Department of Community Health Sciences, Tulane School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, TW-19, New Orleans, LA 70112, USA.
Matern Child Health J. 2012 Nov;16(8):1583-93. doi: 10.1007/s10995-011-0852-3.
Positive deviance inquiry is effective in identifying advantageous health behaviors and improving health outcomes among disadvantaged resource-poor populations. The objective of this study was to apply the positive deviance concept to explore the characteristics of positive deviants for breastfeeding among WIC-enrolled first-time mothers in Louisiana. The cross sectional study included data on 2,036 WIC-enrolled first time mothers (52.6% black) from the LaPRAMs, 2000-2004. Chi-square test was used to compare groups. Multivariable logistic regression was applied to calculate adjusted OR and 95% CI by breastfeeding initiation status. The average age was 21.3 years, 31.5% had less than 12 years of education, and 44.6% of the sample reported having initiated breastfeeding. Black mothers were less likely to initiate breastfeeding than their white counterparts (OR 0.39 (95% CI: 0.31, 0.48)). Among 641 WIC-enrolled first time mothers with less than 12 years of education, 28.4% were identified as positive deviants for breastfeeding initiation. Among the black mothers 19.8% were positive deviants compared to 40.3% of the white mothers. Breastfeeding in the hospital after delivery (P < 0.0001) and having received help on how to breastfeed in the hospital (P < 0.0001) were significantly associated with breastfeeding initiation in white and black mothers. In addition, the black positive deviants were more likely, OR 2.80 (95% CI: 1.20, 6.56) to have initiated breastfeeding if their baby was low birth weight. Breastfeeding practices shortly after delivery including assistance and education from staff in the hospital, are related to breastfeeding initiation among less educated WIC-enrolled mothers.
正偏行为探究在确定资源匮乏的弱势群体的有利健康行为和改善健康结果方面非常有效。本研究旨在应用正偏行为概念，探索路易斯安那州参加 WIC 的初产妇中母乳喂养正偏行为者的特征。这项横断面研究包括了来自 LaPRAMs，2000-2004 年的 2036 名参加 WIC 的初产妇（52.6%为黑人）的数据。卡方检验用于比较组间差异。多变量逻辑回归用于计算按母乳喂养起始状态调整的优势比（OR）和 95%置信区间（CI）。平均年龄为 21.3 岁，31.5%的人受教育程度低于 12 年，44.6%的样本报告已开始母乳喂养。黑人母亲比白人母亲更不可能开始母乳喂养（OR 0.39（95%CI：0.31，0.48））。在 641 名受教育程度低于 12 年的参加 WIC 的初产妇中，有 28.4%被确定为母乳喂养起始的正偏行为者。在黑人母亲中，有 19.8%是正偏行为者，而白人母亲中这一比例为 40.3%。产后在医院母乳喂养（P<0.0001）和在医院获得母乳喂养帮助（P<0.0001）与白人和黑人母亲的母乳喂养起始显著相关。此外，如果黑人正偏行为者的婴儿体重较低，其母乳喂养起始的可能性更大，OR 为 2.80（95%CI：1.20，6.56）。分娩后不久，包括医院工作人员的协助和教育在内的母乳喂养做法与接受 WIC 教育程度较低的母亲的母乳喂养起始有关。
