Race/ethnicity-specific associations between breastfeeding information source and breastfeeding rates among U.S. women.
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ABSTRACT: Background
Despite evidence of the impact of breastfeeding information on breastfeeding rates, it is unknown if information sources and impact vary by race/ethnicity, thus this study assessed race/ethnicity-specific associations between breastfeeding information sources and breastfeeding.Methods
We used data from the 2016-2019 Pregnancy Risk Assessment Monitoring System. Race/ethnicity-stratified multinomial logistic regression was used to estimate associations between information source (e.g., family/friends) and breastfeeding rates (0 weeks/none, < 10 weeks, or ≥ 10 weeks; < 10 weeks and ≥ 10 weeks = any breastfeeding). All analyses were weighted to be nationally representative.Results
Among 5,945,018 women (weighted), 88% reported initiating breastfeeding (≥ 10 weeks = 70%). Information from family/friends (< 10 weeks: aORs = 1.58-2.14; ≥ 10 weeks: aORs = 1.63-2.64) and breastfeeding support groups (< 10 weeks: aORs = 1.31-1.76; ≥ 10 weeks: aORs = 1.42-2.77) were consistently associated with breastfeeding and duration across most racial/ethnic groups; effects were consistently smaller among Alaska Native, Black, and Hispanic women (vs White women). Over half of American Indian and one-quarter of Black women reported not breastfeeding/stopping breastfeeding due to return to school/work concerns.Conclusions
Associations between breastfeeding information source and breastfeeding rates vary across race/ethnicity. Culturally tailored breastfeeding information and support from family/friends and support groups could help reduce breastfeeding disparities. Additional measures are needed to address disparities related to concerns about return to work/school.
SUBMITTER: Quintero SM
PROVIDER: S-EPMC10024358 | biostudies-literature | 2023 Mar
REPOSITORIES: biostudies-literature
Publications
Race/ethnicity-specific associations between breastfeeding information source and breastfeeding rates among U.S. women.
Quintero Stephanie M SM Strassle Paula D PD Londoño Tobón Amalia A Ponce Stephanie S Alhomsi Alia A Maldonado Ana I AI Ko Jamie S JS Wilkerson Miciah J MJ Nápoles Anna María AM
BMC public health 20230317 1
<h4>Background</h4>Despite evidence of the impact of breastfeeding information on breastfeeding rates, it is unknown if information sources and impact vary by race/ethnicity, thus this study assessed race/ethnicity-specific associations between breastfeeding information sources and breastfeeding.<h4>Methods</h4>We used data from the 2016-2019 Pregnancy Risk Assessment Monitoring System. Race/ethnicity-stratified multinomial logistic regression was used to estimate associations between informatio ...[more]
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Project description:IntroductionU.S. smoking prevalence varies greatly by race/ethnicity. However, little is known about how smoking initiation, cessation, and intensity vary by birth cohort and race/ethnicity.MethodsAdult smoking data were obtained from the 1978-2018 National Health Interview Surveys. Age‒period‒cohort models with constrained natural splines were developed to estimate historical smoking patterns among non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian and Pacific Islander, and non-Hispanic American Indian and Alaskan Native individuals. Annual smoking prevalence and probabilities of smoking initiation, cessation, and intensity by age, year, gender, and race/ethnicity were estimated for the 1900 to 2000 birth cohorts. Analysis was conducted in 2020-2021.ResultsSmoking initiation probabilities were highest for the American Indian and Alaskan Native population, second highest among the non-Hispanic White population, and lowest among Asian and Pacific Islander and Hispanic populations across birth cohorts. Historically, initiation probabilities among non-Hispanic Black populations were comparable with those among non-Hispanic White populations but have decreased since the 1970 birth cohort. Cessation probabilities were lowest among American Indian and Alaskan Native and non-Hispanic Black populations and highest among non-Hispanic White and Asian and Pacific Islander populations across cohorts and ages. Initiation and cessation probabilities produce observed patterns of smoking where prevalence among American Indian and Alaskan Native populations is highest across all ages and cohorts. Across cohorts, smoking prevalence among non-Hispanic Black populations, particularly males, is lower than among non-Hispanic White populations at younger ages but higher at older ages.ConclusionsThere are important and persistent racial/ethnic differences in smoking prevalence, initiation, cessation, and intensity across U.S. birth cohorts. Targeted interventions should address widening smoking disparities by race/ethnicity, particularly for American Indian and Alaskan Native and non-Hispanic Black populations.
