Using Data to Understand Breastfeeding Equity in the California WIC - - PowerPoint PPT Presentation

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Using Data to Understand Breastfeeding Equity in the California WIC - - PowerPoint PPT Presentation

Aug 31, 2023 44 likes •444 views

Using Data to Understand Breastfeeding Equity in the California WIC Program Susan Sabatier, MA and Jen Goldbronn, MAS, RD, CLC California Department of Public Health Women, Infants and Children Division 7 th Annual California Breastfeeding

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Susan Sabatier, MA and Jen Goldbronn, MAS, RD, CLC California Department of Public Health Women, Infants and Children Division 7th Annual California Breastfeeding Summit Anaheim, CA January 25, 2017

Using Data to Understand Breastfeeding Equity in the California WIC Program

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Overview

  • WIC Background

– How WIC is structured – How WIC measures breastfeeding

  • WIC Breastfeeding Data

– Trends between 2012-2016 – 2016 Breastfeeding Statistics

  • MIHA WIC Data 2013-14

– MIHA WIC Snapshots – County and Region WIC Breastfeeding data

  • Collaborating with WIC

– WIC Research Review Process

  • WIC Program Updates

Outline

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CDPH WIC Division 83 Local Agencies

~ 575 WIC sites 41 Non-profit Agencies 42 County Agencies

California WIC Structure

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Authors gratefully acknowledge guidance of WIC Caseload Management Workgroup

Map of Local WIC Clinics

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Measuring Breastfeeding in WIC

–Fully (Exclusive) Breastfeeding –Mostly Breastfeeding –Some Breastfeeding –Formula feeding

WIC Breastfeeding Measure: Infant WIC food package is a proxy

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“Any” Breastfeeding Defined

Any Breastfeeding

Partial

Some = higher amount formula Mostly = small amount formula

Fully

No formula

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AUTHORS GRATEFULLY ACKNOWLEDGE GUIDANCE OF WIC CASELOAD MANAGEMENT WORKGROUP

Any and Fully Breastfeeding Trends at 3, 6 and 11 Months 2012-2016

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Any Breastfeeding at 3, 6 and 11 Months, 2012-2016

44.2 44.6 45.5 45.3 45.4 34.2 34.9 35.8 35.8 36.0 28.8 29.3 30.4 30.9 31.1

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0

2012 2013 2014 2015 2016

% B r e a s t f e e d i n g

Age 3 Months Age 6 Months Age 11 Months

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.

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Fully Breastfeeding at 3, 6 and 11 Months, 2012-2016

22.3 22.6 22.9 22.9 22.7 17.4 17.8 18.2 18.4 18.6 15.0 15.2 15.9 16.1 16.6

0.0 5.0 10.0 15.0 20.0 25.0

2012 2013 2014 2015 2016

% B r e a s t f e e d i n g

Age 3 Months Age 6 Months Age 11 Months

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.

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AUTHORS GRATEFULLY ACKNOWLEDGE GUIDANCE OF WIC CASELOAD MANAGEMENT WORKGROUP

Any and Fully Breastfeeding Trends by Race/Ethnicity 2012-2016

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California WIC Infants by Racial/Ethnic Group Annual Monthly Average January-December 2016

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: Report for CY ending December 2016

Percentages based on a total average monthly count of 244,915 infants.

74.7% 6.0% 6.1% 8.8% 3.8% 0.6%

Non-Hispanic Asian Non-Hispanic African American Hispanic Other or Not Reported Non-Hispanic Multiple Race Non-Hispanic White

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3 Month Old Any Breastfeeding Trends by Race and Ethnicity

44.9 45.1 45.7 45.4 45.4 33.7 34.4 36.0 35.4 35.8 41.5 44.5 47.0 46.9 48.4 47.9 48.7 49.8 49.7 49.5 0.0 10.0 20.0 30.0 40.0 50.0 60.0

2012 2013 2014 2015 2016

P e r c e n t

Hispanic Non-Hispanic African Americans Non-Hispanic Asians Non-Hispanic Whites

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.

