Completed By: Kate Schulz RDN, LD, LMNT
Introduction:
The purpose of this project was to complete an environmental scan of available state
and local level breastfeeding support resources and provide consultation on the development
of a statewide action plan to improve breastfeeding support resources. The initial focus of this
project included six counties that were determined by Ashley Busacker, PhD Senior
Epidemiology Advisor with the Maternal and Child Health Division. The county selection was
based on high, medium, and low breastfeeding rates and whether they were urban, rural or
frontier counties. The selected counties and their designations include:
1. Laramie County - low breastfeeding rates, urban area2. Campbell County- low breastfeeding rates, rural area3. Converse County-low breastfeeding rates, frontier area4. Johnson County- medium breastfeeding rates, frontier area5. Sheridan County- high breastfeeding rates, urban area6. Teton County-high breastfeeding rates, frontier area
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Process:
Once the county selection was finalized, a Comprehensive Plan for the Environmental
Scan (See Appendix A) was completed that outlined the process and included the following
components:
1. Stakeholders to consider in above listed counties:a. Public Health Nursing Offices (PHN)b. Non-PHN Home Visiting Programsc. WIC Offices d. Hospitalse. OBGYN providersf. Pediatric providersg. Family Practice Providersh. Midwivesi. Lactation Counselors:
i. Professionalii. Peer
j. Early Intervention/Child Development Centers k. Private Practice Providersl. Community-level organizations:
i. La Leche Leagueii. Local Breastfeeding Coalitions
iii. Othersm. Consumers:
i. parents, clients of existing services, attendees of parent groups
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ii. Focus groupsn. Other target sites, groups or populations as mutually agreed upon by both Agency and Contractor
1. Methodology:a. Interviews:
i. Phoneii. In-Person
b. Site Visitsc. Surveys if applicable d. Focus Groups if applicable e. Existing Data/ Information:
i. mPINCii. Communities Putting Prevention to Work Grant
iii. Additional as available and applicablef. Internet Search
2. What do we want to know: a. Types of resources available:
i. Professional Support (Certified Lactation Counselor (CLC), International Board Certified Lactation Consultant (IBCLC), or other professional certifications)
ii. Peer Supportiii. Group Level Support/Classes (hospital breastfeeding
groups, La Leche groups, parent groups);iv. Breast pump rentalv. Breastfeeding clinics where a professional and peer
support provider are paired b. Provider knowledge about recommendations c. How are individuals/organizations that provide breastfeeding support
resources getting the word out about their programs?d. Do providers of breastfeeding resources have room to accept more clients?
i. Is there a waiting list?ii. Is the service meeting the need?
e. Cost/Availability of Resources
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i. Hours?ii. Cost of classes?
f. General awareness of available services i. How are services marketed?
g. Barriers to receiving desired supporti. Lack of transportation, inconvenient hours, no available
peer/professional support, etc. h. What is the overall climate (political, community) for supporting breastfeeding
i. Are there champions?ii. Is there an active local coalition?iii. Is there support from leaders in the community?iv. Are there supportive places of employment?
Process Narrative:
In each of the six focus counties, there was a local Public Health Office (PHN), WIC Clinic
(WIC), Hospital with a Labor/ Delivery Department and providers; these entities were
immediately identified as stakeholders. An internet search was also completed to locate any
other stakeholders that may offer breastfeeding support, including but not limited to local La
Leche League groups, local breastfeeding coalitions, lactation support counselors, doulas,
midwives, and private practice practitioners. Public Health Nursing and WIC offices were
contacted first. Their contact information and point of contact was provided by the State Public
Health Nursing and WIC offices respectively. An initial email was sent providing a personal
introduction, the purpose of the project, potential other local breastfeeding resources including
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points of contact at the hospital and provider clinics and a mutually convenient time to meet in
person. If information on additional resources was provided, they were contacted as well.
Once the initial contact was made with known stakeholders in the county; in person site
visits were conducted. Every effort was taken to ensure in person meetings, but phone
interviews and email exchanges were also conducted if scheduling did not allow otherwise. In
each county, in person interviews were held with each Public Health Nursing Office and WIC
Clinic. Meeting in person proved to be a bit more challenging due to schedules and the nature
of work for providers and nursing staff at the hospitals and clinics. The interviews that were not
completed in person were done by phone or email.
