Evaluation of a Practice Change Using COPE (Creating Opportunities for Parent Empowerment) to Address Maternal Anxiety, Depression and Expectations Related to Preterm Birth and Subsequent Neonatal Intensive Care Unit (NICU) Admission

Evaluation of an Evidence-Based Breastfeeding Education Program for Pediatric and Women’s Health Care Providers, Family Practice Residents, Medical Students, and Physician Assistant Students Alissa Terry Parker, MSN, CPNP, IBCLC Background Every year approximately $13 billion are spent and an estimated 900 infant lives are lost in the United States as a result of infants not exclusively receiving breast milk for the first six months of life. Many health care providers lack knowledge and supportive skills regarding basic breastfeeding management. However, the results of several research studies indicate that health care providers who provide support and who are knowledgeable in breastfeeding management can improve the breastfeeding rates of the maternal-infant dyads that they serve. An evidencebased breastfeeding educational program can significantly increase the breastfeeding knowledge and attitudes of health care providers. Objectives The goal of this project was to significantly increase the breastfeeding knowledge and attitudes of family practice residents, medical students, Physician Assistant students and the pediatric and women’s health clinical faculty practicing within the outpatient clinics of a rural hospital located in eastern Kentucky. Design This study used a quasi-experimental pre-test and post-test design. Clinical faculty working in the pediatric and women’s health clinics attended a 1-hour evidence-based breastfeeding education program. Family practice residents, medical students, and Physician Assistant students attended 12 1-hour breastfeeding education seminars which occurred twice weekly for six weeks during hospital Grand Rounds. Preand postmeasurements included knowledge and attitude scores. Clinical faculty completed the modified Physicians Breastfeeding Assessment Survey preand post-intervention. Residents, medical students, and Physician Assistance students completed the American Academy of Pediatrics Breastfeeding Residency Curriculum Tests, the modified Physicians Breastfeeding Assessment Survey, and the modified Nursing Support for Breastfeeding Questionnaire preand postintervention. Subjects Thirty clinical faculty members were eligible to attend the program and the program was completed by 27 clinical faculty. All 14 eligible students attended and completed the Grand Rounds program. Results Clinical faculty members had a statistically significant improvement in knowledge scores on the modified Physicians Breastfeeding Assessment Survey after attending the 1-hour program (p < 0.001). Clinical faculty did not display a statistically significant improvement in attitude scores (p = 0.19). Residents and students had statistically significant improvement in knowledge scores on the modified Physicians Breastfeeding Assessment Survey and the American Academy of Pediatrics Breastfeeding Residency Curriculum Tests (p < 0.001; p < 0.001, respectively). Residents and students also experienced statistically significant improvement in breastfeeding attitudes on the modified Physicians Breastfeeding Assessment Survey and the modified Nursing Support for Breastfeeding Questionnaire (p = 0.054; p < 0.001, respectively). Conclusion The implementation of an evidence-based breastfeeding education program for students and faculty improved breastfeeding knowledge and attitudes of students and breastfeeding knowledge of faculty. Evidence-based breastfeeding programs are a cost-effective strategy to improve knowledge of heath care providers.