1. Strengthening Connections between Birth Hospitals and WIC Programs to Improve Breastfeeding Outcomes: A Formative Evaluation Amanda Bilski March 4, 2015

2. Program Mission Massachusetts Department of Public Health 1 –Prevent illness, injury, and premature death; assure access to high quality public health and healthcare services; promote wellness and health equity for all people in the Commonwealth of Massachusetts  The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) 2 Improve health outcomes of pregnant and breastfeeding women, new mothers, and children under the age of 5  Massachusetts Baby-Friendly Collaborative 3 Improvement of breastfeeding-related maternity care practices

3. Increase the number of collaborations between WIC programs and birth hospitals to improve prenatal resources and postpartum support in Massachusetts Birth Hospitals MA Baby-Friendly Collaborative: Program Objective

4. Massachusetts Department of Public Health Family Health and Nutrition Bureau Nutrition Division WIC Nutrition Program Commonwealth of Massachusetts Executive Office of Health and Human Services

5. Formative Evaluation My ALE is a formative evaluation of the MA Baby- Friendly Collaborative titled, “Strengthening Connections Between Birth Hospitals and WIC to Improve Breastfeeding Outcomes” Survey was distributed to Breastfeeding Coordinators at the 35 WIC programs in Massachusetts to collect data on the extent of their current collaborations with birth hospitals since the MA Baby-Friendly Collaborative began in 2012 Breastfeeding coordinators had two weeks to complete the survey; a reminder email was sent after one week I am currently in the process of analyzing the data

6. Formative Evaluation –The number of hospitals where WIC participants deliver –How many of these hospitals each WIC program has an ongoing relationship with (contact person in hospital, regular communications, shared referrals, etc.) –Whether WIC Breastfeeding Peer Counselors visit mothers in the hospital –If WIC staff participate in a Breastfeeding Task Force at any of the hospitals in their catchment area –If WIC staff have a role in support groups or breastfeeding classes provided within the hospital setting –During which trimesters WIC programs provide information to prenatal women about how to breastfeed –During which trimesters, if at all, WIC programs provide prenatal women with information on what to expect in the hospital –Breastfeeding topics relevant to the hospital experience that WIC programs discuss with women at their last prenatal visit (including skin to skin, rooming in, breastfeeding on demand, etc.) –Successes and barriers thus far WIC Breastfeeding Coordinator Survey is being used as a tool to determine:

7. Logic Model

8. Methods: Survey Survey was sent to the Breastfeeding Coordinator at each WIC program in Massachusetts Survey contained both quantitative and qualitative questions

9. Quantitative Example

10. Qualitative Example

11. Mixed Example

12. Quantitative data analysis –Ordinal, nominal, and ratio data –Frequency distributions Qualitative data analysis –Categorization of qualitative responses Methods: Analysis

13. Discussion Quantitative data analysis –From this data, I will be able to determine the extent of current collaborations and can focus on areas that need improvement Qualitative data analysis –I will be able to use this data to provide suggestions to all WIC programs for best practices so they can improve their collaborations with MA birth hospitals, based on Breastfeeding Coordinators’ personal experiences and ideas for improvement