影响这些模式的潜在因素。后者将涉及以下领域：母亲的知识、态度、信仰、感受、障碍、需求和达勒姆县的现有服务。这些变量最初将通过对有关这些主题的已发表文献的全面审查以及对母乳喂养指南、建议和循证干预措施的审查来确定。数据收集将包括利用达勒姆县一般人口统计和母乳喂养模式的二级/现有数据库，以及通过对非裔美国孕妇、非裔美国育龄妇女、非裔美国育龄妇女的伴侣、祖父母和社区中可能对母乳喂养选择有影响的其他群体(如雇主、托儿主任、教区居民、卫生保健提供者)。计划过程的第三步也是最后一步是与社区机构、组织和个人合作，实施试点干预，分析结果，解释影响，传播结果，并计划未来在全社区范围内开展全面的努力，以增加达勒姆县非裔美国妇女的母乳喂养开始和持续时间。公共卫生相关性：AHRQ审查了2007年4月以来关于母乳喂养对婴儿短期和长期健康结果的影响的证据，结果表明，非母乳喂养的儿童遭受更多的健康问题，如耳部感染、下呼吸道感染、类似湿疹的皮疹、哮喘发作、I型和II型糖尿病、婴儿腹泻发作、儿童白血病和猝死综合症发作。此外，超过6个月的纯母乳喂养已被证明与5岁时更苗条的体型有关，许多评论和病例对照研究表明，母乳喂养对儿童肥胖有保护作用。北卡罗莱纳州卫生统计中心和2005年NC CHAMPS表明，在北卡罗莱纳州，少数民族婴儿不太可能接受母乳喂养，即使母乳喂养，平均持续时间也短得多，他们患的疾病的死亡率不成比例，而已知母乳喂养可以减少同样的疾病。因此，改善母乳喂养率和持续时间可能对北卡罗来纳州非裔美国人的死亡和疾病产生深远影响。我们创建了Durham B.E.S.T（母乳喂养，教育和支持团队）婴儿联盟，并提议在北卡罗来纳州的Durham县开展非裔美国妇女母乳喂养差异的社区参与研究。