The First Food Friendly Community Initiative (3FCI) explores the role of “place” in breastfeeding duration and success by implementing community-generated interventions to thereby improve infant and maternal health outcomes in vulnerable communities. Breast milk is the optimal first food and is one of life’s earliest preventative health measures with unparalleled immunological benefits to infants and proven health benefits to mothers. Increasing breastfeeding rates in communities of color has a powerful potential to shift the life-long health trajectory from as early as infancy and to reduce health disparities among infants and mothers.
3FCI utilizes a high-impact research model that combines a proprietary community assessment tool, with community-partnered curriculum development and job skills training to reduce local social stressors and ultimately to create more breastfeeding supportive communities. The primary objective of the project, currently being piloted in targeted communities in Detroit and Philadelphia, is to create a nationally replicable model of community accreditation for breastfeeding supportive communities, that moves from “checklist” to community-sourced solutions. The innovative accreditation process is based on a four-step community engagement strategy that includes community-led information gathering followed by educating and empowering residents to execute the needed interventions in their own community by means of a paid work experience.
3FCI also uniquely recognizes that infant and maternal health and family economic security are inextricably linked. A mother’s decision to breastfeed and ability to successfully breastfeed for any meaningful duration is greatly influenced by her financial security and her hierarchy of needs. In addition, job insecurity and low wages are a chronic social stressor that contribute to poor maternal and child health outcomes, particularly among low-income families, and are often reported as a key barrier to breastfeeding specifically, and to improved community health, writ large. As such, a key component of 3FCI process is developing the model for a community-driven curriculum and a job skills/work training component that provides demand-driven job skills training along with a paid internship conducting community health related activities that increase social support and shift cultural norms for breastfeeding at the local level. At the same time, program participants, with a priority given to pre- and postnatal mothers and fathers, are given an opportunity to receive job skills that improve their income generating ability.
Step 1: What can we learn about this community? This pilot views the community as a source of rich knowledge and insights that simply need to be effectively leveraged to activate a community’s innate ability to save itself. Community Assessment: Recruit, train and engage community residents to conduct an environmental scan using a propriety surveying tool and provides a unique understanding of local cultural norms, key decision making influences and the specific community “touch points” that may be unsupportive to breastfeeding. A data scientist will be engaged to develop an algorithm that translates survey results into easy-to-understand community data that is reported back to the community via a local gathering.
Step 2: How do we “re-educate” the community? The pilot views the community as a critical peer in the breastfeeding ecosystem. Just as there are renewed efforts to educate physicians, other health professionals and mothers, the community itself must be re-educated on the critical importance of breastfeeding and the role of infant health in community resiliency and success. To achieve this goal, a curriculum is currently under development that uses a framework that is inclusive of dialogical and experiential learning techniques. The 3FCI community curriculum, is locally adaptable, and provides program participants with the knowledge and tools to promote infant and maternal health in their communities and provides the personal assessments and self-awareness needed for ongoing job success. The model leverages individual experiences and connections to the community into personal and community level action plans.
Step 3: Recruit and train community residents to execute community organizing and community health activities in their neighborhood via a paid work experience. Interns will attend the 2-3day community curriculum training and then begin a 4-6 week part-time, paid internship as “Community Change Agents” to execute the necessary interventions in the community, focusing on important community touch points, such as faith-based organizations, businesses, local restaurants, laundromats, fitness centers, shopping malls, public parks and public transportation authorities, to ensure breastfeeding is supported wherever mothers eat, live, play or worship. While providing education, motivation, tools and practical strategies to these community “touch points”, participants also receive additional job skills training and certifications via a local workforce development partner organization.
Step 4: Reward community with accreditation: After activities are completed and sustained, the community becomes eligible to become accredited as a First Food Friendly Community. This reward system gives communities typically operating under negative perceptions and low achievement, an opportunity to develop a new sense of pride in their community and to be recognized for their strengths instead of being identified by any weaknesses.