No formal process was followed for the interviews. The purpose of the project was again
explained, along with a short personal introduction. Attention was paid to ensure all
components outlined in the comprehensive plan were covered. Including but not limited to the
following:
● What types of services are provided
● Types of breastfeeding professionals available (CLC, IBCLC, etc.)
● Known challenges/barriers that affect a mom choosing to breastfeed and/or
continuing to breastfeed
● Providers support of breastfeeding and knowledge of breastfeeding 6
● Known barriers including cost of services, waitlist, etc.
● Coordination of services between community partners
● Overall climate for supporting breastfeeding, including if there were any
physician champions or supportive places of employment
Through interviews and additional research, the following were identified as available
breastfeeding support resources in each county:
L-Laramie, Ca- Campbell, Co-Converse, J-Johnson, S-Sheridan, T-Teton
1. PHN Nurses (L, Ca, Co, J, S, T)2. Local WIC Nurses (L, Ca, Co, J, S, T)3. WIC Dietitians (L, Ca, T)4. Hospital Nurses (L, Ca, Co, J, S, T)5. Private Practice IBCLC (S)6. Local mom’s support group (J)7. Local La Leche leaders (Co, L,)8. A daycare center (S)9. A UW Practice Resident (L)
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10. Physicians (L, Ca, Co, J, S, T)11. Pharmacy (Co)12. A Dentist (S)13. Community pregnancy centers (Ca, S) 14. Doulas (T)15. Midwifes (L)16. A developmental preschool (S)17. A Nurse Practitioner (Ca) 18. The State WIC office (statewide) 19. The State WIC Breastfeeding Coordinator (statewide)20. State WIC Peer Counselor Coordinator (statewide)21. Past Peer Counselor-WIC program (L)22. Current Peer Counselor- WIC program (T)23. Numerous places of employment that are supportive of breastfeeding
employees including:a. School District (L, Ca, Co, J, S, T)b. Hospitals (L, Ca, Co, J, S,T)c. VA (S)d. National Guard (L)
Please refer to the 2016 Environmental Scan of Breastfeeding Resources Guide (See Appendix
B) and the following table for more information:
Findings:
Overview of Breastfeeding Resources Available in Focus Counties
County PHN WIC Hospital/Providers Community
Laramie 3-CLCs 1-CLE, 2-CLCs
1-CLC trained, not
certified
3-IBCLCs, 4-CLCs, UW
Resident, Breastfeeding
La Leche League, Midwife, School District, National Guard
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Clinic
Campbell 8-CLCs,
2-ANCLCs
2-CLCs, 1-ANCLC,
1 Adv. CLC,
Peer Counselor
1-IBCLC, 2-ANCLCs,
12-CLC, Breastfeeding
Clinic, Nurse
Practitioner
Women’s Resource
Center, School District
Converse 2-CLCs 1-CLC, Peer
Counselor
0-CLC La Leche League, School District, Pharmacy
Johnson 1-CLC 1-IBCLC (Sheridan) 3-CLCs, 1-ANLC School District
Sheridan 3-CLCs 1-IBCLC, 1-CLC
Peer Counselor
4-CLCs Legacy Pregnancy
Center, Patty Bell
Usher, IBCLC, Day Care Center, Dentist, School District, VA, Developmental Preschool
Teton 2-CLCs, MSN
in MCH,
CLC trained
Translator, not
certified
Peer Counselor 3-IBCLCs, 3-CLCs
1-CLE, Breastfeeding
Clinic, Teton Mamas
Mountain Doulas,
Teton Mamas
* Information provided was current at time of interviews and follow up but subject to change
CLC-Certified Lactation Counselor
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IBCLC- International Board Certified Lactation Consultant
ANCLC-Advanced Nurse Certified Lactation Counselor
CLE-Certified Lactation Educator
ACLS-Advanced Certified Lactation Specialist
Quantitative Findings: (from 6 focus counties)
● 100% of counties offer breastfeeding support resources
● 100% of the Public Health Nursing offices offer professional breastfeeding
support resources*
● 83% of WIC clinics offer professional breastfeeding support resources*
● 50% of WIC clinics offer peer counselors
● 83% of hospitals/providers offer professional breastfeeding support resources*
● One hospital offers a group level support class
● 50% of hospitals offer an in house breastfeeding clinic that is free
● 33% of counties have La Leche League groups
● 100% of counties scanned have additional community resources that either
offer professional breastfeeding support resources* or are supportive
breastfeeding environments
● No counties had a known wait list for services
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● 100% of counties offer free or reduced cost services for breastfeeding support
● 100% of counties had at least one place of employment that is supportive of
breastfeeding moms returning to work
● No counties have an active local breastfeeding coalition
● 100% of counties have access to breast pump rentals in some capacity
*Professional breastfeeding resources=advanced training/certification such as CLC/
IBCLC/ANCL, etc.
