A RE-AIM Evaluation of Communities and Hospitals Advancing Maternity Practices (CHAMPS) in Mississippi
Report Publish Date: May 4, 2022
This journal article describes a study of an initiative that aimed to boost breastfeeding rates among people giving birth in Mississippi hospitals.
The Communities and Hospitals Advancing Maternity Practices (CHAMPS) program recruited and enrolled 95% of hospitals that were eligible for the program and reached 98% of Mississippi birthing women who were eligible. CHAMPS also reached 65% of peer breastfeeding counsellors for Mississippi’s Special Supplemental Program for Women, Infants, and Children.
On average, the percentage of women who began breastfeeding while in hospital rose from 56% to 66%. During the years long studied, the percentage of Mississippi hospitals that had acquired a Baby-Friendly designation or were in the final stages of gaining the designation rose from 15% to 90%.
From 2015 to 2019, the gap between Black and White moms’ likelihood of breastfeeding while in hospital shrunk by 17 percentage points, going from 43% to 63% for Black moms and from 69% to 73% for White moms.
CHAMPS promotes the World Health Organization’s Ten Steps to Healthy Breastfeeding program using a quality improvement approach that includes technical assistance, coaching, hospital visits, data analysis, and more.
The authors used 2010–2019 data from the hospitals, CHAMPS, the Mississippi Department of Health, and USDA to measure the program’s reach, effectiveness, adoption, and maintenance.
"Widespread change in healthcare practices is possible when implemented in partnership with diverse institutions and community groups.”
—Anne Merewood, Laura Burnham, Jacqueline Berger, and Aishat Gambari, Boston Medical Center; Cara Safon and Paige Beliveau, Boston University; Tawanda Logan-Hurt, Mississippi State Department of Health; and Nathan Nickel, Manitoba University
“Broad-scale breastfeeding promotion and engagement initiatives can be successfully implemented and assessed using evidence-based implementation science frameworks,” the authors write.
Communities and Hospitals Advancing Maternity Practices (CHAMPS) is a public health initiative, operating in Mississippi since 2014, to improve maternal and child health practices and reduce racial disparities in breastfeeding. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, this study assessed CHAMPS, which used a Quality Improvement intervention at hospitals, and engaged intensively with local community partners.
The study team assessed outcomes through quantitative data (2014–2020) from national sources, Mississippi hospitals, community partners and CHAMPS program records, and qualitative data from focus groups. With 95% of eligible Mississippi hospitals enrolled into CHAMPS, the program reached 98% of eligible birthing women in Mississippi, and 65% of breastfeeding peer counsellors in Mississippi's Special Supplemental Nutrition Program for Women, Infants and Children. Average hospital breastfeeding initiation rates rose from 56% to 66% (p < 0.05), the proportion of hospitals designated Baby-Friendly or attaining the final stages thereof rose from 15% to 90%, and 80% of Mississippi Special Supplemental Program for Women, Infants, and Children districts engaged with CHAMPS. CHAMPS also maintains a funded presence in Mississippi, and all designated hospitals have maintained Baby-Friendly status.
These findings show that a breastfeeding-focused public health initiative using broad-based strategic programming involving multiple stakeholders and a range of evaluation criteria can be successful. More breastfeeding promotion and support programs should assess their wider impact using evidence-based implementation frameworks.
Maternal & Child Nutrition, May 4, 2022, https://doi.org/10.1111/mcn.13370
This study and report was conducted and created by the following people.
