Background: Breastfeeding confers important health benefits to mothers and infants. Despite these proven benefits, breastfeeding rates for African American mothers remain much lower than for other races and ethnicities. To address these disparities, a multi-disciplinary team hosted the 2nd Annual Conference to Eliminate Racial Disparities in Breastfeeding and Infant Mortality. The conference included three moderated discussions in which parents and healthcare providers interacted with audience members to identify barriers and opportunities toward improving breastfeeding support in the African American community. Objective(s): Our objective was to conduct a qualitative analysis of emergent themes from the moderated discussions. Methods: Conference participants attended one of three breakout sessions focused on a different dimension of breastfeeding barriers for African American mothers. All sessions included a breastfeeding content expert, facilitator, transcriptionist, and parents. Breakout sessions were semi-structured, with questions developed in a SWOT (strengths, weaknesses, opportunities, and threats) analysis format aimed at obtaining information related to factors impacting breastfeeding initiation and duration, with the goal of developing actionable objectives to address breastfeeding barriers for African American women. De-identified data from each panel was compiled and analyzed using a phenomenological qualitative approach with a black feminist theoretical framework. Two researchers analyzed the data and coded the transcribed sessions, initially performing a text query to identity common keywords using Nvivo. Frequently used keywords within the text were used to develop nodes within Nvivo. Emerging themes were identified. As this was a secondary analysis of anonymous text from the conference workshop transcriptions, it was considered non-human subjects research. Results: Word Query examining the root word, stem words, and synonyms found the word “support” and its derivatives to be the most frequently used word by conference key informants. The words “communicate” and “cultural” were found to be the second and third most frequently used words respectively. Nodes that emerged from the frequently used words and the pre-determined themes of weaknesses and threats to breastfeeding were: stereotypes and discrimination/microagression, social isolation/stigma, internalization, and disempowerment. Nodes that emerged from the frequently used words and the pre-determined themes of strengths and opportunities were: resources, social support, community, agency and empowerment. Themes were further collapsed into: (a) Cultural Competence, (b) Racial Concordance, and (c) Support, Education, and Communication. Conclusions: This analysis of conference proceedings offers a novel approach to examining disparities in breastfeeding initiation, duration, and exclusivity, through directly engaging African American mothers and healthcare providers in a moderated discussion. The construction of the integrated panels and subsequent analysis of texts aimed to examine sociocultural barriers to breastfeeding at multiple levels, providing expanded knowledge. Findings from this analysis will be used to develop programming and intervention studies to address the low rates of initiation, duration, and exclusivity in breastfeeding for African American mothers.
Eliminating Racial Disparities in Breastfeeding and Infant Mortality: A Qualitative Analysis of Conference Proceedings
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Julie Ware, Francoise Knox-Kazimierczuk, Natashia King-Conner, Camille Graham, Laurie Nommsen-Rivers; Eliminating Racial Disparities in Breastfeeding and Infant Mortality: A Qualitative Analysis of Conference Proceedings. Pediatrics August 2019; 144 (2_MeetingAbstract): 259. 10.1542/peds.144.2MA3.259
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