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Project description:This study examined the association between preferences for being informed about the COVID-19 vaccine and where to receive it with vaccination intent and race/ethnicity. We conducted an online survey, oversampling Black and Latino panel members. The 1668 participants were 53.2% female, 34.8% White, 33.3% Black, and 31.8% Latino. Participants who were vaccine hesitant (answered "not sure" or "no" to vaccination intent) were more likely to prefer a conversation with their doctor compared to those who answered "yes" (25.0% and 23.4% vs 7.8%, P < .001, respectively). Among participants who responded "not sure", 61.8% prefer to be vaccinated at a doctor's office, compared with 35.2% of those who responded "yes" (P < .001). Preferred location differed by race/ethnicity (P < .001) with 67.6% of Black "not sure" participants preferring a doctor's office compared to 60.2% of Latino and 54.9% of White "not sure" participants. These findings underscore the need to integrate healthcare providers into COVID-19 vaccination programs.
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Project description:ImportanceThere are substantial disparities in breastfeeding rates by race and ethnicity. Telelactation services that connect parents to lactation consultants via video are increasingly available and may reduce inequities in breastfeeding support; however, there is limited evidence on effectiveness.ObjectiveTo assess the impact of video telelactation services on breastfeeding duration and exclusivity across a racially and ethnically diverse population of parents.Design, setting, and participantsThis digital randomized clinical trial was conducted across 39 states. Eligible participants were aged 18 years or older, were in their third trimester of pregnancy with their first child, and intended to breastfeed. Participants were recruited through pregnancy apps from July 2021 to December 2022 and followed up through 24 weeks post partum. Analyses were completed from December 2023 to June 2024.InterventionPregnant individuals were randomized 1:1 to the treatment arm, which received access to a smartphone app with on-demand access to lactation consultants 24 hours a day via video visits, or to the control arm, which received an infant care e-book.Main outcomes and measuresAny breastfeeding and any infant formula use at 24 weeks post partum and time to breastfeeding cessation. The intention-to-treat analysis used regression models to estimate unadjusted effects and effects adjusted for baseline characteristics.ResultsA total of 2108 participants were randomized, and 1911 were analyzed for primary outcomes. The mean (SD) age at the time of recruitment was 29.61 (5.37) years, and 707 participants (37.0%) had a household income of less than $55 000. In all, 611 participants (32.0%) identified as Black, 678 (35.5%) as Latinx, and 622 (32.5%) as races and/or ethnicities other than Black or Latinx. Among treatment arm participants, 466 (48.8%) used telelactation services. In intention-to-treat analyses, the proportion of all participants who reported any breastfeeding at 24 weeks was 674 (70.6%) in the treatment group and 639 (66.8%) in the control group (adjusted difference, 3.6 percentage points; 95% CI, -0.5 to 7.6 percentage points; P = .08), and the proportion with exclusive breastfeeding at 24 weeks was 447 (46.9%) in the treatment arm and 421 (44.1%) in the control arm (adjusted difference, 2.4 percentage points; 95% CI, -1.9 to 6.8 percentage points; P = .28). Differences were significant among Black participants. The proportion of Black participants who reported any breastfeeding at 24 weeks was 196 of 301 (65.1%) in the treatment arm and 178 of 310 (57.4%) in the control arm (adjusted difference, 7.5 percentage points; 95% CI, 0.2-14.8 percentage points; P = .045) and who reported breastfeeding exclusively at 24 weeks was 128 of 300 (42.7%) in the treatment arm and 105 of 310 (33.9%) in the control arm (adjusted difference, 9.2 percentage points; 95% CI, 1.4-16.9 percentage points; P = .02).Conclusions and relevanceIn this randomized clinical trial, telelactation services had no significant effect on breastfeeding rates among participants overall, but significant improvements were found among Black individuals. The results suggest that telelactation services could be a component of a comprehensive strategy to reduce racial disparities in breastfeeding rates.Trial registrationClinicalTrials.gov Identifier: NCT04856163.
