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ABSTRACT: Manager attitude is influential in female employees' perceptions of workplace breastfeeding support. Currently, no instrument is available to assess manager attitude toward supporting women who wish to combine breastfeeding with work. We developed and piloted an instrument to measure manager attitudes toward workplace breastfeeding support entitled the "Managers' Attitude Toward Breastfeeding Support Questionnaire," an instrument that measures four constructs using 60 items that are rated agree/disagree on a 4-point Likert rating scale. We established the content validity of the Managers' Attitude Toward Breastfeeding Support Questionnaire measures through expert content review (n=22), expert assessment of item fit (n=11), and cognitive interviews (n=8). Data were collected from a purposive sample of 185 front-line managers who had experience supervising female employees, and responses were scaled using the Multidimensional Random Coefficients Multinomial Logit Model. Dimensionality analyses supported the proposed four-construct model. Reliability ranged from 0.75 to 0.86, and correlations between the constructs were moderately strong (0.47 to 0.71). Four items in two constructs exhibited model-to-data misfit and/or a low score-measure correlation. One item was revised and the other three items were retained in the Managers' Attitude Toward Breastfeeding Support Questionnaire. Findings of this study suggest that the Managers' Attitude Toward Breastfeeding Support Questionnaire measures are reliable and valid indicators of manager attitude toward workplace breastfeeding support, and future research should be conducted to establish external validity. The Managers' Attitude Toward Breastfeeding Support Questionnaire could be used to collect data in a standardized manner within and across companies to measure and compare manager attitudes toward supporting breastfeeding. Organizations can subsequently develop targeted strategies to improve support for breastfeeding employees through efforts influencing managerial attitude.
Journal of the Academy of Nutrition and Dietetics. 04/2012; 112(7):1042-7.
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ABSTRACT: Managers' attitudes influence female employees' perceptions of workplace breastfeeding support. Five focus groups were conducted with managers in the state of Michigan (N = 25) to assess their attitudes toward supporting breastfeeding. All focus group discussions were recorded, transcribed verbatim, and analyzed for themes. Participants supported efforts by managers and companies to assist breastfeeding employees, but the extent of accommodations they supported varied. Most participants reported no company breastfeeding policy or were unaware of their company having one and showed mixed attitudes about needing a policy. Participants acknowledged the potential for lower productivity and coworker jealousy toward time for breastfeeding or expressing milk but believed that benefits of support included employee recruitment and retention. Participants demonstrated some understanding of breastfeeding benefits. They identified barriers and facilitators for breastfeeding support at both the organizational and individual levels. Results of this study will be used for instrument development to measure managers' attitudes toward supporting breastfeeding.
Journal of Human Lactation 03/2011; 27(2):138-46. · 1.15 Impact Factor
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ABSTRACT: Breastfeeding peer counseling support programs for low-income women have been implemented across the United States. Data from one such program were used to examine participant and program characteristics, of those enrolled prenatally (n = 2168) or postnatally (n = 2899), and to determine how these characteristics affected breastfeeding outcomes. Shorter breastfeeding duration was significantly predicted by introduction of formula on day 1 postpartum in participants enrolled prenatally (-37.9 days [95% CI: -57.9 to -17.9]) as well as postnatally (-49.1 days [95% CI: -63.4 to -34.8]). In both groups, increasing maternal age and previous breastfeeding experience were associated with significantly longer breastfeeding duration. Breastfeeding duration may be improved in programs by targeting younger mothers, those without breastfeeding experience, and focusing on delaying the introduction of formula.
Journal of Human Lactation 11/2008; 25(1):18-27. · 1.15 Impact Factor
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ABSTRACT: Breastfeeding rates remain low in the United States, especially among working women. Unfortunately, no quantitative instrument exists to facilitate the examination of why women who return to work discontinue breastfeeding sooner than the general population. The objective of this study was to develop an instrument to measure female employees' perceptions of breastfeeding support in the workplace, which would be suitable for piloting with the target population.
Examination of the literature, reviews with experts, and one-on-one interviews with women who had experience combining breastfeeding and work were used to create the instrument subscales and items. Examination of the literature was used to develop four subscales: company policies/work culture, manager support, co-worker support, and workflow. Expert review resulted in the addition of a fifth subscale, the physical environment of the breastfeeding space. One-on-one interviews were used to ensure that the item wording was appropriate for the target population.
Eighteen items were added, and 15 were reworded based on comments from the expert review and from the interviews. The resulting survey contained 54 items that required either categorical yes/no or Likert scale responses.
Results from this process indicate the survey subscales and items adequately reflect women's perceptions of breastfeeding support in the workplace and the instrument is appropriate for piloting with new mother employees.
Breastfeeding Medicine 10/2008; 3(3):151-7. · 1.65 Impact Factor
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ABSTRACT: Breastfeeding rates among working mothers are lower than among mothers who are not employed. An ecological framework suggests that health behaviors, such as breastfeeding, are influenced by intrapersonal and environmental factors. There is no existing instrument to measure women's perception of the workplace environment in providing breastfeeding support. The objective of this study was to pilot an instrument measuring perceptions of the work climate for breastfeeding support among working women.
Data were collected from self-administered mailed questionnaires filled out by 104 pregnant women or women who had recently given birth and were employed and breastfeeding.
Dimensionally analyses supported the two-dimensional model suggested by the literature. Internal consistency reliability coefficients were high (near 0.90), and the correlation between the subscales was moderately strong (0.68).
