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: 7580915
• 负责人: Tamar Ringel-Kulka
• 金额: $ 19.87万
• 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 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7580915
• 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 Leukemia; Clinic; Communities; Community Participation; County; Data; Data Collection; Databases; 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; Infantile Diarrhea; Intervention; Investments; Knowledge; Literature; Lower Respiratory Tract Infection; Medical; Methods; Minority; Modeling; Mothers; Movement; Names; Nature; Needs Assessment; North Carolina; Not Hispanic or Latino; Outcome; Pattern; Persons; Pilot Projects; Population; Postpartum Period; Pregnant Women; Principal Investigator; Process; Publishing; 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; demographics; design; ear infection; experience; grandparent; health disparity; improved; meetings; member; minority health; mortality; obesity in children; outreach; pediatrician; prenatal; programs; public health relevance; 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)：非洲裔美国妇女母乳喂养差异的社区参与研究目标：使用迭代的、基于社区的参与性研究(CBPR)方法，吸引学术和社区合作伙伴的代表，包括社区组织、企业和非专业人士，合作评估、解决和改善达勒姆县非裔美国妇女中的母乳喂养问题。方法：这项试点研究的重点是达勒姆县非裔美国妇女的母乳喂养，该社区是根据以前与达勒姆县卫生局和其他社区项目的合作和接触以及社区内部合作的基础而选择的。促进因素包括非洲裔美国妇女的大量人口、健康差距的存在、城乡人口的混合以及离大学很近。现有的协作组包括来自卫生和公共服务组织、学术界、社区组织和民间组织的代表。在一系列九次会议上，协作小组找出了目前提供服务方面的差距，制定了一个主题，并成立了小组委员会，以集体制定研究应用，包括预算、具体目标、文献审查、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伙伴，以包括更多的社区合作伙伴，使我们受益于医疗、社会、经济、文化、历史、信仰和政治等方方面面的参与。为了在倡议的背景下熟悉和教育旧成员和新成员，并使每个人都有一个共同的起点，在研究期开始时将举行两次为期半天的会议。在这两次会议上，我们将组成小组委员会，如：外联、数据管理、调查、焦点小组、试点研究、传播和写作。每个小组委员会最少会有一名社会代表和一名学术界代表。社区和大学首席调查员将分担监督这一项目执行的同等责任，并将每周举行会议。计划过程的第二步是开发一组变量，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：达勒姆县母亲的知识、态度、信仰、情感、障碍、需求和可用的服务。这些变量最初将通过对已发表的关于这些主题的文献的全面审查以及对母乳喂养指南、建议和循证干预的审查来确定。数据收集将包括使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人孕妇、非裔美国人育龄妇女、非裔美国人育龄女性的伴侣、祖父母和社区中可能对母乳喂养选择产生影响的其他群体(例如雇主、儿童保育主任、教区居民、保健提供者)进行焦点小组和调查而收集的基本数据。计划进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，并计划未来在整个社区范围内全面努力，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影响的证据，结果显示，非母乳喂养的儿童面临更多的健康问题，如耳朵感染、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、儿童白血病和猝死综合症的事件。此外，纯母乳喂养超过6个月已被证明与5岁时更苗条的体型有关，许多综述和病例对照研究表明，母乳喂养对儿童肥胖具有保护作用。北卡罗来纳州卫生统计中心和北卡罗来纳州2005年全国冠军表明，在北卡罗来纳州，少数族裔婴儿不太可能接受母乳喂养，当他们进行母乳喂养时，平均母乳喂养的持续时间要短得多，他们死于同样的疾病的比例不成比例，而如果一个人母乳喂养，这些疾病就会减少。因此，母乳喂养率和持续时间的提高可能会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达勒姆县开展关于非裔美国女性母乳喂养差异的社区参与研究。