An Evaluation of Mississippi WICs Use of Smartphone Technology to Improve Lactation Support Jameshyia B Thompson PhD RDN LD CLC Deputy Bureau Director Mississippi WIC Program Background Mississippi WIC Program ID: 580056
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Breastfeeding Support for Millennial Moms: An Evaluation of Mississippi WIC’s Use of Smartphone Technology to Improve Lactation Support
Jameshyia B. Thompson, PhD, RDN, LD, CLC
Deputy Bureau Director
Mississippi WIC ProgramSlide2
BackgroundMississippi WIC Program
Average participation 84,143
Mississippi Breastfeeding Program
Average participation 2,721FNS Operational Adjustment Grant$204,500Slide3
Mississippi At-Risk
0
0
50 Miles
50 KM
District 1
District 7
District 6
District 2
District 3
District 5
District 4
District 8
District 9Slide4
Mississippi At-Risk
2014
2016
Ever breastfed
61.5
52
Breastfeeding at 6 months
28.9
23.9Breastfeeding at 12 months10.011.3Exclusively breastfeeding at 3 months28.821.4Exclusively breastfeeding at 6 months10.19.3Number of CLCs per 1,000 live births0.572.21Number of IBCLCs per 1,000 live births1.811.93https://www.cdc.gov/breastfeeding/pdf/2014breastfeedingreportcard.pdfhttps://www.cdc.gov/breastfeeding/pdf/2016breastfeedingreportcard.pdfSlide5
Mississippi At Risk
Generation
Age Range
(Based on MS
State workforce data)
WIC Population
(Approximations based on WIC data
from Oct. 2015
)Baby Boomers1946- 1964(53- 71)0%Generation X1965- 1979(38- 52)2.4%Generation Y, Millennials1980- 1995(22- 37)70.2%Generation Z, iGen1996- 2010(7- 21)27.4%Slide6
Using technology to improve upon evidence-based strategies
Former US Surgeon General recommends increased access to IBCLCs as an evidence-based strategy for increasing breastfeeding duration and exclusivity
Women with telephone-based IBCLC support
maintained exclusive breastfeeding for three times as long as control
groups
97
% of women aged 18-35 own smartphones
Sources:
1) U.S. Surgeon General’s Call to Action to Support Breastfeeding, 2014 https://www.ncbi.nlm.nih.gov/books/NBK526822) American journal of Clinical Nutrition, 2013 http://ajcn.nutrition.org/content/98/5/1226.full3) “Millennials are top smartphone users.” 2016. Nielsen, http://www.nielsen.com/us/en/insights/news/2016/millennials-are-top-smartphone-users.htmlSlide7
Intervention
Dates
Procedures
April- May, 2016
Contract
secured with Pacify
June, 2016
Developed
Mississippi- specific training materials June, 2016Procedures developedJune, 2016On-site training provided by PacifyJune, 2016Program launchedJuly- August, 2016Webinar based follow-up trainingJuly 2016- September 2016Monthly reportsSlide8
Mobile ApplicationSlide9
Evaluation StrategiesIncrease participant access to breastfeeding support services
Number of accounts activated by WIC participants
Participant utilization
Improve the quality of breastfeeding promotion and supportStar quality ratingSlide10
Evaluation StrategiesEnsure peer counselors can yield to IBCLC’s when appropriate
Peer counselor access to application
Provide a cost- saving alternative to in-clinic staffing with professional
IBCLCsRelative cost comparison (FTEs vs Pacify)Slide11
Key Findings – 6 month assessment
Month of Enrollment
Total Enrollment
June 18
44
July
94
August
94September132October136November98 TOTAL598Slide12
Key Findings
Of the 486 WIC participants completing the star rating, average rating was 4.5/5.0
“Sandy was very helpful. She answered my question and helped with a question I had the other day but forgot to ask!”
“Joanne was very helpful I was on the verge of giving up
bc
I thought my body wasn’t making enough milk but she explained everything!”
“very knowledgeable and sweet. I enjoyed her visuals and the way she explained everything. very good at building confidence.”
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Key Findings
BUDGET ITEM
COST
Total to fund 9 IBCLCs for
one
year
(During clinic hours only)
$313,200Total for Pacify for one year(24/7 access)$204,500DIFFERENCE$108,700Slide14
Key FindingsSlide15
Findings To Date
June 18, 2016 – March 11, 2017
Total enrollments
866
Total clinical consultations
891
Portion of clinical consultations completed outside of MS WIC hours
43%
Average time to answer21 secondsAverage participant star rating4.5/5.0 starsSlide16
Best Practices
State Office
WIC and Pacify involvement in kick-off trainings (held in-person trainings in all nine health districts)
Peer counselor- led enrollment process in clinics. Pacify app was an extension of the services provided by WIC.Pacify providers often refer MS WIC clients back to WIC program and peer counselor for additional support (collective effort to support breastfeeding women)
Reports are always shared in HIPAA-compliant manner (encrypted email with password protection)Slide17
Lessons Learned
Adjustments to enrollment timing
Implemented to maximize impact of program
Started with offering to only breastfeeding participants (postpartum) and ended with offering to both breastfeeding and prenatal participants.Importance of demonstration callsUtilization was higher for women who made demonstration calls during enrollment
Demonstration calls can be completed in a couple of minutes.Slide18
ConclusionsBenefit for Mississippi WIC Program
24/7 access
Positive participant feedback
Cost savingsIncreased support for staff and participantsImproved breastfeeding rates – will continue to monitor impact on retentionSlide19
Any Questions?