Loving Support Makes Breastfeeding Work

1
Loving Support Makes Breastfeeding Work

• A Resource Guide for the East Tennessee
  Breastfeeding Coalition

2
Loving Support Makes Breastfeeding Work

• What is the Loving Support campaign?
• A social marketing campaign developed in 1997 by
  Best Start, Inc., for USDA/FCS as part of the WIC
  National Breastfeeding Promotion Project
• What is the goal of the campaign?
• To increase breastfeeding initiation and duration
  rates
• To improve public support for breastfeeding
  through the implementation of a comprehensive
  social marketing program

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Loving Support Makes Breastfeeding Work

• How does Loving Support work?
• Mass media (TV and radio public service
  announcements billboard advertisements posters,
  etc.), client education materials, staff
  training, community outreach
• Campaign materials emphasize benefits of
  breastfeeding Bonding, enjoyment, and health
• Addresses the perceived barriers to breastfeeding
  that women face support, time demands, and
  embarrassment

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Loving Support Makes Breastfeeding Work

• Who uses the Loving Support Campaign?
• Ten Pilot Communities
• Arkansas, California, Iowa, Mississippi, Nevada,
  New Jersey, New York, Ohio, West Virginia, and
  the Chicksaw Indian Tribal Organization
• Media Phase officially began during World
  Breastfeeding Week, August 1 - 7, 1997
• Community Profiles
• Mississippi State WIC Services
• Iowa State WIC Program

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Community Profile Mississippi State Department
of Health

• Cathy Carothers, IBCLC, State WIC Breastfeeding
  Coordinator
• 601-987-6735
• Funding Sources
• State WIC Budget (USDA/FCS)
• Breastfeeding Friendly Community Grant from the
  March of Dimes
• 400, 000.00 Grant from USDA for Evaluation
  Component

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Community Profile Mississippi State Department
of Health

• Stages of Implementation
• Phase 1 Preparing for the campaign (June - July)
• State, district, and county level communication
  of the project
• Orientation for clinic staff and health care
  providers
• Training for nurses and nutritionists in local
  health departments, independent clinics, and
  hospitals
• Developing a Breastfeeding Resource Directory

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Community Profile Mississippi State Department
of Health

• Stages of Implementation, continued...
• Phase 2 The Media Campaign
• Local TV and radio spots
• Billboards in Key Mississippi Communities
• Advertising in weekly community papers
• Client education materials
• Clinic promotional materials

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Community Profile Mississippi State Department
of Health

• Stages of Implementation, continued...
• Phase 3 Ongoing Promotional Activities
• Initiation of community breastfeeding coalitions
  to explore ways to create a supportive
  environment for breastfeeding
• Form intra-agency breastfeeding task force
• Development of educational materials for health
  care professionals and day care centers
• Clinic environment assessment

9
Community Profile Mississippi State Department
of Health

• Campaign Components A Comprehensive effort
• Orientation and education for clinic staff
  reinforcement for campaign banner with logo in
  every health department in state
• Training for hospital and health department
  staff how to support a breastfeeding mother
  Breastfeeding rooms in clinics
• Patient, family, and community education
  pamphlets, posters, Purely Yours pump program,
  Wal-Mart, churches Where the moms are...

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Community Profile Mississippi State Department
of Health

• Used every component of the campaign, from TV and
  radio to posters and brochures
• Stressed personal contact with media
• Hand delivered a media packet to every news
  station in the state
• Contract with MAB receive 7 in air time for
  every 1 invested (5,000.00 -----gt 35,000.00)
• 200, 000.00 worth of air time in the first month
  alone!
• PSA aired at night and Sunday mornings and
  afternoons
• All ads tagged with State WIC toll-free number

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Community Profile Mississippi State Department
of Health

• Outcome Evaluation
• Evaluation currently underway through Southern
  Mississippi State University
• 400,000.00 grant from USDA pays for evaluation
• Number breastfeeding has increased from 1700
  women at the beginning of the campaign to 2733
  women in December of 1999

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Community Profile Mississippi State Department
of Health

• Outcome Evaluation, continued...
• Larger increase than any other state
• Results of Ross Products Mothers Survey Results

13
Community Profile Mississippi State Department
of Health

• Personal Recommendations
• Stressed Personal Contact
• Cannot increase the rate of breastfeeding with TV
  and radio ads alone
• Change requires a comprehensive effort