Only a single item exhibited misfit to the scaling model, and that item was revised after review.
Breastfeeding Medicine 10/2008; 3(3):159-63. · 1.65 Impact Factor
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ABSTRACT: The Breastfeeding Initiative program is a collaboration between the Michigan Department of Community Health (Women, Infants, and Children Division) and Michigan State University Extension. It aims to increase breastfeeding rates among low-income women through the use of peer counselors. The study's purpose was to identify the program's strengths, operation procedures, and improvement areas from participants' and peer counselors' perspectives. Six focus groups were conducted: 3 of peer counselors and 3 of program participants. Findings revealed that peer counselors and participants were satisfied with the quality of services due to emotional and practical assistance and breast pumps provided by peer counselors. Peer counselors' job satisfaction was explained positively by the intrinsic rewards of helping others and negatively by perceived inadequate resources and recognition. Operating procedures varied greatly. Possible improvements include expanding services, providing peer counselors with additional support, and standardizing peer counselor operating procedures. The peer counselor model can effectively support low-income breastfeeding women.
Journal of Human Lactation 09/2007; 23(3):262-8. · 1.15 Impact Factor
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ABSTRACT: To evaluate whether an intervention of foods high in soluble fiber from psyllium and/or oats plus a telephone-based, personalized behavior change support service improves serum lipids and elicits cholesterol-managing lifestyle changes vs usual care.
7-week randomized, controlled intervention.
150 moderately hypercholesterolemic men and women, age range 25 to 70 years.
The intervention group consumed 4 servings/day of high-fiber foods and had weekly telephone conversations with a personal coach who offered support and guidance in making lifestyle changes consistent with the National Cholesterol Education Program's (NCEP) cholesterol-lowering guidelines. The usual care group received a handout describing the NCEP Step-1 diet.
Serum lipids and lipoproteins and self-reported lifestyle changes.
For physiologic and dietary changes, mixed linear models for repeated measures were applied. Models were simplified using analysis of covariance where age in years was the covariate. Traditional general linear models were used to assess lifestyle changes.
In the intervention group total cholesterol (TC) decreased 5.6%, low-density lipoprotein (LDL) cholesterol 7.1%, LDL/high-density lipoprotein (HDL) cholesterol ratio 5.6%, and triglycerides (TG) 14.2% (P<.0167); decreases in TC and LDL were significantly different from the usual care group. In the usual care group TC decreased 1.9%, LDL 1.2%, LDL/HDL 1.9%, and TG 4.4% (all not significant). The intervention group also reported an increase in their knowledge, ability, and confidence to make cholesterol-managing diet and exercise changes compared with the usual care group (P<.05). The intervention group had a greater decrease in energy intake from saturated fat (-1.6%) and increase in soluble fiber intake (7.3%) than the usual care group (P<.05). The intervention group reported an increase in exercise vs the usual care group (P<.05). Both intervention and control groups had a minimal reduction (<1%) in body weight compared with baseline (P<.0167).
A 7-week intervention that includes both functional foods and individualized, interactive support for behavior change could be an effective model for dietitians to use with patients at risk for CVD, pending results of long-term studies.
Journal of the American Dietetic Association 04/2002; 102(4):503-10. · 3.59 Impact Factor
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Garry W Auld,
Ann Diker,
M Ann Bock,
Carol J Boushey,
Christine M Bruhn,
Mary Cluskey,
Miriam Edlefsen,
Dena L Goldberg,
Scottie L Misner, Beth H Olson,
Marla Reicks,
Changzheng Wang,
Sahar Zaghloul
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ABSTRACT: A decision tree was developed to determine when NVivo is an appropriate tool for qualitative analysis. NVivo, a qualitative analysis software package, was used to analyze interviews of 204 Asian, Hispanic, and white parents in 12 states. The experience provided insight into issues that should be considered when deciding to use the software. NVivo can enhance the qualitative research process, quickly process queries, and expand analytical avenues. Before using, however, the following must be considered: training time, establishing inter-coder reliability, number and length of documents, coding time, coding structure, use of automated coding, and possible need for separate databases or additional supporting software.
Journal of Nutrition Education and Behavior 39(1):37-47. · 1.69 Impact Factor
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ABSTRACT: To understand how parental influences on dairy food intake relate to early adolescent children's use of calcium-fortified food.
Content analysis of qualitative interviews to identify parental influences on dairy intake; calcium-fortified food survey to identify children as either calcium-fortified food users or nonusers.
A convenience sample of Asian (n = 56), Hispanic (n = 61), and white (n = 74) parents of children 10-13 years old, including boys (n = 86) and girls (n = 105). VARIABLES MEASURED AND ANALYSIS: Cluster analysis to identify groups with similar coded parental influences and chi-square analysis to determine associations between these groups and calcium-fortified food use.
Two dominant patterns of parental influences: Cluster 1 (n = 128), with positive parental influences related to availability of dairy, milk, and cheese; positive health beliefs for dairy, and child preferences for dairy and cheese, included parents whose children were more likely to use calcium-fortified food. Cluster 2 (n = 63), with positive influences for availability of dairy and milk, included parents whose children were equally likely to be either users or nonusers of calcium-fortified food (P < .05).
Strategies to improve parental influence on children's dairy intake might also encourage calcium-fortified food intake and improve calcium nutriture.
Journal of nutrition education and behavior 41(1):53-7. · 1.36 Impact Factor
