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| Breastfeeding
Promotion in Physicians' Office Practices (BPPOP III) Program |
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While
overall incidence and duration of breastfeeding have increased
in recent years, significant progress is required to meet the
Healthy People 2010 national health objectives, especially among
racially and ethnically diverse populations. The Healthy
People 2010 national health objectives recognizes breastfeeding
as a major public health concern and advocates collaborative efforts
to increase rates and close the wide racial and ethnic gaps. The
US Breastfeeding Committee strategic plan, Breastfeeding in the
United States: A National Agenda, sets goals, objectives, and
activities to make breastfeeding the cultural norm. The US Preventive
Services Task Force recommends structured breastfeeding education,
behavioral counseling, and ongoing support outside the clinical
setting as the most effective means to encourage mothers to initiate
and continue breastfeeding. Data collected in the 2001-2004 Breastfeeding
Promotion in Physicians' Office Practices program shows that while
97% of physicians agree that cultural beliefs are important influences
in a mother's decision to initiate and continue breastfeeding,
40% never consider cultural beliefs when advising about feeding.
In response to these evidence-based directives, the American Academy
of Pediatrics (AAP) proposes to work in partnership with the Maternal
and Child Health Bureau (MCHB), maternal and pediatric health
professionals and residency programs, public health representatives,
and breastfeeding support personnel who work with underserved
families to strengthen and expand the successful AAP/MCHB Breastfeeding
Promotion in Physicians' Office Practices (BPPOP III) program
toward Healthy People 2010 goals.
Program
Goals |
Program Objectives | Methodology
| Coordination | Evaluation
| Residency
Curriculum | Teleconferences | Additional
Information
|
| Program
Goals |
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Educate
and support pediatric, obstetric, and family medicine residents;
practicing physicians; and other health care professionals
in effective breastfeeding promotion and management in racially
and ethnically diverse populations
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Develop
strategies to bring together health professional, public health,
and breastfeeding support organizations to increase the incidence
and duration of breastfeeding and decrease racial and ethnic
disparities
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Collect
and disseminate information about structured behavioral interventions
and model practices that promote and sustain breastfeeding
|
| Program
Objectives |
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Deliver
focused, culturally effective training in breastfeeding promotion
and effective maternal support to 30 practices or 100 individuals
in the BPPOP III program through Web cast/teleconferencing
technology
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Develop
model obstetric, pediatric, and family medicine residency
program curricula in conjunction with the multidisciplinary
project advisory committee
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Provide
technical assistance and resources to physicians, residents,
public health representatives, and families
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Strengthen
and expand established nationwide collaborative networks and
local, state, and regional action groups to implement effective
breastfeeding strategies and initiatives in underserved populations
-
Assess
changes in breastfeeding rates in participating medical practices
after implementing effective breastfeeding education, counseling
interventions, and ongoing support for mothers
|
| Methodology |
Using
the pre-existing AAP infrastructure and multidisciplinary partnerships
to train physicians in promoting and managing breastfeeding, the
BPPOP program will sustain the momentum generated by the 2 previous
BPPOP programs by continuing to provide culturally effective breastfeeding
education and resources, and encouraging nationwide collaboration
and networking opportunities among BPPOP III participants and interested
others. Ten Steps to Support Parents' Choice to Breastfeed Their
Baby, a cornerstone publication of previous BPPOP programs, provides
strategies to implement in office settings ranging from staff training
and creating a breastfeeding friendly office environment, to demonstrating
breastfeeding techniques and encouraging the use of community resources.
These strategies will provide a basis for a series of Web casts/teleconferences
to train program members. Another major development will be an adaptable
model residency education program to prepare future office practitioners
to better manage breastfeeding, thus effectively institutionalizing
the BPPOP program.
|
| Coordination |
This
is a national project, coordinated by the AAP in partnership with
the MCHB, to initiate and sustain system-wide changes in breastfeeding
management at the community, state, and national levels. The existing
BPPOP Project Advisory Committee (Academy of Breastfeeding Medicine,
American Academy of Family Physicians, American College of Obstetricians
and Gynecologists, Indian Health Service, MCHB, Migrant Clinicians
Network, National Medical Association, National Hispanic Medical
Association, National Association of WIC Directors, US Department
of Agriculture Food and Nutrition Service) will be expanded to include
obstetric, pediatric, and family medicine residency programs; nursing
and breastfeeding support organizations. Participation in action
groups in the 10 Department of Health and Human Services regions
includes State Title V Maternal and Child Health, and Children with
Special Health Care Needs Directors, WIC nutritionists and breastfeeding
coordinators, lactation consultants, and others interested in networking
on culturally sensitive breastfeeding promotion and support. The
AAP Chapter Breastfeeding Coordinators will serve as facilitators
with their obstetric and family medicine colleagues.
|
| Evaluation |
| Evaluation of the BPPOP III Program is centered around the Residency Curriculum Pilot-study. Two areas of evaluation will be examined during this pilot-study including: 1) Pre and post-implementation data collection regarding infant feeding from test and comparison sites and 2) Pre and post-implementation knowledge, practice pattern, and confidence assessments of residents and faculty from the test and comparison sites. In addition, all aspects of the program, including technical assistance
efforts, will be monitored, tracked, and analyzed, and an overall
program evaluation will be conducted at the conclusion of the grant. |
| Residency Curriculum |
The
AAP's BPPOP III Program is currently concluding its pilot-testing of a a Breastfeeding Residency
Curriculum. It is designed to be multidisciplinary, culturally effective,
and compatible with any residency program. After the receipt of
over 70 applications, 7 intervention and 7 comparison sites were
chosen to participate in this project. These sites began pilot-testing
the curriculum in July, 2006. The final curriculum will be available
to all resident hospitals and clinics in the Fall of 2007.
TEST SITES:
Duke University Medical Center
Durham, NC
Project Director: Aditee Narayan, MD
Harbor-UCLA Medical Center
Torrance, CA
Project Director: Julie Noble, MD
Jacobi Medical Center
Bronx, NY
Project Director: Lawrence Noble, MD
Johns Hopkins University
Baltimore, MD
Project Director: Jessica Bienstock, MD
Medical University of South Carolina
Charleston, SC
Project Director: Carol Wagner, MD
MetroHealth Medical Center
Cleveland, OH
Project Director: Susan Kovacs Santos, MD
Texas Tech University Health Sciences Centerat Amarillo
Amarillo, TX
Project Director: Fred McCurdy, MD
COMPARISON SITES:
Bellevue Hospital
New York, NY
Project Director: Susan Vierczhalek, MD
Cardinal Glennon Children's Hospital, Saint Louis University
St. Louis, MO
Project Director: Shahida Naseer, MD
Forum Health, Western Reserve Care Systems
Youngstown, OH
Project Director: Lisa Weiss, MD
Medical College of Georgia
Augusta, GA
Project Director: Kathryn McLeod, MD
Texas Tech University Health Sciences Center at El Paso
El Paso, TX
Project Director: Ralitsa Akins, MD
University of Minnesota Medical School
Minneapolis, MN
Project Director: Phillip Rauk, MD
White Memorial Medical Center's Pediatric Residency
Los Angeles, California
Project Director: Ernie Guzman, MD
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| Additional Information |
|
Background Information
for BPPOP Program
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