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3 Month Old Fully Breastfeeding Trends by Race and Ethnicity

21.7 21.9 22.2 22.3 22.0 17.2 17.9 18.0 18.1 18.3 14.6 15.0 15.9 16.5 17.1 33.1 33.6 34.3 33.4 33.5 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0

2012 2013 2014 2015 2016

P e r c e n t

Hispanic Non-Hispanic African Americans Non-Hispanic Asians Non-Hispanic Whites

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.

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6 Month Old Any Breastfeeding Trends by Race and Ethnicity

34.9 35.4 36.1 36.0 36.1 24.7 26.0 27.3 26.7 27.5 32.6 34.5 36.3 37.3 37.4 36.9 38.3 39.4 39.4 39.7 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0

2012 2013 2014 2015 2016

P e r c e n t

Hispanic Non-Hispanic African Americans Non-Hispanic Asians Non-Hispanic Whites

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.

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AUTHORS GRATEFULLY ACKNOWLEDGE GUIDANCE OF WIC CASELOAD MANAGEMENT WORKGROUP

Any and Fully Breastfeeding Trends by Ethnicity and Language Preference 2012-2016

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California WIC Infants by Ethnicity and Language Preference, Annual Monthly Average January-December 2016

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: Report for CY ending December 2016

Percentages based on a total average monthly count of 244,915 infants.

25.9% 48.6% 22.2% 3.3% Hispanic, Prefers Spanish Non-Hispanic, Prefers English Other Hispanic, Prefers English

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3 Month Old Any Breastfeeding Trends by Ethnicity & Language Preference

36.3 37.4 38.7 38.7 38.8 57.5 57.6 57.7 57.5 57.8 42.4 43.5 45.1 45.0 45.5

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0

2012 2013 2014 2015 2016

P e r c e n t

Hispanic, Prefers English Hispanic, Prefers Spanish Non-Hispanic or Other

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.

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3 Month Old Fully Breastfeeding Trends by Ethnicity & Language Preference

18.8 19.6 20.4 20.6 20.4 26.0 25.7 25.3 25.4 25.1 24.0 24.4 24.9 24.7 24.8

0.0 5.0 10.0 15.0 20.0 25.0 30.0

2012 2013 2014 2015 2016

P e r c e n t

Hispanic, Prefers English Hispanic, Prefers Spanish Non-Hispanic or Other

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.

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6 Month Old Any Breastfeeding Trends by Ethnicity & Language Preference

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.

26.6 27.6 29.2 29.5 29.6 46.9 48.0 48.0 47.9 48.4 32.4 33.7 35.0 35.3 35.7

0.0 10.0 20.0 30.0 40.0 50.0 60.0

2012 2013 2014 2015 2016

P e r c e n t

Hispanic, Prefers English Hispanic, Prefers Spanish Non-Hispanic or Other

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AUTHORS GRATEFULLY ACKNOWLEDGE GUIDANCE OF WIC CASELOAD MANAGEMENT WORKGROUP

Breastfeeding Data by Feeding Choice Monthly Annual Average 2016

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WIC Breastfeeding Rates by Infant Age and Feeding Choice, 2016

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January through December 2016

23% 19% 17% 14% 10% 8% 9% 8% 7% 55% 64% 69%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Infants Age 3 Months Infants Age 6 Months Infants Age 11 Months

Fully Breastfeeding Mostly Breastfeeding Some Breastfeeding Formula Fed

32% 37% 46% % Breastfeeding

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WIC Breastfeeding Rates by Age of Mother, 2016

35 16 25 12 21 42 22 32 18 28 48 25 38 21 34 53 25 44 21 39

10 20 30 40 50 60 Any Breastfeeding Age 3 Months Fully Breastfeeding Age 3 Months Any Breastfeeding Age 6 Months Fully Breastfeeding Age 6 Months Any Breastfeeding Age 11 Months

% Breastfeeding Age <21 Ages 21 to 25 Ages 26 to 30 Ages 31 and Over

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January through December 2016

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WIC Breastfeeding Rates by Urban/Rural Residence, 2016

