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Despite the persistence of breastfeeding racial and ethnic disparities in the United States, little is known about Black fathers' perceptions of breastfeeding and breastfeeding support services (e.g., maternity hospital-based care and lactation management care). This qualitative, community-based participatory research study reports Black fathers' perceptions of barriers and facilitators to breastfeeding, including the provision of breastfeeding support services in Connecticut. A focus group guide was co-developed with community partners and adapted from the Barrier Analysis Tool to identify breastfeeding facilitators, barriers, and service improvement areas. Four focus groups were conducted with 30 Black fathers who were Connecticut residents with a child under 3 years old. Qualitative data were analyzed using rapid template analysis involving deductive and inductive coding. We identified factors influencing breastfeeding and fathers' ability to support breastfeeding across all levels of the Socio-Ecological Model. Facilitators included high paternal breastfeeding knowledge, paternal breastfeeding involvement, parents' shared decision-making, extensive maternity hospital discharge support, ongoing breastfeeding support into the postnatal period, availability of community breastfeeding resources, and designated spaces for public breastfeeding. Barriers included low paternal breastfeeding knowledge, familial discouragement, insufficient prenatal breastfeeding education, exclusion of the father from breastfeeding support services, and stigma against breastfeeding in public. Understanding breastfeeding perceptions among members of a mother's support network, including their partners, is key for developing effective person- and family-centered breastfeeding education and counseling services that are well coordinated from the prenatal to postnatal periods with strong direct engagement from fathers.
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Background. Food insecurity, affecting approximately 10% of the U.S. population, with up to 40% or higher in some communities, is associated with higher rates of chronic conditions and inversely associated with diet quality. Nutrition interventions implemented at food pantries are an effective strategy to increase healthy food choices and improve health outcomes for people experiencing food and nutrition insecurity. Supporting Wellness at Pantries (SWAP), a stoplight nutrition ranking system, can facilitate healthy food procurement and distribution at pantries. Purpose. Guided by the RE-AIM Framework, this study assesses the implementation and outcomes of SWAP as nutritional guidance and institutional policy intervention, to increase procurement and distribution of healthy foods in pantries. Method. Mixed-methods evaluation included observations, process forms, and in-depth interviews. Food inventory assessments were conducted at baseline and 2-year follow-up. Results. Two large pantries in New Haven, Connecticut, collectively reaching more than 12,200 individuals yearly, implemented SWAP in 2019. Implementation was consistent prepandemic at both pantries. Due to COVID-mandated distribution changes, pantries adapted SWAP implementation during the pandemic while still maintaining the ?spirit of SWAP.? One pantry increased the percentage of Green foods offered. Challenges to healthy food distribution are considered. Discussion. This study has implications for policy, systems, and environmental changes. It shows the potential for SWAP adoption at pantries, which can serve as a guide for continued healthy food procurement and advocacy. Maintaining the ?spirit of SWAP? shows promising results for food pantries looking to implement nutrition interventions when standard practice may not be possible.
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- Journal Article (2)