2. Introduction
WIC has been increasing the support for
breastfeeding for more than 7 years
Delaware County WIC has seen a 10% increase
in initiation
Duration of breastfeeding has not increase
proportionally
3. Healthy People 2010
Breastfeeding Goal
75% Breastfeeding Initiation
50% Breastfeeding at 6 months
25% Breastfeeding at 1 year
Breastfeeding has enormous public health
implications
5. Community Based Participatory Research
Recognizing community as a unit of identity
Building on strength of resources
Facilitating collaborative research
Integrating knowledge and action
Promoting co-learning and an empowering
process
Maintaining cyclical and iterative process
From Minkler and Wallerstein, 2003
6. Photovoice as a CBPR Method
Improves the quality and validity of the
research
Illustrates the local knowledge
Develops local theory
Progresses towards action
All features important to CBPR
7. Photovoice: inductive questioning
Enabled 7 WIC participants in Muncie, IN to
record and reflect on their personal strengths
and concerns about breastfeeding support
Promoted critical dialogue and knowledge
concerning support for breastfeeding mothers
Provided a medium for the presentation of
community participant’s lived experiences
(Wang, 1999).
12. Results
Sense of Community Support
Health Care Providers
Public Space
Workplace
Church
School
Sense of Support from others
Father of Child
Friends
Mother
Children
Importance of Role Models
Sense of Strength Within
14. Sense of Receiving Support
“Most of my pictures I took
were just family pictures;
them doing things together
or my husband and them or
my parents and them
because that is my real
support”.
15. Sense of Mutual Support
“We have been good support
to one another, calling each
other with random questions
and concerns and all that”
“… just reaching out to
somebody who had done it
before was important”
“We just have a really tight
friendship and part of it was
that we were nursing
together”
16. Sense of Emotional Support
“He has such high respect
for me, for what I have done
for his son. There is nothing
else I could have done that
would really make him
appreciate me like he does.”
17. Importance of Role Models
“Breastfeeding sets a
certain role model in
our family.”
Crystal
18. Importance of Role Models
“I think there is that
eternal concept of
breastfeeding and [it] is
very welcoming,
nurturing, soft, come
here and cuddle, you
don’t turn them away”.
Crystal
19. Sense of Strength Within
Finding and attending La
Leche League
Discovering how to talk to
her mother about mother’s
negative attitude
Her mother had said: ‘if you
don’t want to starve your
child you should use formula’
and the participant thought
“No way is she going to force
this [giving formula] on us”
20. Sense of Strength Within
“It’s not what’s important to me. It’s what is important for
them…. That’s the most natural way to feed them.”
Kathryn
Breastfed her daughter
and now her twin sons
21. Sense within and the natural way
“They were exploring and
discovering. It’s like
breastfeeding.”
Crystal
22. Sense within of the natural way
“Its really relaxing sitting
down and feeding them.
They are really relaxed,
you get really relaxed.”
Mother of twins
Before Feeding
After Feeding
23. Social Actions
Ideas developed during second session
3rd session participants developed the theme
5 out of 7 participants participated
Follow up via email or phone
Unable to complete social action
Participant moved for a job
Too busy juggling work and parenting
Participant working with husband’s job
Busy family activities
Another pregnancy
Compromised with community interactions
Presented poster at County Fair
Presented poster at Community Artwalk
24. Support from Family
Acknowledgments
We thank I. Güor for laboratory assistance, Mary Juana for seeds, Herb
Isside for applying the greenhouse stress treatment, and M.I. Menter for
statistical advice and scintillating discussions. Funding for this project was
provided by the Swarthmore College Department of Biology, a Merck
summer stipend, and my mom. [Note that people’s titles are omitted.]
Workplace Policy
Conclusions
For further information
Please contact email@swarthmore.edu. More information on this and
related projects can be obtained at www.swarthmore… (give the URL for
general laboratory web site). A link to an online, PDF-version of the
poster is nice, too.
If you just must include a pretentious logo,
hide it down here. But don’t include a pretentious logo.
Use the space for something else.
Blah, blah, blah. Blah, blah, blah. However, blah, blah, blah.
What Makes Breastfeeding Successful
WIC Mothers’ Photo
Project
Community
Programs
Support from Family
“Most of my
pictures were just
family pictures;
them doing things
together or my
husband and
them or my
parents and them
because that is
my real support.”
Kara
Childcare
Policy
School Curriculum
for Health
Community Support
Helpful Professionals
Parent to Parent
Programs
WIC Mothers’ Photo
ProjectWe are seven WIC mothers who have breastfed for at least 4-6 months and volunteered
to
take pictures of what we needed for success as breastfeeding mothers. We met with
the Delaware County WIC lactation consultant three times to share our pictures and
discuss our experience. The quotes and themes come from the discussions. This
community based participatory research was funded by the Indiana University School of
Nursing, Institute for Action Research in Community Health.
Who we are:
“I love these
cards..
Breastfeedin
g is just
taking care
of your child
and
completely
natural.”
Layla
Hospital Policy
A Mother’s Right to Breastfeed
“I was determined
to breastfeed” Layla
Library Resources
Savings of Breastfeeding
.
When Kara had twins one of
the boys was in Neonatal
Intensive Care and one was
with her. It was difficult
getting started but “I knew I
could do it because I had
breastfed my first child”.
Kara
“My breast pump
make it easier to
still go to work.”
“I take my
pump
and bottles
to work
and pump
on a
break.”
“My best friend…
she has encouraged
me at work”
This company has a
written policy ”…they have
been
really supportive”.
Workplace Policy
Ball Memorial Hospital has
been making many positive
changes in the last few
years. The changes have
been a big support for
breastfeeding mothers.
Nutrition
Education
Delaware County Fair, July 2007
26. Results
WIC women identified self determination and a belief
that breastfeeding was the natural way to feed their.
These beliefs and attitudes appeared to be very
important in their success of breastfeeding.
Positive attitudes about breastfeeding by the family, a
friend or a partners increased the duration
Community attitudes that did not encourage
breastfeeding were a deterrent to feeling comfortable
breastfeeding in church and other public places
Workplace policies that did not acknowledge the
needs of the breastfeeding mother were the most
difficult to overcome.
27. Conclusions
Participation within a targeted community can
inform stakeholders of local knowledge and
beliefs that can be incorporated for more
effective interventions that increase duration.
Participation in the project increased the
participants awareness and interests in being
change agents in there own community
28. Limitations
Adaptation of these findings to interventions
is appropriate to this specific situation but
should not be generalized
Analyzing is time consuming for many
programs
Working in community is time consuming
Community involvement of young mothers
can be difficult because of family obligations
and jobs
29. References
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References continued
31. References continued
U.S. Department of Health and Human Services. Healthy
People 2010. 2nd ed. 2 vols. Washington, DC: U.S. Government
Printing Office, November 2000.
(http://www.healthypeople.gov/Publications).
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32. Thank You so much
This was a wonderful
opportunity for me.
It advanced my understanding
of research
It increased my understanding
of qualitative work needed for
assessing the community needs
I have shared the methodology
of photovoice with others at the
International Lactation
Consultant Association
Meeting, 2007
American Public Health
Association Meeting. 2007
ILCA San Diego, 2007
APHA Washington DC, 2007