LATCH: Lactation Advice Thru Texting Can Help

Study Overview
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Brief Summary
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The purpose of this study is to find out if a two-way texting platform to be used as an adjunct tool for breastfeeding peer counselors can improve breastfeeding behaviors among women enrolled in the WIC program in Connecticut. The hypothesis of the study is that providing additional information and support through text messaging starting in pregnancy and continuing after the birth of the child will increase exclusive breastfeeding rates during the first six months of life.

Official Title
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LATCH: Lactation Advice Thru Texting Can Help

Conditions
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Breastfeeding Support

Intervention / Treatment
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* Behavioral: LATCH Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pregnant women > 18 years Prenatal intention to breastfeed Prenatal enrollment < 28 weeks gestation Have an unlimited text message cell phone plan Knows how to send a text message 5th grade literacy level Exclusion Criteria: Lack of fluency in either English or Spanish Infant born premature (<37 weeks) > 3 days in NICU Any major maternal-newborn medical problem affecting breastfeeding Birth weight <5lbs

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: LATCH Intervention<br>Women enrolled in the WIC program and receiving breastfeeding peer counseling services will receive text messages to support them with their breastfeeding intentions. They will start receiving automated text messages starting in pregnancy and continuing throughout the first 6 months after giving birth. Messaging during pregnancy will emphasize what to expect in the hospital, the onset of lactation, skin-to-skin contact with baby, early and often breastfeeding in post-partum period, milk transfer (suck & swallow), positioning (with links), common breastfeeding problems and how to seek help. Throughout the study, participants will be able to respond to automated text messages with specific questions that will be received and answered by their WIC program peer counselors. Texting will also have prompts to respond occasionally (at minimum once every two weeks) to ensure that phone is still in service and that the participant in the intervention arm are receiving intervention. | Behavioral: LATCH Intervention<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Exclusive Breastfeeding Rate |  | 2 weeks after birth | 
| Change in Exclusive Breastfeeding Rate |  | 3 months after birth | 
| Change in Exclusive Breastfeeding Rate |  | 6 months after birth | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Chance in the Percent of WIC Participants Reached by Breastfeedng Counselor |  | 48 hours after giving birth | 
| Change in Number of Contact Between WIC Participants and Breastfeeding Peer Counselors |  | 2 weeks after birth | 
| Change in Number of Contact Between WIC Participants and Breastfeeding Peer Counselors |  | 3 months after birth | 
| Change in Number of Contact Between WIC Participants and Breastfeeding Peer Counselors |  | 6 months after birth | 
| Change in breastfeeding self-efficacy | Self-efficacy refers to an individuals' confidence in their capability to initiate, maintain, and (if stopped) re-start breastfeeding. It will be measured with the scale proposed by Schwarzer. Self-efficacy scale includes 5 questions, each with 4 response options ranging from very false to very true. Average score will be generated by summing responses to questions 1 through 5 and dividing by the total number of questions. Average scores will range from 1 to 4. The higher the score the better the level of self-efficacy. Reference: Schwarzer R. Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology: An International Review. 2008 2008;57(1):1-29. | 2 weeks after birth | 
| Change in breastfeeding self-efficacy |  | 3 months after birth | 
| Change in breastfeeding self-efficacy |  | 6 months after birth | 
| Change in breastfeeding action planning | Action planning refers to the when, where, and how of the behavior or the sequence of events making up breastfeeding behaviors. It will be measured with the scale proposed by Schwarzer. Action planning scale includes 7 questions, each with 4 response options ranging from very false to very true. An average score will be generated by summing responses to questions 1 through 7 and dividing by the total number of questions. Average scores will range from 1 to 4. The higher the score the better the level of action planning. Reference: Schwarzer R. Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology: An International Review. 2008 2008;57(1):1-29. | 2 weeks | 
| Change in breastfeeding action planning |  | 3 months | 
| Change in breastfeeding action planning |  | 6 months | 
| Change in breastfeeding coping planning | Coping planning refers to the identification of potential barriers to engaging in and maintaining breastfeeding behavior and the extent to which an individual has developed strategies to cope with those barriers. It will be measured with the scale proposed by Schwarzer. Coping planning scale includes 6 questions, each with 4 response options ranging from very false to very true. An average score will be generated by summing responses to questions 1 through 6 and dividing by the total number of questions. Average scores will range from 1 to 4. The higher the score the better the level of coping planning. Reference: Schwarzer R. Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology: An International Review. 2008 2008;57(1):1-29. | 2 weeks | 
| Change in breastfeeding coping planning |  | 3 months | 
| Change in breastfeeding coping planning |  | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Breastfeeding, Breastfeeding peer counseling, Exclusive breastfeeding, Formula supplementation, Mobile health, WIC program