Two Temple University faculty members’ research project on improving low breastfeeding rates among low-income African-American and Hispanic mothers recently received a five-year, $2 million grant from the National Institutes of Health (NIH). Temple University College of Public Health professor Dr. Bradley Collins and Lewis Katz School of Medicine associate professor Dr. Gail Herrine will serve as site principal investigator and project co-investigator, respectively. This multi-site study, which will examine whether a monetary incentive can encourage breastfeeding, will be spearheaded by principal investigator Dr. Yukiko Washio, a researcher in the substance use, gender, and applied Research unit at RTI International.
Building off a successful pilot project that saw breastfeeding rates increase, this larger-scale project will test a behavioral intervention among Delaware- and Pennsylvania-based African-American and Hispanic mothers who receive support from Women, Infant and Child (WIC) programs. Women will be randomized to either a control group that receives standard WIC counselor advice, support and resources to facilitate breastfeeding, or an experimental group that receives the same WIC services plus a monthly monetary incentive (known in the study as Breastfeeding Onset and Onward with Support Tools, or “BOOST”) to mothers for continuing to breastfeed their infants.
The smaller pilot study, Dr. Collins said, provided a “proof of concept” for this larger study and suggested that a monetary incentive could “drastically improve” breastfeeding rates among low-income mothers. The researchers hope that the larger study will provide firm evidence that a financial incentive can tip the scales toward higher levels of breastfeeding among mothers who face both economic and cultural barriers.
“Despite the breastfeeding support and services available in the community, continued breastfeeding rates drop tremendously for low-income, non-white women,” says Dr. Washio. Barriers, such as the misconception that formula milk makes infants healthier as well as the difficulty to keep breastfeeding after returning to an unsupportive work environment, can be major deterrents for these mothers. “The study works to provide linkage to existing breastfeeding support in the community and provide monthly home visitations to maintain motivation and confidence levels to continue breastfeeding with social and financial support,” she says.
This larger study, which will recruit 168 mothers in total, is still in its early phases — researchers were notified that the project would receive a grant in August — but it should be fully underway in early 2019, according to Dr. Collins. Dr. Herrine’s role as medical director of the postpartum clinic at Temple University Hospital will be crucial to recruiting and assessing mothers in the Philadelphia area. “In the pilot, the results showed a pretty dramatic, positive effect,” Dr. Collins says. “To test the BOOST intervention in a full-scale trial could show not only the potential efficacy of this intervention, which could improve maternal and child health, but also bolster evidence supporting its potential sustainability.”