We propose to develop a bilingual touch screen Computer based Breast-feeding Educational Support program to promote breast-feeding among Hispanic rural women living in Scottsbluff area of rural Nebraska. We propose to utilize our previous successful experience in implementation and evaluation of bilingual computer mediated health education programs (Patient Education and Motivation Tool, PEMT) to disseminate information to diverse users with low literacy levels in diverse settings. PEMT is a touch screen, computer based interactive health education program designed based on a variety of cognitive-behavioral theories. PEMT facilitates health information and messages to be adapted depending on the psychosocial elements including attitude, self-efficacy, prior knowledge, personal norms and social influences. We will modify our existing PEMT to develop an interactive, tailored, touch screen, bilingual breast-feeding educational program specifically designed to deliver breast-feeding education. The entire bilingual breast-feeding educational modules will be broken down into a series of sub-modules that will be further broken down into series of tailored educational messages using varied multimedia formats (such as audio, text, images) after taking into account the health literacy levels and the preferred modes of learning of these Hispanic women. We will further examine the effect of the bilingual, touch screen;computer based Breast-feeding educational Support program to improve breast-feeding knowledge, breast-feeding self-efficacy and partial breast-feeding among those who will be using this program as compared to those using Bi-lingual printed educational materials. We plan to enroll and randomize 54 subjects from Regional West Medical Center (RWMC), at Scottsbluff to two groups including intervention (bilingual Computer based Breast-feeding Educational Support program, n=27) and attention control (bilingual printed educational material). The difference between the two study groups is that subjects in the intervention will record their baseline assessment on a computer and receive tailored breast-feeding education compared to the attention control (bilingual printed breast- feeding educational materials) who will record ther baseline information on paper. Baseline information includes socio-demographic, health literacy and motivational interviewing assessments, breast-feeding knowledge and breast-feeding self-efficacy. Telephone follow up will be performed on postpartum day 3, week 6 months 3 and 6 in both groups. The primary outcome assessed is partial (combined formula and breast milk feeding) breast-feeding at six months. Program acceptance will also be assessed.

Public Health Relevance

Healthy People 2020 objectives on breast-feeding are to Increase the proportion of mothers who breastfeed their babies. Women less than 20 years of age and living in rural areas are less likely to breastfeed their babies. This vital research shoul provide important information to develop computer mediated interventions targeted to periods of greatest risk of premature breastfeeding cessation to prolong breastfeeding duration in populations.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Exploratory/Developmental Grants (R21)
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Health Care Technology and Decision Science (HTDS)
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Bernstein, Steve
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University of Nebraska Medical Center
Schools of Public Health
United States
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