Qualitative Findings/Themes
1. Overall findings show good outreach/coverage of breastfeeding support resources by PHN,WIC, hospitals and supplemental community resources
2. Multiple stakeholders expressed concern with lack of physician support/knowledge of breastfeeding
3. Multiple stakeholders expressed concern with lack of continuing education opportunities for CLCs/IBCLCs etc.
4. Multiple stakeholders expressed concern with lack of an active Wyoming Breastfeeding Coalition
5. Multiple stakeholders expressed concern with lack of consumer/ provider knowledge of services CLCs, IBCLCs etc. provide
6. Multiple stakeholders expressed concern with moms returning to work as a barrier to continuing to breastfeed
7. Multiple stakeholders expressed concern with lack of planning/preparation by expecting moms as a barrier to breastfeeding
8. Some stakeholders expressed concern with lack of referrals between WIC and PHN clinics that are not co-located.
Evidence Based Strategies/Recommendations
The following strategies are excerpted from the CDC’s Guide to Strategies to Support
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Breastfeeding Mothers and Babies http://www.cdc.gov/breastfeeding/resources/guide.htm
Recommendations are based on the quantitative and qualitative findings/ themes from the
information gathered during the environmental scan.
Strategy 1: Maternity Care Practices
The following are recommend action steps surrounding maternity care practices to
address the expressed concern with lack of physician support/knowledge of breastfeeding, lack
of continuing education opportunities for CLCs/ IBCLCs etc. and the lack of an active Wyoming
Breastfeeding Coalition:
a. Provide opportunities for hospital staff members and providers to participate in training courses in breastfeeding.
b. Create links between maternity care facilities and community breastfeeding support networks across the state.
In regards to the first recommendation, it would also be beneficial to offer these
continuing educational opportunities to PHN, WIC, supplemental community resources, CLCs,
IBCLCs and other advanced breastfeeding professionals. The second recommendation would
be beneficial for networking and possibly help to facilitate reactivating the Wyoming
Breastfeeding Coalition.
Strategy 2: Professional Education
The following are recommended action steps surrounding professional education to
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address the expressed concern with lack of physician support/knowledge of breastfeeding and
lack of continuing education opportunities for CLCs/ IBCLCs etc.
a. Make available and coordinate grand rounds or in-service presentations on breastfeeding by health care professionals with training in this area
b. Distribute clinical protocols developed by experts, such as the Academy of Breastfeeding Medicine to local doctors.
c. Expand the reach of professional development by providing training.
It is recommended that for each of the previous steps to find opportunities for
physicians to present to other physicians. A nurse presenting the information was listed as a
barrier to physician’s willingness to participate. It is also recommended to offer continuing
education credits for participants, specifically physicians and those needing hours for their
CLC/IBCLC etc. credentials.
Strategy 3: Access to Professional Support
Based on information gathered during the scan, there are no further recommended
action steps surrounding access to professional support. Findings from the environmental scan
show good outreach and coverage of breastfeeding services by PHN, WIC, hospitals and
supplemental community resources. During the scan, an ongoing action step was completed
which was to:
a. Develop and disseminate a resource directory of local lactation support services available to new moms.
The Environmental Scan of Breastfeeding Resources Guide (See Appendix B) provides local
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lactation support services and contact information, as available, in each Wyoming County.
Strategy 4: Peer Support Programs
The following is a recommended action step surrounding peer support programs:
a. Create and maintain a sustainable infrastructure for mother-to-mother support groups and peer counseling programs in hospitals and community health settings
There wasn’t much concern expressed regarding peer support programs and 50% of
WIC clinics provide peer support counselors, but one community has a noteworthy
program to highlight. During the environmental scan, one community was found to
have great success with a mother-to-mother support group facilitated by an IBCLC
through the hospital. It is recommended that other communities consider replicating
such services, as able.
