92 - Using a mixed-methods evaluation study of mothers’ experiences and realities with breastfeeding to foster programmatic improvement within community-based organizations

Abstract Information: The Improving Health Equity and Maternal and Infant Health (MIH) Outcomes project, supported by the NYC Department of Health and Mental Hygiene, funds 12 community-based organizations (CBOs) in grassroots work aimed at improving MIH outcomes by directing intensive efforts to neighborhoods in New York City (NYC) with the greatest health inequities. This poster presents a unique evaluation study within this project, focusing on the engagement of clients from four of these CBOs to understand their experiences regarding breastfeeding, support received during and after pregnancy, and the effectiveness of breastfeeding education programs. We wil provide a brief overview of the MIH project, the 12 CBOs providing services in five topic areas including: breastfeeding, safe sleep, family planning, women’s health, and toxic stress and trauma, and CAI’s intensive training and technical assistance model. We will then describe our mixed-methods evaluation methodology, incorporating quantitative data collection with baseline and follow-up focus groups, our engagement strategies with the CBOs to reach clients, as well as the insightful narratives we heard from breastfeeding mothers on the effectiveness of breastfeeding programs and challenges and gaps of MIH health programs. Secondly, we will share the benefits of these mixed-methods approaches, including how injecting qualitative insights into quantitative data adds depth and nuance to findings and can maximize the positive influence of evaluation on the community. We will discuss our analysis methods and the findings from the study. We will present salient themes and subthemes, including: the extent to which clients believed breastfeeding services influenced their decision to breastfeed, how these services impacted their breastfeeding journeys, what they liked or disliked about breastfeeding services, the relevance of breastfeeding education materials to their realities, current challenges and gaps in experiences with MIH services, critical resources needed to support postpartum mothers, and the impact COVID-19 has had on mothers’ decisions to breastfeed. We will also present quotes to further bring these women’s stories about the everyday realities of breastfeeding to life. We will then discuss how these methods revealed important knowledge and attitudes related to our project, and how, without amplifying these clients’ voices, we would not have been able to easily learn this information. In particular, we will describe how the focus groups acted as conduits of constructive dialogue about the challenges affecting the mothers’ health and health behaviors, ensuring their voices were not only heard but also valued and used. We will highlight how we disseminated the findings to clients, brought the data back to all CBOs and facilitated fruitful discussions, lessons learned, and more importantly, how we worked closely with the NYC DOHMH to translate these important findings into actionable next steps, identification of emerging priorities, MIH’s programmatic changes as a direct result of hearing the mothers’ unique perspectives, and recommendations to increase efficacy and relevance of the MIH program for NYC’s breastfeeding mothers.