Latino Best Start Curriculum: Development and Implementation of Community Based Programs Supporting Breastfeeding in the Latino Community

Background. While rates of initiating breastfeeding are relatively high among Hispanics living in the United States, they fall short of the goals for Healthy People 2020.  Studies show that the longer Hispanic women have been in the United States the more likely it is that they will not exclusively breastfeed and breastfeed for less time.  In 2012, the W.K. Kellogg Foundation funded the “Latino Best Start Health and Nutrition Initiative” (Latino Best Start) to support Hispanic-serving community- and faith-based grassroots organizations’ (CFBO) efforts to promote, educate, and support the practice of exclusive breastfeeding in the Hispanic community. The Latino Best Start project worked with eight community based partners to develop a program utilizing focus groups approach to assure the community involvement in the needs assessment, and the development of the program. The program was developed and conducted by multi-disciplinary professionals from public health, social work, and nursing. 

Methods. Twenty-seven focus groups were conducted throughout the US and Puerto Rico. Participants were recruited using convenient sampling from each of nine different sites; each focus group consisted of 7-10 participants. Three distinct groups of people - 1) mothers/fathers/families, 2) Hispanic business individuals (with a focus on business owners), and 3) health workers, including social workers, serving Hispanic families, were identified for facilitated conversations about health, identity and culture, and breastfeeding practices and attitudes. The discussions were transcribed verbatim and then coded. Elements of grounded theory were applied in both, the data collection and analysis phases of the project (Charmaz, 2006). Dedoose qualitative software was used to analyze the data.

 

Results.  Data analysis indicates that mothers/fathers/families group participants identified strongly with both their Hispanic and American culture and traditions. They repeatedly discussed the importance of family in their culture and mentioned health as a significant cultural weakness.  Across sites, health workers, including social workers, perceived themselves as providing culturally appropriate care but upon further exploration their understanding of the Hispanic culture was limited and seemed superficial. Most mothers in the focus groups did breastfeed, and understood the benefits of breastfeeding but they did not get the needed support from work and family and they felt disempowered when engaged in the health care system. 

Conclusions and Implications. Social workers play a major role in health promotion programs. Latino Best Start suggests that breastfeeding promotion programs for Hispanics must be tailored to the needs of individual communities and include family, culture, and a focus on “health leadership” as a means of self-advocacy. Social workers role lie in empowering young mothers to self-advocate, and help them navigate the health care system. Social workers can also influence policy to provide support for breastfeeding mothers. Working with multiple care providers to provide lactation support for new mothers is essential.  Latino Best Start is a successful model for collaborative efforts between multidisciplinary professionals and care providers, families, and community.