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Community Profile Iowa Department of Public
Health

• Holly Szcodronski, Iowa State WIC Breastfeeding
  Coordinator
• 515-281-5024
• Funding Sources
• State WIC Budget Breastfeeding (USDA/FCS)
• Budget used for Mass Media advertising
• 85,000 in 1997
• 90,000 in 1998

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Community Profile Iowa Department of Public
Health

• Use of funds
• WIC for breastfeeding educational materials
  went towards purchase of campaign brochures,
  posters
• Conducted training for all WIC staff using
  campaign materials and staff training kits
• Saved by conducting training through ICN (Iowa
  Communication Networkfiber optics) too costly
  to bring everyone to Des Moines

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Community Profile Iowa Department of Public
Health

• Stages of Implementation
• 1997
• Brochures and posters for all WIC agencies
• TV and billboards in 3 media markets (including
  Des Moines)
• 1998
• 3 Media Markets-- TV, billboards, and added radio
• Some free billboards because of amount purchased
• Great TV and radio air time because purchased
  prime-time advertising

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Community Profile Iowa Department of Public
Health

• Stages of Implementation, continued...
• 1998
• 64 billboards in 1997
• 38 billboards in 1998
• Also used community newspapers only 10 out of
  over 300 newspapers published ads
• Used more expensive media markets in 1998 to
  reach east and west borders of state
• Included Des Moines each time covered entire
  state

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Community Profile Iowa Department of Public
Health

• Stages of Implementation, continued...
• 1999, 2000
• Brochures and posters still in use
• Summer 2000
• Final phase will be launched during world
  Breastfeeding Week (August 1 - 7, 2000)
• Newspaper ads
• All ads tagged with State WIC toll-free phone
• Paid advertisements in both daily and weekly
  newspapers through 75,000 grant

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Community Profile Iowa Department of Public
Health

• Outcome Evaluation
• Conducting evaluation internally in stages
• Evaluation will be completed after the final
  launch this summer
• Carol Bryant, University of South Florida, Dept.
  of Community and Family Health is helping with
  evaluation (involved with Best Start)

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Community Profile Iowa Department of Public
Health

• Outcome Evaluation, continued...
• Baseline rate based on
• hospital discharge data (Iowa Newborn Metabolic
  Screening Profile)
• WIC data
• Mailing Survey to assess attitudes and practices
• Survey mailed before launch of campaign to WIC
  clients
• Follow-up survey after launch of second phase of
  campaign

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Community Profile Iowa Department of Public
Health

• Outcome Evaluation, continued...
• Random Sampling Mailing Survey attitudes and
  practices
• Post campaign survey directed at women who had
  given birth after campaign was initiated
• Looked at counties that had the campaign to
  relate it to the campaign
• Response rate 50
• Great feedback from both breastfeeding and
  non-breastfeeding women

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Community Profile Iowa Department of Public
Health

• Outcome Evaluation, continued...
• Establishment of relationship between attitudes
  and practices to the campaign
• Specific questions about awareness, attitude,
  behavior
• Limited to WIC participants
• Specific questions related to campaign materials,
  such as Did you see television ads, see
  billboards, or hear radio ads promoting
  breastfeeding?
• Questions about use of formula and when formula
  was introduced

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Community Profile Iowa Department of Public
Health

• Outcome Evaluation, continued...
• Mailing Survey the results so far
• Based on the numbers for 6-months duration,
  surprised to see the number of women who
  maintained breastfeeding
• Surprised by the number of women breastfeeding
  long term and past one year of age
• Women share things in the survey that they may
  not share often with others
• Also wanted to target support systems and
  evaluate presence or absence of support

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Community Profile Iowa Department of Public
Health

• Outcome Evaluation, continued...
• Ross Products Mothers Survey Results

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Community Profile Iowa Department of Public
Health

• Outcome Evaluation, continued...
• Iowa Newborn Metabolic Screening Profile

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Community Profile Iowa Department of Public
Health

• Holly Szcodronski Personal Feelings and
  Recommendations
• Campaign is definitely worth it! The campaign
  reaches much more than pregnant women women who
  will someday become pregnant society as a whole
  support systems attitudes and beliefs public
  awareness
• Hard to measure outcome because campaign message
  extends far into the future effects are far
  reaching
• TV and billboards very effective because of
  visual reinforcement recommends TV and
  billboards before radio