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Project description:Background:Higher socioeconomic status (SES) indicators such as educational attainment and income reduce the risk of chronic lung diseases (CLDs) such as Chronic Obstructive Pulmonary Disease (COPD), emphysema, chronic bronchitis, and asthma. Marginalization-related Diminished Returns (MDRs) refer to smaller health benefits of high SES for marginalized populations such as racial and ethnic minorities compared to the socially privileged groups such as non-Hispanic Whites. It is still unknown, however, if MDRs also apply to the effects of education and income on CLDs. Purpose:Using a nationally representative sample, the current study explored racial and ethnic variation in the associations between educational attainment and income and CLDs among American adults. Methods:In this study, we analyzed data (n = 25,659) from a nationally representative survey of American adults in 2013 and 2014. Wave one of the Population Assessment of Tobacco and Health (PATH)-Adult study was used. The independent variables were educational attainment (less than high school = 1, high school graduate = 2, and college graduate =3) and income (living out of poverty =1, living in poverty = 0). The dependent variable was any CLDs (i.e., COPD, emphysema, chronic bronchitis, and asthma). Age, gender, employment, and region were the covariates. Race and ethnicity were the moderators. Logistic regressions were fitted to analyze the data. Results:Individuals with higher educational attainment and those with higher income (who lived out of poverty) had lower odds of CLDs. Race and ethnicity showed statistically significant interactions with educational attainment and income, suggesting that the protective effects of high education and income on reducing odds of CLDs were smaller for Blacks and Hispanics than for non-Hispanic Whites. Conclusions:Education and income better reduce the risk of CLDs among Whites than Hispanics and Blacks. That means we should expect disproportionately higher than expected risk of CLDs in Hispanics and Blacks with high SES. Future research should test if high levels of environmental risk factors contribute to the high risk of CLDs in high income and highly educated Black and Hispanic Americans. Policy makers should not reduce health inequalities to SES gaps because disparities sustain across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.
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Project description:BackgroundRace- and ethnicity-based differences in treatment access and outcomes have been reported in the orthopaedic sports medicine literature. However, the rate at which race and ethnicity are reported and incorporated into the statistical analysis of sports medicine studies remains unclear.PurposeTo determine the rate at which race and ethnicity are reported and analyzed in athlete-specific sports medicine literature.Study designSystematic review; Level of evidence, 4.MethodsUsing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, articles published by the 3 journals of the American Orthopaedic Society for Sports Medicine between 2017 and 2021 were considered for inclusion. Original sports medicine research studies that focused on athletes were included. Outcome measures included reporting and analysis of patient demographics (age, sex, race, ethnicity). Studies that included demographic variables in a multivariate analysis or that performed a race-/ethnicity-based stratified analyses were considered to have analyzed that variable. Studies that reported and/or analyzed patient demographics were examined. Chi-square tests were performed to determine statistical significance.ResultsA total of 5140 publications were screened, and 842 met the inclusion criteria. Age and sex were well reported (84.1% and 87.0%, respectively), while race (3.8%) and ethnicity (2.0%) were poorly reported. There was no difference in rates of reporting age, sex, race, or ethnicity between the American Journal of Sports Medicine (AJSM), the Orthopaedic Journal of Sports Medicine (OJSM), or Sports Health: A Multidisciplinary Approach (Sports Health). The rate of analysis was also calculated as a percentage of the studies that reported that variable. Of the studies that reported age, 38.5% analyzed age. Using this method, 26.2% of studies analyzed sex, 40.6% analyzed race, and 17.6% analyzed ethnicity. Although there was no difference in the overall rate at which studies from the 3 journals analyzed ethnicity, Sports Health studies analyzed age (P = .044), sex (P = .001), and race (P = .027) more frequently than studies published in AJSM and OJSM. Of the studies that analyzed race, most of those studies (8/13, 61.5%) found significant race-based differences in reported outcomes.ConclusionThis systematic review demonstrated that race and ethnicity are poorly reported and analyzed in athlete-specific sports medicine literature, despite the fact that a majority of studies analyzing race found significant differences between racial groups. Improved reporting of race and ethnicity can determine whether race- and ethnicity-based differences exist in patient interventions to ameliorate disparities in patient outcomes.
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