Examination of the Association Between Social Determinants of Health, Environmental Factors, and Infant Feeding Practices Courtney N Slater

Format:

Book

Thesis/Dissertation

Author/Creator:

Slater, Courtney N., author.

Contributor:

University of Pennsylvania. Nursing., degree granting institution.

Language:

English

Subjects (All):

0569.

0573.

0769.

Local Subjects:

0569.

0573.

0769.

Physical Description:

1 electronic resource (205 pages)

Contained In:

Dissertations Abstracts International 87-07B

Place of Publication:

Ann Arbor : ProQuest Dissertations and Theses, 2025

Language Note:

English

Summary:

Statement of the Problem: Access to breastfeeding support and care varies significantly across different U.S. population groups, particularly by race and socioeconomic status. This dissertation investigated environmental influences on breastfeeding through two lenses: the examination of social determinants of health (SDOH) and the physical and social environments, on infant feeding practices and breastfeeding supports. Methods: In this multi-methods, three-paper dissertation, a scoping review, secondary data analysis, and a qualitative study were conducted. In the scoping review, a comprehensive search of three databases was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review guidelines. Frequency counts were tabulated for each type of breastfeeding support and for each facilitating element or individual in the physical and social environments. The secondary data analysis used multiple logistic regression and causal mediation analyses. Modified grounded theory guided the analysis of the qualitative study. Results: Breastfeeding support was the most frequently reported type of support in the extracted data of the scoping review. Additionally, work/school and healthcare were the categories with the highest frequency counts of facilitating elements or individuals. Findings from the secondary data analysis showed multiple adverse SDOH were associated with increased odds of stopping breastfeeding at both four and six months of age among Black or African American women. This analysis also demonstrated that this relationship was partially mediated by the introduction of solid foods at four months of age. Results from the qualitative study revealed that some adverse SDOH among Black or African American participants, such as low-income status, provided eligibility and thereby access to crucial breastfeeding supports. While other adverse SDOH, such as poor breastfeeding support in the workplace, were barriers to breastfeeding for most participants. Conclusions: Overall, this dissertation study demonstrated that environmental factors, such as the physical and social environments or SDOH, influence breastfeeding outcomes and experiences. These results provide a crucial foundation for informing policy changes and clinical interventions aimed at enhancing access to breastfeeding support among U.S. women

Notes:

Advisors: Kral, Tanja V. E. Committee members: Brooks-Carthon, J. Margo; Spatz, Diane L.; Zemel, Babette

Source: Dissertations Abstracts International, Volume: 87-07, Section: B.

Ph.D. University of Pennsylvania 2025

Vendor supplied data

Local Notes:

School code: 0175

ISBN:

9798276001876

Access Restriction:

Restricted for use by site license