Strategy 5: Support for Breastfeeding in the Workplace
The following are recommended action steps surrounding breastfeeding in the
workplace to address the expressed concern with mom’s returning to work as a barrier to
continuing to breastfeed.
a. Provide employers with resources and technical assistance to help them comply with federal and state regulations on breastfeeding support in the workplace.
b. Develop a resource to help employers find creative ways to provide 14
breastfeeding support in the workplace.Though the above listed action steps are geared towards employers, it is recommended
to develop and provide these resources to employees as well, as a way to empower them to
start a conversation with their employers. Previous work on these action steps has already been
completed through the Communities Putting Prevention to work grant and could be updated as
necessary and easily shared through PHN, WIC, hospitals and other community breastfeeding
support agencies.
Strategy 6: Support for Breastfeeding in Early Care and Education
Based on information gathered during the scan, there are no recommended action steps
at this time, geared towards support for breastfeeding in early care and education.
Strategy 7: Access to Breastfeeding Education and Information
The following are recommended action steps surrounding access to breastfeeding
education and information to address the expressed concern with lack of planning/preparation
by expecting moms as a barrier breastfeeding and concern with lack of referrals between WIC
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and PHN clinics that are not co-located.
a. Evaluate how breastfeeding education may be integrated into public health programs that serve new families
b. Partner with local community groups that support breastfeeding mothers by providing educational seminars and classes
c. Work with childbirth educators to include evidence-based breastfeeding education in their curricula
d. Promote and support breastfeeding classes that are convenient for family members to attend.
Those interviewed shared that a large number of pregnancies seemed to be unplanned;
therefore not a lot of thought or consideration had been made into the preferred feeding
practices for their babies. Any opportunity to offer support and educate expecting moms on the
benefits of breastfeeding is encouraged and recommended. Also any opportunity for PHN and
WIC services to collaborate and work together, even when not co-located is encouraged and
recommended.
Strategy 8: Social Marketing:
The following are recommended action steps surrounding social marketing to address
the expressed concern with lack of an active Statewide Breastfeeding Coalition and lack of
consumer/ provider knowledge of services CLCs, IBCLCs or other breastfeeding professionals
with advanced training provide:
a. Identify local experts (champions) who can pitch stories that promote breastfeeding to the media
b. Develop and implement a public health campaign on breastfeeding that uses social marketing
Through conducted interviews, it appeared that individuals with advanced breastfeeding 16
credentials were not utilized to their full extent. Often times when a breastfeeding problem
occurred it was reported that the physician or provider was contacted first. It is recommended
that a marketing campaign include what training and services a CLC, IBCLC, etc. provides and
the benefits of utilizing them. The Wyoming Breastfeeding Coalition, once reactivated, could
serve as another means of marketing services and champions.
Strategy 9: Addressing the Marketing of Infant Formula
Based on information gathered during the scan, there are no recommended action steps
at this time, geared towards addressing the marketing of infant formula.
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Statewide Snapshot:
After the initial six county environmental scan, a snapshot of services provided
statewide was also conducted. Public Health offices were contacted by email, each hospital
with a Labor/Delivery Department was contacted by phone, WIC office information was
provided by Lisa Caldwell, State WIC Breastfeeding Coordinator and Connie James,
Breastfeeding Peer Counselor Program Coordinator and community information was gathered
by internet search or through communication with the other stakeholders.