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Community Profile Iowa Department of Public
Health

• Holly Szcodronski Personal Feelings and
  Recommendations
• Be aware of the VOLUME of phone calls for
  several months, afternoons were dedicated to
  answering calls!
• Of all incoming calls, only 25 were pregnant
  women and only 1/4 were on WIC or had family
  member on WIC
• 3/4 of callers saw TV ad and were able to write
  down the phone number
• Direct phone to WICalways person to answer
  phone and transfer call to nutrition consultant

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Community Profile Iowa Department of Public
Health

• Holly Szcodronski Personal Feelings and
  Recommendations
• Newspaper ads with toll-free phone number
• Phone calls equal between the sexes
• Not all of the phone calls were pleasantsome
  people offended by TV and billboard ads
• Response to calls
• Sent materials or provided referral to lactation
  consultant

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Community Profile Iowa Department of Public
Health

• Holly Szcodronski Personal Feelings and
  Recommendations
• Look for grants and get the program going! It is
  definitely worth it.
• Deb Montgomery, Colorado Department of Health
• Phone [phone]
• Never spoke to her Cathy Caruthers thinks
  Colorado may have raised funds for program

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Loving Support Materials

• Television ads
• Radio advertisements
• Billboards
• Pamphlets
• Posters
• Videos
• Physicians Breastfeeding Support Kit
• ...And More!

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Loving Support Cost of Materials

• Television advertisements
• Four 30-second television ads each video
  contains four spots
• 72.00 Beta SP (1 or 3/4), which is the form
  required by most stations
• 350.00 Optional TV tag with customized
  message, agencys name and phone number

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Loving Support Cost of Materials

• Radio advertisements
• Three 60-second radio spots
• 62.00
• 750.00 Optional radio tag with customized
  voice-over announcement of agencys name and
  phone number

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Loving Support Cost of Materials

• Outdoor Advertisements
• Billboards not currently available will be
  available for purchase again soon in CD
  formhopefully by mid-April 2000
• No estimate available yet
• Price does not include media placement

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Loving Support in East Tennessee Media
Information

• Television Public Service Announcements
• WATE TV 6 (Cable channel 13)
• Contact Person Bill Evans
• Phone [phone]
• E-mail bevans_at_wate.com
• WVLT TV 8 (Cable channel 5)
• Contact Person Dino Cartwright
• Phone [phone]
• WBIR TV 10 (Cable channel 9)
• Contact Person Ruth Edwards
• Phone [phone]
• Newspaper

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Loving Support in East Tennessee Media
Information

• Television Paid Advertising
• WATE TV 6 (Cable channel 13)
• Contact Person Ronda Landsman
• Phone [phone]
• Quarterly rate varies with season, demand, and
  program schedule
• 2nd and 4th Quarters are most expensive
• 1si Quarter Jan - Mar
• 2nd Quarter Apr - Jun
• 3rd Quarter Jul - Sept
• 4th Quarter Oct - Dec
• See rate card look at female viewers per program

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Loving Support in East Tennessee Media
Information

• Television Paid Advertising
• WVLT TV 8 (Cable channel 5)
• Contact Person Phil Jarnagin
• Phone [phone]
• See rate card samples per 2nd Q vary by program
• WBIR TV 10 (Cable channel 9)
• Contact Person Stacey Whitt
• Phone [phone]
• E-mailswhitt_at_wbir.gannett.com
• Rates fluctuate custom proposal990/wk
• See rate information customize to times of day
  when women are viewing comparison to other
  networks!

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Loving Support in East Tennessee Media
Information

• Radio Public Service Announcements
• B 97.5
• (MIX 95.7, WIMZ 103.5 AM 1240)
• Contact Person Karen Taylor
• Phone [phone] (main number)
• PSAs are live reads (source Rhonda Kenner)
• The X 98.7
• (WIVK 107.7, WNOX FM 99.1, AM 990, WOKI-FM 100.3)
• Contact Person Channing Smith
• Phone 588 - 6511

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Loving Support in East Tennessee Media
Information

