Eldridge JD, Hartnett JO, Lee FF, Sekhobo JP, Edmunds LS. Implementing a WIC-Based Intervention to Promote Exclusive Breastfeeding: Challenges, Facilitators, and Adaptive Strategies.
JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017;
49:S177-S185.e1. [PMID:
28689555 DOI:
10.1016/j.jneb.2017.04.005]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 04/07/2017] [Accepted: 04/14/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE
Understand factors that contributed to the implementation of a successful multicomponent intervention to promote exclusive breastfeeding (EBF) within Special Supplemental Nutrition Program for Woman, Infants, and Children (WIC) clinics.
DESIGN
Qualitative study of staff implementers' experiences using implementation status reports, facilitated group discussion immediately after implementation, and WIC administrative data.
SETTING
WIC staff from 12 clinics participated in an EBF Learning Community composed of 8 intervention trainings and ongoing support from trainers and peers.
PARTICIPANTS
A total of 47 WIC staff including 11 directors, 20 other administrators, 8 nutritionists, and 6 peer counselors.
INTERVENTION
A WIC-integrated EBF promotion initiative, supported through a Learning Community, composed of prenatal screening, tailored trimester-specific counseling, and timely postpartum follow-up.
PHENOMENON OF INTEREST
Challenges and facilitators to implementation within clinics.
ANALYSIS
Iterative qualitative analysis using directed, emergent, and thematic coding.
RESULTS
Implementation experiences were characterized by (1) perceived benefits of implementation, including improved EBF knowledge and counseling confidence among staff; and (2) managing implementation, including responding to challenges posed by clinic settings (resources, routine practices, values, and perceptions of mothers) through strategies such as adapting clinic practices and intervention components.
CONCLUSIONS AND IMPLICATIONS
Implementation was shaped by clinic setting and adaptive strategies. Future WIC interventions may benefit from formal consideration of intervention fit with local clinic setting and allowable adaptations.
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