45.5 20.8 36.5 17.1 31.8 45.1 24.8 35.2 20.1 30.2 51.5 32.9 41.8 27.7 33.9

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Any Breastfeeding Age 3 Months Fully Breastfeeding Age 3 Months Any Breastfeeding Age 6 Months Fully Breastfeeding Age 6 Months Any Breastfeeding Age 11 Months

% Breastfeeding 100% Urban Urban/Rural Mix 100% Rural

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January through December 2016

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Any Breastfeeding at 3 months

Annual State Average: 52.3%

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January through December 2016

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Any Breastfeeding at 6 months

Annual State Average: 41.5%

Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January through December 2016

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SOURCE: WIC-MIS, 2011

WIC MIHA Snapshots 2013-14

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Release of Statistical MIHA Products for WIC Program

  • MIHA Data Snapshots, 2013-2014 for

the WIC Program, key indicators of maternal and infant health: – Statewide by WIC status (WIC participant, eligible nonparticipant, not eligible) – Statewide prenatal WIC participants by race/ethnicity, income, age, prenatal health insurance, education, total live births, level of neighborhood poverty, geographic area (urban, rural/frontier) – County prenatal WIC participants compared to State prenatal WIC participants, 35 counties

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Statewide WIC Status by Indicators & Demographics

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The Maternal and Infant Health Assessment (MIHA) is an annual population based survey of women with a recent live birth with a sample size of n=13,963 in 2013-14. Percentages and 95% confidence intervals are weighted to represent all women with a live birth from 2013 through 2014 in California.

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Statewide Prenatal WIC Participants: Indicators by Race/Ethnicity

The Maternal and Infant Health Assessment (MIHA) is an annual population based survey of women with a recent live birth with a sample size of n=13,963 in 2013-14. Percentages and 95% confidence intervals are weighted to represent all women with a live birth from 2013 through 2014 in California.

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County Prenatal WIC Participants Compared to State Prenatal WIC Average

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The Maternal and Infant Health Assessment (MIHA) is an annual population based survey of women with a recent live birth with a sample size of n=13,963 in 2013-14. Percentages and 95% confidence intervals are weighted to represent all women with a live birth from 2013 through 2014 in California.

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Exclusive Breastfeeding at 3 months postpartum among Prenatal WIC Participants, for 35 counties, MIHA 2013-2014

5 10 15 20 25 30 35 40 45 50 55

53% 8% % prenatal WIC participants exclusively breastfeeding at 3 months

The Maternal and Infant Health Assessment (MIHA) is an annual population based survey of women with a recent live birth with a sample size of n=13,963 in 2013-14. Percentages and 95% confidence intervals are weighted to represent all women with a live birth from 2013 through 2014 in California.

California Prenatal WIC Participants, avg. = 20.1%

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SOURCE: WIC-MIS, 2011

Collaborating with WIC: Conducting Research in WIC

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Criteria Used to Evaluate Research -

  • 1. Study benefits the WIC participant or WIC

Program

  • 2. Study safeguards participant dignity, autonomy,

confidentiality and privacy.

  • 3. Time, space or other requested local agency

resources are clearly described and acceptable.

  • 4. Review and approval processes are clearly

understood including intellectual property rights for any products/publications.

  • 5. Proposal is methodologically sound such that

results can be measured and are meaningful.

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WIC Research Review Process

  • Contact your local agency (LA) WIC director.
  • If supported by the LA, a brief synopsis of the

research will be submitted to the State for review.

  • If State supports the study, researchers will

complete a research concept form which provides more detailed information about the study.

  • If concept is approved, research will need to be

approved by CDPH’s IRB committee.

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WIC Program/Data Update

Introducing… breastfeeding performance measures!

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WIC Program Updates

Picture Source: United States Breastfeeding Committee

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WIC Program Updates Consistent, evidence-based breastfeeding messages

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WIC Program Updates Number of Regional Breastfeeding Liaisons (RBLs) has doubled!

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Questions??

Susan Sabatier, Data Analysis, Research and Evaluation Chief, at Susan.Sabatier@cdph.ca.gov Jen Goldbronn, WIC State Breastfeeding Coordinator, at Jen.Goldbronn@cdph.ca.gov Pat Gradziel, Research Specialist, at Pat.Gradziel@cpdh.ca.gov