Findings:
Overview of Breastfeeding Resources Available Statewide Snapshot
County PHN WIC Hospital/Providers Community
Albany 3-CLCs
2-CLCs trained,
results pending
CLC trained staff available, Peer Counselor
2-IBCLCs, 7 CLCs
Mother’s Milk Bank
Baby-Friendly Hospital
Initiative
Laramie Breastfeeding Coalition
Big Horn 2-CL’s CLC trained staff available
Campbell 8-CLCs,
2-ANCLCs
2-CLCs, 1-ANCLC,
1 Adv. CLC,
Peer Counselor
1-IBCLC, 2-ANCLCs,
12-CLCs, Breastfeeding
Clinic, Nurse
Practitioner
Women’s Resource
Center, School District
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Carbon 4-CLCs CLC trained staff available,
Converse 2-CLCs 1-CLC, Peer
Counselor
0-CLCs La Leche League, School District
Crook 3-CLCs CLC trained staff, Peer Counselor
Fremont 2-CLCs CLC trained staff, Peer Counselor Position Open
1- IBCLC, 5-CLCs
Goshen 2-CLCs CLC trained staff 1-CLC La Leche League
Hot Springs 0-CLC CLC trained staff, Peer Counselor
0-CLC
Johnson 1-CLC 1-IBCLC (Sheridan) 3-CLCs, 1-ANLC School District
Laramie 3-CLCs 1-CLE, 2-CLCs
1-CLC trained, not
certified
3-IBCLCs, 4-CLCs, UW
Resident, Breastfeeding
Clinic
La Leche League, Midwife, School District, National Guard
Lincoln 2-CLCs CLC trained staff Kemmerer- 1-CLC
trained, not
certified
Afton-CLC nurses
available
Natrona 3-CLCs CLC trained staff, Peer Counselor
4-CLCs La Leche League
Niobrara 0 CLC trained staff,
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(Goshen)
Park 2-CLCs CLC trained staff,
Peer Counselor
Powell-4-CLCs, Baby Friendly Designation
Cody- 1-CLC trained, awaiting results, 1-CLC trained, not certified
Billings Clinic-IBCLC
Platte 1-IBCLC, 1-CLC CLC trained staff,
Peer Counselor
1-CLC
Sheridan 3-CLCs 1-IBCLC, 1-CLC
Peer Counselor
4-CLCs Legacy Pregnancy
Center, Patty Bell
Usher, IBCLC, Day Care Center, Dentist, School District, VA Developmental Preschool
Sublette 2-CLCs
Sweetwater 4-CLCs CLC trained staff,
Peer Counselor
7-CLCs
Teton 2-CLCs, MSN
in MCH,
CLC trained
Translator, not
certified
Peer Counselor 3-IBCLCs, 3-CLCs
1-CLE, Breastfeeding
Clinic, Teton Mamas
Mountain Doulas,
Teton Mamas
Uinta 3-CLCs CLC trained staff, Peer Counselor
5-CLCs
Washakie 1-CLC, 1-CLC trained, not
CLC trained staff, 0-CLCs La Leche League
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certified Peer Counselor
Weston 1-ACLS, 1-breastfeeding educator, not certified
CLC trained staff, Breastfeeding Peer Counselor
* Information provided was current at time of interviews and follow up but subject to change
Quantitative Findings: Statewide Snapshot
● 100% of counties offer breastfeeding support resources
● 95% of Public Health Nursing offices offer professional breastfeeding support resources*
● 95% of WIC clinics offer professional breastfeeding support resources*
● 60% of WIC clinics offer peer counselors
● 84% of hospitals/providers offer professional breastfeeding support resources*
● 21% of counties have La Leche League groups
● 48% of counties have additional community resources that either offer professional
breastfeeding support or are supportive breastfeeding environments
● One county has an active local breastfeeding coalition
● One hospital has a current Baby-Friendly Designation
*Professional breastfeeding support resources = advanced training/certification such as CLC/
IBCLC/ANCL, etc.
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Conclusion:
As previously stated and discussed through the report, the purpose of this project was to
complete an environmental scan of available state and local breastfeeding support resources
and provide consultation on the development of a statewide action place to improve
breastfeeding support resources. In conclusion, I believe the findings indicate adequate
coverage of breastfeeding support services in most counties statewide. In addition to the data
reported from the environmental scan, the International Board of Lactation Consultant
Examiners www.IBCLE.org reports that as of August 4th, 2016 there are 22 IBCLCs in Wyoming
and the Academy of Lactation Policy and Practice www.alpp.org reports that there are 170 CLCs
registered in Wyoming on their site.
Though evidence based strategies and recommendations were already outlined in the
report, my personal recommendation is to look to each stakeholder to determine which 22
strategy fits their needs best to continue to support breastfeeding and provide breastfeeding
support resources. One possibility would be to offer mini grants to stakeholders wanting to
focus on breastfeeding efforts and providing breastfeeding resources. Some ideas that
stakeholders expressed while completing the scan would be to offer breastfeeding training to
the local translation service while another stakeholder would like to sponsor more local
continuing education opportunities for breastfeeding support professionals. Though multiple
stakeholders expressed the same concerns as to barriers to breastfeeding success and
resources, each stakeholder also expressed a different solution to that concern based on their
county’s needs and resources.
Overall, the environmental scan provided an opportunity for the Maternal and Child Health
Unit (MCH) to communicate with other important stakeholders in the state. County findings
will hopefully help inform policy and decision making at the state level, and state findings may
help inform counties about ways in which their gaps in service, needs, resources and practices
compare with other counties.