• Radio Paid Advertising
• B 97.5
• (MIX 95.7, WIMZ 103.5 AM 1240)
• Contact Person Rhonda Kenner
• Phone [phone]
• Will give lowest rate possible
• 6a - 7p 150.00 per spot (30-60 sec.)
• Rates fluctuate based on demand and vary with
  station used (recommends 97.5 and 95.7 for women)
• Christmas 200 - 250.00 (retail season)
• Would do the creative for free

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Loving Support in East Tennessee Media
Information

• Radio Paid Advertising, continued...
• The X 98.7
• (WIVK 107.7, WNOX FM 99.1, AM 990, WOKI-FM 100.3)
• See rate sheet

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Loving Support in East Tennessee Media
Information

• LAMARNot-for Profit Rate
• Contact Beverly Deleese, Director of Public
  Service
• 546-5011 (main number)
• 293-0160 (direct line)
• Flat rate 150 per board
• LAMAR donates the space
• Can purchase minimum 1, maximum 5 per month in
  Knoxville less availability in Oak Ridge and
  Anderson County (max3 boards/month)
• Guaranteed about 3 weeks of advertising
• Try to book with 30 day notice
• Place boards several x/mo in Knoxville once/mo
  in smaller comm.

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Loving Support in East Tennessee Options in
Television

• TV ad, without tag
• 72.00
• Run as a Public Service Announcement
• TV ad, without tag
• 72.00
• Run as paid advertising (See rate cards)

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Loving Support in East Tennessee Options in
Television

• TV ad, with tag
• 72.00 350.00 422.00
• Run as a Public Service Announcement
• TV ad, with tag
• 72.00 350.00 422.00
• Run as paid advertising
• Resources needed for ad with tag
• Phone line, voice-mail, office space. personnel
• Support materials to mail as needed
• Lactation consultants for referrals

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Loving Support in East Tennessee Options in
Radio

• Radio ad, without tag
• 62.00
• Run as a Public Service Announcement no cost for
  air time
• Radio ad, without tag
• 62.00
• Run as paid advertisingSee rate card

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Loving Support in East Tennessee Options in
Radio

• Radio ad, with tag
• 62.00 750.00 812.00
• Run as a PSA No cost for air time
• Radio ad, with tag 62.00 750.00 812.00
• Run as paid advertising See rate card
• Radio ad, produced by station Free
• Pay for advertising cost See rate card
• Resources needed for ad with tag
• Phone line, voice-mail, office space. personnel
• Support materials to mail as needed
• Lactation consultants for referrals

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Loving Support in East Tennessee Other Options

• Newspaper Advertisements?
• Very expensive
• Rate per column inch newspaper 6 columns
• rate varies daily lt Fri./Sat. lt Sunday ()
• Daily 38.41 per column inch
• Example Knoxville News-Sentinel
• 2 columns X 5 10 column inch-ad
• Daily 384.10
• Friday/Saturday 407.80
• Sunday 587.60
• Contact Gay King 342-6490

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Loving Support in East Tennessee Other Options

• Newspaper Advertisements, Continued...
• Metro Pulse Rate Card
• Look for free advertising in community papers
• Resources needed if ad is tagged
• Phone line, voice-mail, office space. personnel
• Support materials to mail as needed
• Lactation consultants for referrals
• Billboards
• Purchase one CD from Best Start (Cost TBA)
• 150 per board from LAMAR

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Loving Support in East Tennessee More Options

• Training Materials
• Best Starts 3-Step Counseling Strategy Training
  Module 72.00
• Assists staff in promoting breastfeeding
• Includes Instructors Guide, lesson plans, role
  plays, transparencies, participant handouts and a
  video
• Resources Needed
• Staff and office space to conduct training

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Loving Support in East Tennessee More Options

• Training Materials
• Best Start Training Sessions
• On-site staff training provided by Best Start
  Staff
• Contact Best Start Breastfeeding Coordinator for
  prices
• Linda Inglis linglis_at_beststartinc.org
• 1-800-277-4975
• Train the trainer (3-3.5 hrs. of training)
• Resources Needed
• Office space in which to conduct training

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Loving Support in East Tennessee More Options

• Loving Support Logo Disc
• PC and Macintosh platforms available 100.00
• Videotapes
• For All the Right Reasons
• 22 minute tape-25.00 110-minute tape-30.00
• Nobody Loves Them Like You
• Targets teens
• 25.00
• What Difference Does it Make and Loving Our
  Children, Loving Ourselves
• 25.00

