Breastfeeding to Reduce Breast Cancer in Young Mothers
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Introduction: The burden of breast cancer mortality among low-income women, women of color, and younger women, is disproportionately high. 
 
 Adolescent mothers are an important target population given that adolescent parenthood is disproportionately concentrated in low-income 
 
 communities and communities of color. Breastfeeding is significantly protective against breast cancer, especially against aggressive types. While 
 
 younger age at first birth is protective against other cancers, the risk pattern for the most aggressive breast cancers is the opposite: younger 
 
 
 
 mothers are at significantly higher risk. Both research and Brighter Beginnings (BB) experience have identified gaps in breastfeeding promotion, 
 
 as well as gaps between intentions to breastfeed and actual breastfeeding behavior. 
 
 
 
 
 
 Question(s) or hypotheses: What are the structural and social barriers to and motivators of breastfeeding that young mothers encounter during 
 
 their child’s first year? 
 
 
 
 
 
 We hypothesize that there are multiple, intersecting factors that influence breastfeeding in this population, in part due to the multiple and 
 
 overlapping oppressions/marginalizations experienced by many of them.
 
 
 
 
 
 General methodology: We will conduct at least nine in-depth interviews with providers who work with the target population, six dyadic 
 
 interviews with adolescent parents and their decision-making partners, and at least three community mapping sessions with adolescent mothers. 
 
 Community mapping is a participatory action research method that allows communities to identify, align, and leverage their resources to support 
 
 social and economic change at a community level. We will facilitate community mapping with small groups of three to six teen parents at each of 
 
 
 
 the three BB study sites, focusing attention on social and physical spaces that influence their infant feeding behaviors by using a facilitator 
 
 guide that will be developed in conjunction with the steering committee. We will use rapid assessment analysis to engage a subcommittee of 
 
 steering committee members in the analysis and interpretation of the qualitative data. 
 
 
 
 
 
 Aim 1: To identify and describe the structural and social factors that influence breastfeeding among low-income young mothers in Alameda and 
 
 Contra Costa Counties.
 
 
 
 Aim 2: To design an intervention based on findings from Aim 1 that will be piloted in a subsequent study. 
 
 
 
 Aim 3: To strengthen and sustain an equitable, productive partnership between CAHC, BB, and the communities they represent.
 
 
 
 
 
 Innovative elements: This is the only study that we know of addressing increased breastfeeding as a protective factor against breast cancer 
 
 disparities, especially among adolescent mothers. This study will be the first that we are aware of to use community-based participatory research 
 
 (CBPR) to engage young mothers and their providers as co-researchers to investigate and then act to improve breastfeeding rates. Findings from 
 
 this study will contribute to increased knowledge of barriers to and facilitators of breastfeeding. 
 
 
 
 
 
 Community involvement: A Steering Committee (SC) comprised of representatives of BB, CAHC, local breast cancer advocates, lactation 
 
 consultants (see letters of support from committed members), and BB client population (adolescent mothers) will guide all aspects of the proposed 
 
 research. We expect to recruit at least three young mothers (one from each of our target areas) to join the SC as equal members. The role of the 
 
 SC is to review all proposed research activities throughout the phases of the study (see timeline in proposal), provide input into the design of 
 
 
 
 research tools and interpretation of results, to vet these tools and research findings with the groups they represent, and facilitate community 
 
 feedback. They will also advise on when and how to engage the various community partners. Another key function of the SC will be to identify and 
 
 help design a promising pilot intervention. 
 
 
 
 
 
 Future Plans: The proposed study will be the first step in our partnership’s long-term research agenda. This 18-month exploratory study 
 
 to discover barriers to and facilitators of breastfeeding, enabling identification of one (or more) factor that is impactful and amenable to 
 
 change, will prepare us to design, pilot and then evaluate an intervention. The next step will be a second 18-month project, in which we will 
 
 collaboratively develop and pilot the community-driven policy or programmatic intervention in our focus population. These two studies will 
 
 provide the foundation for a rigorous, three-year participatory intervention evaluation to measure its impact on breastfeeding initiation, 
 
 duration and exclusivity. We believe that this three-step endeavor will yield significant contributions to understanding how breastfeeding 
 
 
 
 behavior modification can enable breast cancer risk reduction in this vulnerable population.