Development and Evaluation of New Breastfeeding Questions Applicable to Multiple National Surveys

项目总结/摘要 在过去的二十年里，美国的母乳喂养发生了根本性的变化：母乳喂养曾经是 规范，但现在超过85%的母乳喂养的婴儿是从一个瓶子里喂养的， 5%-7%的母乳喂养的婴儿从来没有母乳喂养过。国家调查的数据是 通常用于在国家和地方各级宣传和评估母乳喂养促进工作， 也是研究的基础，但目前在NCHS调查中使用的问题不再反映当代 婴儿喂养和哺乳实践，并导致显著的测量误差。我们的长期目标是 有助于对当代婴儿喂养和哺乳实践的影响有新的认识， 妇幼保健。我们在此的目标，也是实现这一目标的下一步，是发展和 评估一套简短的调查问题，以准确地了解受访者的这些做法。我们将 通过建立在我们对0 - 5岁儿童的母亲进行调查的前瞻性Moms2Moms研究基础上， 年我们的目标是根据我们的初步数据制定的，这些数据显示， Moms2Moms研究可能被错误分类为"非母乳喂养"或母乳喂养持续时间 如果使用了NCHS问题， 我们的试点调查问题。拟议项目的理由是支持未来的高质量 利用联邦调查数据对孕产妇和儿童健康进行研究和公共卫生监测。我们计划 通过追求以下具体目标来实现我们的目标：1）开发和评估一套简明的调查 关于反映当代实践的哺乳和婴儿喂养的问题，以及2）确保任何回忆偏差 我们的问题集所施加的偏见等于或小于目前使用的问题所施加的偏见， NCHS调查。该方法将包括3个阶段：预测试，横截面现场测试，并与 前瞻性数据。拟议的研究是创新的，因为它将积极解决陷阱， 系统地预先测试我们的问题集，然后再回答，它将正式测试我们的问题集 与现有的NCHS问题进行直接比较，并通过比较直接估计召回偏差 对我们的问题集的回答是4年前从相同的受访者那里收集的前瞻性数据。 通过本申请中提出的研究，我们希望能够提供一套新的、简洁的、经过现场测试的 可能在NCHS调查和非联邦调查中使用的问题。这一贡献意义重大 因为它将对这些调查产生的数据质量产生直接的积极影响，因此， 对依赖这些数据的研究和监测工作的质量产生积极影响。

PROJECT SUMMARY/ABSTRACT Breastfeeding in the US has radically changed over the past two decades: feeding at the breast was once the norm, but now more than 85% of infants fed human milk are fed expressed milk from a bottle at least some of the time, and 5-7% of human-milk fed infants are never fed at the breast at all. Data from national surveys are routinely used to inform and evaluate breastfeeding promotion efforts at the national and local levels and are also the basis for research, but the questions currently in use in NCHS surveys no longer reflect contemporary infant feeding and lactation practices and result in significant measurement error. Our long-term goal is to contribute a new understanding of the impact of contemporary infant feeding and lactation practices on maternal and child health. Our objective here, which is the next step towards that goal, is to develop and evaluate a brief set of survey questions to accurately capture these practices among respondents. We will meet this objective by building on our prospective Moms2Moms study to survey mothers of children aged 0-5 years. Our objective was formulated based on our preliminary data revealing that up to 19% of children in our Moms2Moms study would have been misclassified as “not breastfed” or had human milk feeding duration values that were under/overestimates of greater than 1 month if the NCHS questions had been used rather than our pilot survey questions. The rationale for the proposed project is to support future, high-quality research and public health surveillance of maternal and child health which use federal survey data. We plan to attain our objective by pursuing the following Specific Aims: 1) Develop and evaluate a concise set of survey questions about lactation and infant feeding that reflect contemporary practices, and 2) Ensure any recall bias imposed by our question set is equivalent to or less than the bias imposed by the questions currently used in NCHS surveys. The approach will include 3 phases: Pretest, Cross-sectional Field Test, and Comparison with Prospective Data. The proposed research is innovative because it will proactively address pitfalls by systematically pre-testing our question set before fielding with respondents, it will formally test our question set against the existing NCHS questions for direct comparison, and it will directly estimate recall bias by comparing responses to our question set to prospective data collected with the same respondents 4 years' previous. Through the research proposed in this application, we expect to contribute a new, concise, field-tested set of questions that may be used in NCHS surveys and also non-federal surveys. This contribution is significant because it will have a direct, positive impact on the quality of the data produced by these surveys, and thereby, a positive impact on the quality of research and surveillance efforts that rely on these data.