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Loving Support in East Tennessee More Options

• Physicians Breastfeeding Support Kit 15.00
• Developed by Best Start and MCHB to assist
  physicians in answering questions about
  breastfeeding
• Includes
• pocket guide with information on
• Diet and nutrition during pregnancy
• Positioning while nursing
• Solving nursing related problems like engorgement
• Breastfeeding resource guide
• Patient letter
• Patient education booklet
• Companion Kit The Healthcare Providers
  Breastfeeding Support Kit

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Loving Support in East Tennessee Additional
Information

• Joe Hecker, Business Manager, Best Start
• Q Does Best Start have any information on
  evaluation and cost-effectiveness?
• A The program is still very new in most states,
  so outcome evaluation and statistics are largely
  unavailable --gt Mississippi should have most
  complete data
• Q Who are the smaller groups who have used the
  campaign and how did they raise ?
• A Contact Linda Inglis for possible information
  on smaller organizations that may have raised
  (currently away on training)

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Loving Support in East Tennessee Additional
Information

• Joe Hecker, continued...
• Q Does Best Start have people who could help
  conduct the evaluation? (Iowa, for instance,
  receives assisstance from Carol Bryant, Ph.D.)
• A Probably not within Best Start themselves but
  they have links to University of South Florida.
  Dr. Bryant has done many (types) of evaluations
  and has many contacts.
• (History on Carol Bryant and JimLindenberger)
• Q Does Best Start have information on
  cost-effectiveness of the different types of
  media used?
• AThe effect of the media depends on the region.

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Loving Support in East Tennessee Additional
Information

• Joe Hecker, continued...
• Q Does Best Start have information on
  cost-effectiveness of the different types of
  media used?
• A Large amount of breastfeeding education
  (awareness/acceptance) still needed
• Cathy Carothers in Mississippi
• California experiences
• Pamphlets support, embarrassment
• Jim Lindenberger believes TV and radio ads are
  equally effective in many states depends on the
  region
• In Southeast, educational component is very
  important

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Loving Support in East Tennessee Additional
Information

• Joe Hecker, continued...
• Q Advice on funding sources?
• A Look for government funding--USDA look at
  regional resources
• Foundations, United Way are often best sources
• Questions for Best Start Social Marketing?
• Contact Joe Hecker, Business Manager
• 1-800-277-4975
• [phone]
• beststart_at_mindspring.com
• Jhecker_at_beststartinc.org

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Loving Support in East Tennessee Funding?

• The Cracker Barrel Old Country Store Foundation
• Awards Grants Only in Tennessee
• Operating grants were awarded to the following
  sampling Women in Community Service The Center
  for Women and Families Youth Ranch Senior
  Citizens, Inc.
• Address 305 Hartmann Drive,Lebanon, TN 37087
• The Thompson Charitable Foundation
• Award grants for Education Youth Women Health
  Organizations and Social Service Organizations
• Typical grant range 25,000 - 75,000
• Address P.O. Box 10516,Knoxville, TN 37939,
  [phone]

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Loving Support in East Tennessee Funding?

• Lucille S. Thompson Family Foundation
• Awards Grants in Knoxville for Disabled Youth
  Health Organizations and Social Service
  Organizations
• Typical grant range is 2,000 to 50,000
• Address 4823 Old Kingston Pike, Suite 140,
  Knoxville, TN 37919 [phone]
• Robert Lee Weiss Foundation
• Award grants in Knoxville only. Grants for
  operating funds include Habitat for Humanity
  Knoxville Womens Center and Second Harvest Food
  Bank
• Addressc/o First Tennessee Bank, N.A, Trust
  Division, 800 South Gay Street, Knoxville, TN
  37929 [phone]

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Loving Support in East Tennessee Many Questions!

• Where do we go from here?
• Which components are of highest priority?
• What are the most feasible steps to take now?
• What additional information do we need?

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Loving Support in East Tennessee A Plan?

• Discussion
• Decisions...
• A Vote!
• Which two components are of highest priority?
• What are the most feasible options?
• What do we do now and who will be responsible?

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Presentation prepared by Anne-Marie
Nocton Graduate Student University of Tennessee,
Knoxville E-mail amn_at_utkux.utcc.utk.edu Phone
865-523-9533