Background: Public health recommendations state that infants should be breastfed exclusively for six months, and up to 12 months following the introduction of foods. Unfortunately, significant racial differences in breastfeeding exist, in that US Black infants have lower initiation and exclusive breastfeeding rates compared to White infants. Similar to national rates, disparities in breastfeeding are most extreme in the Southeast, including South Carolina, where breastfeeding initiation among Black infants is 20 percentage points lower than White infants. Disparities in breastfeeding are particularly troubling given the internationally recognized health benefits of breastfeeding for both the infant and mother.

Proposed Solution to the Problem: The project goal is to establish a sustainable, breast/chest feeding equity research and support network rooted in patient-centered outcomes research/comparative clinical effectiveness research (PCOR/CER) best practices as a solution to persistent and extreme racial and ethnic disparities in breast/chest feeding in South Carolina. This solution will be designed and implemented by an advisory council and network of patients and key stakeholders.

Objectives: Objective 1: Establish a patient and stakeholder network to identify PCOR/CER priorities in breast/chest feeding equity research and disseminate findings among African American families and community; Objective 2:  Adapt existing PCORI maternal disparities tools to address breast/chest feeding equity in African American families; and Objective 3:  Enroll and train a group of (n=30) patients, stakeholders, and community leaders in PCOR/CER.

Activities: The project team and advisory council will develop a toolkit with a tailored curriculum for duplication of capacity building engagement activities, host education sessions on PCOR/CER, and facilitate community forums and disseminate findings using best practices from PCORI’s Engagement Rubric.

Projected Outcomes and Outputs: 

Short-term outcomes during the project period include: a website, breast/chest feeding PCOR/CER toolkit, and five-year PCOR/CER-focused research agenda on breast/chest feeding equity among African Americans.

Medium-term outcomes (0-2 years post-project period) include: researcher use of priorities identified in the five-year research agenda to inform PCOR/CER and additional patient/stakeholder and community use and dissemination of toolkit in South Carolina and beyond.

Long-term outcomes (3+ years post-project period) include: sustained breast/chest feeding equity network and the conduct of large-scale PCOR/CER trials that address breast/chest feeding equity.

Patient and Stakeholder Engagement Plan: The project network will engage a wide variety of patients, stakeholders, and community partners in the planning, execution, and evaluation of the project. These groups include African American breast/chest feeding women, African American fathers, lactation consultants, family physicians, obstetricians, nurses and other providers, researchers, and hospitals. In addition, an advisory council of 12 patients and stakeholders will be engaged to shape the network goals, activities, and deliverables.

Project Collaborators: University of South Carolina and network members will serve as collaborators of this project and will represent a range of organizations and initiatives who are passionate about achieving maternal and breast/chest feeding equity among African Americans