Though the environmental scan process was about collecting information, it also served as
an opportunity for MCH to dialogue with stakeholders, establish and strengthen partnerships
and inform the community. All of which have led to conversations and some preliminary activity
in reactivating the Wyoming Breastfeeding Coalition.
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Appendix A
Comprehensive Plan for Environmental Scan
As outlined in the contract between The Wyoming Department of Health, Public Health Division and Kate Stratton-Schulz, an environmental scan of available state and local breastfeeding support resources is to be completed along with consultation on the development of a statewide action plan to improve breastfeeding support services with the goal of increasing breastfeeding duration rates.
Organization of the Environmental Scan-The Environmental scan will serve as the foundation for the statewide action plan. The environmental scanning process will include three steps:
a. Developing an approach to the scanning process
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b. Scanning the environmentc. Analyzing the information collected
A. Developing an Approach for the Environmental Scan The following will be included in gathering information for the environmental scan:
● Adapt, update or refer to existing environmental scanso Communities Putting Prevention to Work State Agency Breastfeeding in
the Workplace Policy Scan● Initial interviews with community stakeholders. Focus groups, surveys and travel
once initial interviews are completed● Development of template to distribute to key stakeholders ,if necessary, to
provide or confirm scan information
B. Scanning the Environment After some discussion on the scope of the environmental scan, it has been decided that rather than a statewide scan, the initial focus will include 6 counties. Ashley Busacker, PhD Senior Epidemiology Advisor with the Maternal and Child Health Division based the county selection on high, medium, and low breastfeeding rates and whether they were urban, rural or frontier counties. The selected counties and their designation include:
1. Laramie- low breastfeeding rates, urban area2. Campbell- low breastfeeding rates, rural area3. Converse-low breastfeeding rates, frontier area
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4. Johnson- medium breastfeeding rates, frontier area5. Sheridan- high breastfeeding rates, urban area6. Teton-high breastfeeding rates, frontier area
1. Stakeholders to consider in above listed counties:a. Public Health Nursing Offices b. Non-PHN Home Visiting Programsc. WIC Offices d. Hospitalse. OBGYN providersf. Pediatric providersg. Family Practice Providersh. Midwivesi. Lactation Counselors
iii. Professionaliv. Peer
j. Early Intervention/Child Development Centers k. Private Practice Providersl. Community-level organizations
iv. La Leche Leaguev. Local Breastfeeding Coalitions
vi. Othersm. Consumers
iii. parents, clients of existing services, attendees of parent groups
iv. Focus groupsn. Other target sites, groups or populations as mutually agreed upon by both
Agency and Contractor
2. Methodology:g. Interviews
i. Phoneii. In-Person
h. Site Visitsi. Surveys if applicable j. Focus Groups if applicable k. Existing Data/ Information
i. mPINC
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ii. Communities Putting Prevention to Work Grantiii. Additional as available and applicable
l. Internet Search
3. What do we want to know: a. Types of resources available:
vi. Professional Support (CLC, IBCLC, or other certification levels you’re aware of)
vii. Peer Supportviii. Group Level Support/Classes (hospital breastfeeding
groups, La Leche groups, parent groups);ix. Breast pump rentalx. Breastfeeding clinics where a professional and peer
support provider are paired b. Provider knowledge about recommendations c. How are individuals/organizations that provide breastfeeding support resources getting the word out about their programs?
a. Do providers of breastfeeding resources have room to accept more clients/attendees?
iii. Is there a waiting list?iv. Is the service meeting the need?
b. Cost/Availability of Resourcesiii. Hours?iv. Cost of classes?
c. General awareness of available services i. This would be helpful for professionals and consumers
d. Barriers to receiving desire supportv. This would be very relevant for consumers. First,
understanding what they want, and then assessing what they got, and the gap between the two.
vi. Specifics such as transportation, no available prof/peer support, services not available during off-hours, etc.
e. What is the overall climate (political, community) for supporting breastfeeding? vii. Are there champions?viii. Is there an active local coalitionix. Is there support from leaders in community?
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4. Findings: A summary of findings from the scan will include conclusions that can be drawn from the scan that will aid in defining goals, objectives and outcomes for the statewide action plan.
C. Analyzing the Scan and Drawing Conclusions-The information gathered in the environmental scan will help aid in the development of a statewide action plan to improve access to breastfeeding support resources with the goal of increasing breastfeeding duration rates.
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