2023-09-28 14:46:10 +00:00
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abstract: 'Background: Implementing evidence-based practices and policies for
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breastfeeding support in community clinics is a promising, but
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challenging, approach to reducing disparities in breastfeeding rates.
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Objective: This study aimed to apply a policy process research framework
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to increase knowledge of factors that facilitate adoption and
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implementation of breastfeeding policy changes.
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Methods: In 2013, Washington State piloted a process to encourage 8
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clinics to adopt and implement steps to become breastfeeding friendly.
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Evaluation data were collected through interviews, project reports,
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training evaluations, and pre- and post-self-assessments of achievement
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of the steps.
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Results: In 6 months, clinics increased the breastfeeding-friendly steps
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that they were implementing from a median (interquartile range) of 1.5
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(0-3) to 6 (5-7). Improvements were most likely in the steps that
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required the fewest resources and administrative changes. Barriers to
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implementation included misperceptions about breastfeeding and
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breastfeeding support; lack of administrative buy-in; need for
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organizational changes to accommodate actions like monitoring
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breastfeeding rates and allowing providers training time; and the
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social-political climate of the clinic. Several factors, including
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actions taken by public health practitioners, enhanced the change
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process. These included fostering supportive relationships, targeting
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technical assistance, and providing resources for planning and training.
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Conclusion: This pilot project demonstrates that it is possible to make
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changes in breastfeeding support practices and policies in community
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clinics. Recommendations to enhance future work include framing and
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marketing breastfeeding support in ways that resonate with clinic
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decision makers and enhancing training, resources, and advocacy to build
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capacity for internal and external systems changes to support
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breastfeeding best practices.'
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affiliation: 'Johnson, DB (Corresponding Author), Univ Washington, Nutr Sci, Box 353410,
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Seattle, WA 98195 USA.
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Johnson, Donna B.; Lamson, Erica, Univ Washington, Ctr Publ Hlth Nutr, Seattle,
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WA 98195 USA.
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Schwartz, Rachel; Goldhammer, Camie, WithinReach, Seattle, WA USA.
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Ellings, Amy, Washington State Dept Hlth, Olympia, WA USA.'
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author: Johnson, Donna B. and Lamson, Erica and Schwartz, Rachel and Goldhammer, Camie
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and Ellings, Amy
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author-email: djohn@uw.edu
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author_list:
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- family: Johnson
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given: Donna B.
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- family: Lamson
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given: Erica
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- family: Schwartz
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given: Rachel
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- family: Goldhammer
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given: Camie
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- family: Ellings
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given: Amy
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da: '2023-09-28'
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doi: 10.1177/0890334415579656
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eissn: 1552-5732
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files: []
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issn: 0890-3344
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journal: JOURNAL OF HUMAN LACTATION
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keywords: 'breastfeeding; breastfeeding practices; government policy; low-income
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women; nutrition policy; process evaluation; program evaluation; Ten
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Steps to Successful Breastfeeding'
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keywords-plus: 10 STEPS; IMPLEMENTATION; ATTITUDES; SUPPORT; CARE; KNOWLEDGE
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language: English
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month: NOV
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number: 4, SI
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number-of-cited-references: '37'
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pages: 660-670
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papis_id: 40b779ffedcf1fa92ceb779b9ce1b5fb
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ref: Johnson2015communityhealth
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times-cited: '6'
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title: 'A Community Health Clinic Breastfeeding-Friendly Pilot: What Can We Learn
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about the Policy Process?'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000362686100015
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usage-count-last-180-days: '0'
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usage-count-since-2013: '7'
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volume: '31'
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web-of-science-categories: Nursing; Obstetrics \& Gynecology; Pediatrics
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year: '2015'
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