Evaluate a Peer Counseling Program to Promote Breastfeeding in WIC Participants

评估同伴咨询计划以促进 WIC 参与者母乳喂养

• 批准号: 8523947
• 负责人: THEODORE J JOYCE
• 金额: $ 7.48万
• 依托单位: BERNARD M. BARUCH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-06 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8523947
• 关键词: Academy; American; Breast Feeding; Characteristics; Child; Client; Control Groups; Counseling; County; Coupled; Data; Dose; Effectiveness; Food; Infant; Infant Health; Infant formula; Information Systems; Intention; Intervention; Linear Regressions; Logistic Regressions; Maternal Health; Methods; Oregon; Outcome; Participant; Pediatrics; Randomized; Randomized Controlled Trials; Rest; Selection Bias; Services; Source; Surgeon; Telephone; Time; United States Dept. of Health and Human Services; Validity of Results; Woman; arm; base; comparison group; cost effective; design; improved; nutrition; peer; programs; response; safety net; treatment effect; trial comparing; voucher

DESCRIPTION (provided by applicant): A long-standing programmatic tension within the Supplemental Nutrition Program for Women, Infants and Children (WIC) has been the promotion of breastfeeding coupled with the availability of free infant formula. Breastfeeding initiation and duration is substantially lower among WIC participants than their eligible non-participants. Peer counseling has been viewed as a potentially cost-effective means of increasing breastfeeding without removing the safety net of free formula. In fact, the recent Surgeon General's Call to Action on Breastfeeding recommends that peer counseling become a core service in all WIC agencies. The proposed study will evaluate the effectiveness of a telephone-based peer counseling program to improve breastfeeding among WIC recipients. The study leverages already collected data from the largest randomized control trial (RCT) of peer counseling for breastfeeding ever undertaken among WIC clients by contrasting results from the RCT conducted in four counties in Oregon to those from a non-randomized peer counseling intervention of the same design that was implemented at the same time in two different counties in the state. As a third contrast, we will analyze changes in breastfeeding among WIC clients in the same state over the same study period but in counties that had no peer counseling intervention. Data from the last two sources will be extracted from Oregon's WIC administrative data system. We will compare estimates of the intention-to-treat as well the effect of treatment on the treated in the RCT to those obtained from a non-randomized design. This will provide the first estimates of selection bias associated with a peer counseling intervention based on observational data. In addition, we can estimate the potential external validity of results from th RCT by contrasting the characteristics and breastfeeding outcomes of WIC participants in the control arm of the RCT to those of WIC participants in counties with no peer counseling. By exploiting data in three distinct settings, (RCT of peer counseling, non-RCT of peer counseling and no peer counseling), we will provide a comprehensive examination of the potential of peer counseling to enhance the initiation, duration and exclusivity of breastfeeding among WIC participants.

描述(由申请人提供)：妇女、婴儿和儿童补充营养计划(WIC)中的一个长期方案紧张一直是促进母乳喂养和提供免费婴儿配方奶粉。与符合条件的非参与者相比，WIC参与者的母乳喂养开始和持续时间要低得多。同伴咨询一直被视为一种潜在的高性价比手段，可以在不取消免费配方奶粉安全网的情况下增加母乳喂养。事实上，最近卫生局局长关于母乳喂养的行动呼吁建议同伴咨询成为所有WIC机构的核心服务。这项拟议的研究将评估电话同伴咨询计划的有效性，以改善WIC接受者的母乳喂养。这项研究利用了有史以来在WIC客户中进行的最大规模的母乳喂养同伴咨询随机对照试验(RCT)收集的数据，通过将在俄勒冈州四个县进行的RCT结果与在该州两个不同县同时实施的相同设计的非随机同伴咨询干预的结果进行比较。作为第三个对比，我们将分析同一研究期间同一州的WIC客户之间母乳喂养的变化，但在没有同伴咨询干预的县。最后两个来源的数据将从俄勒冈州的WIC行政数据系统中提取。我们将比较随机对照试验与非随机设计中对意向治疗的估计以及治疗对受试者的影响。这将提供基于观察数据的与同伴咨询干预相关的选择偏差的第一次估计。此外，我们可以通过对比随机对照研究控制组的WIC参与者和没有同伴咨询的县的WIC参与者的特征和母乳喂养结果来评估TRCT结果的潜在外部效度。通过利用三个不同环境中的数据(同伴咨询的RCT、非同伴咨询的RCT和非同伴咨询)，我们将全面考察同伴咨询的潜力，以提高WIC参与者母乳喂养的初始、持续时间和排他性。