It Takes an E-Village: Supporting African American Mothers in Sustaining Breastfeeding Through Facebook Communities.

BACKGROUND: Lack of breastfeeding support is a common barrier reported by African American mothers, whose breastfeeding rates remain significantly below the national average. Despite mothers' reported use of social network sites to access support on topics relating to child rearing, few studies have examined their use to exchange breastfeeding support. RESEARCH AIMS: To describe (1) the experiences of African American mothers who participate in breastfeeding support groups on Facebook and (2) the breastfeeding beliefs, practices, and outcomes for this population of mothers. METHODS: This was a prospective, cross-sectional qualitative study with an online focus group design. The study was guided by Black Feminist Thought and an integrated model of behavior prediction. Four online focus groups (N = 22) were conducted using video conferencing during September 2017 with African American mothers who were participating in breastfeeding support groups on Facebook. RESULTS: Thematic analysis was used to develop four themes and two subthemes, including creating a community for Black mothers, online interactions and levels of engagement, advantages of participating in online support groups, critiques of online support groups, empowerment of self and others, and shifts in breastfeeding perceptions and decisions. Among participants in this study, positive imagery of African American breastfeeding mothers and ongoing support from women with shared experiences improved confidence with public breastfeeding and prolonged goals for breastfeeding duration. CONCLUSION: Receiving peer support within Facebook communities may positively influence breastfeeding norms and confidence in breastfeeding, help mothers to overcome breastfeeding challenges, and ultimately extend intended breastfeeding duration.

Facebook support for breastfeeding mothers: A comparison to offline support and associations with breastfeeding outcomes.

OBJECTIVES: For breastfeeding mothers, online support groups through Facebook may be a more convenient and preferred source for accessing breastfeeding information and support, but few studies exist that examine the use of Facebook groups specifically for breastfeeding support. This study explores the sources of support among users of Facebook breastfeeding support groups and a possible mechanism by which support received on Facebook may translate to behavioral outcomes among breastfeeding mothers. METHODS: From July-September 2017 a survey was distributed online to African American mothers (N = 277) who participate in breastfeeding support groups on Facebook. The survey assessed network support from Facebook and other sources of breastfeeding support, perceived breastfeeding norms, breastfeeding self-efficacy and breastfeeding attitudes. Correlations and linear regression analysis were used to examine the relationship between covariates and outcome variables. RESULTS: The average intended breastfeeding duration among participants in this study was 19 months. Participants reported the highest amount of breastfeeding support received from their Facebook support group, in comparison to other sources of support, and Facebook support was significantly correlated with intended breastfeeding duration (p < 0.05). Self-efficacy and breastfeeding attitudes remained significant predictors of intended breastfeeding duration within the final regression model. CONCLUSIONS: Breastfeeding support received within Facebook groups may compensate for inadequate support received within mothers' networks. More research is needed to understand the mechanism through which Facebook support may contribute to prolonged breastfeeding durations.

The importance of leadership in Soldiers' nutritional behaviors: results from the Soldier Fueling Initiative program evaluation.

INTRODUCTION: Improving Soldiers' nutritional habits continues to be a concern of the US Army, especially amidst increasing obesity and high injury rates. This study examines leadership influence on nutritional behaviors within the context of the Soldier Fueling Initiative, a program providing nutrition education and improved dining facility menus to Soldiers in Basic Combat Training (BCT) and Advanced Individual Training (AIT). METHODS: A mixed methods design using surveys (N=486) and focus groups (N=112) was used to collect data at Fort Jackson, SC, and Fort Eustis, VA, in 2011. RESULTS: Survey results showed 75% of Soldiers in BCT believed their drill sergeant was helpful in making performance-enhancing food choices, and 86% agreed their drill sergeant believed it is important to eat for performance. Soldiers in AIT perceived their cadre as less helpful than their BCT drill sergeants and agreed less frequently that the AIT cadre believed it was important to eat for performance (P<.05). These measures of leader influence were significantly associated with nutritional attitudes and behaviors in both BCT and AIT. Focus groups revealed 5 key themes related to cadre influence and nutrition behavior (listed in order of most to least frequent): (1) cadre influence food choices through consequences related to selection, (2) cadre teach Soldiers how to eat, (3) cadre rush Soldiers to eat quickly to return to training, (4) cadre influence choice through example but often do not make healthy choices, and (5) cadre have no influence on food choices. COMMENT: Leaders influence most Soldiers' nutrition practices within the training environment, particularly within BCT. Given that leader influence can impact Soldiers' attitudes and behaviors, it is critical that military leaders become knowledgeable about optimal nutrition practices to disseminate appropriate information to their Soldiers, avoid reprimand associated with trainees' food choices, reinforce key messages associated with nutrition programming, and lead by example in their own food choices.