Beyond community assessment into the real world of learning aggregate practice.

One certainty for nursing, and therefore for nursing education, is that nurses of the 21st century will be called upon to deliver aggregate-based care. Faculty, seeking ways to prepare students for this challenge, often use community assessment as a strategy to help develop skills required to implement care at the aggregate level. In this unique program, community projects completed during an undergraduate community and family health nursing course are expanded in scope to include community diagnosis, planning, intervention, and outcome evaluation. Projects offer immediate benefit to the agency and may continue for several semesters, involving students in various phases of the nursing process.

Comparison of breastfeeding attitudes and practices: low-income adolescents and adult women.

Breastfeeding attitudes and practices of two independent samples of low-income adolescents were compared to a third sample of low-income, adult women. Low-income status was based on subject eligibility for the Special Supplemental Food Program for Women, Infants, and Children (WIC). Breastfeeding attitudes were significantly related to setting, race, and age. Other factors, such as previous exposure to breastfeeding, also influenced breastfeeding attitudes. Breastfeeding rates were 16.7% and 32.4% for the two teen samples, and 35.4% for the sample of adult women. Choice of infant feeding method post delivery was significantly related to intention regarding feeding method during pregnancy. Implications of these findings for health care professionals are discussed.

Breast-feeding attitudes and practices among adolescents.

Breast-feeding attitudes of 128 low-income, pregnant adolescents were assessed using a questionnaire developed for this population. Teens who had been breast-fed as infants had more positive attitudes than bottle-fed teens (p less than 0.002); no differences in attitudes were found by race or age. Pregnant teens who planned to breast-feed their infants had higher attitude scores than those who planned to bottle feed or who were uncertain (p less than 0.001). Of the sample, 32.4% subsequently breast-fed their baby; these teen mothers had more positive attitude scores than the teen mothers who bottle fed (p less than 0.001). The prenatal infant feeding plans of these pregnant teens were significantly related to their postnatal feeding practices (p less than 0.001). Selected implications of these data for health care professionals are discussed.

PIP: Breastfeeding attitudes of 128 low-income, pregnant adolescents were assessed using a questionnaire developed for the urban population attending the Teen Pregnancy Service of Milwaukee, Wisconsin. The sample was between 13 and 20 years of age (mean age = 17.7 years). There were 14 adolescents 15 years of age or less, 81 teens 16-18 years, and 31 19-20 years. 68% were black, 6% hispanic, 24% white and 2% other. 100% were enrolled in the Special Supplemental Food Program for Women, Infants, and Children (WIC) 84% were receiving Title 19 benefits. Most were having their 1st child (72%); 21 had 1 other child; 6 had 2, and 2 mothers had 4. Teens who had been breastfed as infants had more positive attitudes than bottle-fed teens (p0.002); no differences in attitudes were found by race or age. Pregnant teens who planned to breastfeed their infants had higher attitude scores than those who planned to bottle feed or who were uncertain (p0.001). Of the sample, 32.4% subsequently breastfed their baby; these teen mothers had more positive attitude scores than the teen mothers who bottle fed (p0.001). The prenatal infant feeding plans of these pregnant teens were significantly related to their postnatal feeding practices (p0.001). Health care professionals could use the breastfeeding questionnaire, combined with information about a pregnant teen's plans for infant feeding, to provide baseline data regarding a pregnant adolescent's breastfeeding attitudes. Such information can be efficiently obtained during an early prenatal visit. Subsequent prenatal visits could correct teen misconceptions about breastfeeding (e.g. results in obesity) and emphasize the positive benefits to the infant and mother. It may be useful to invite the teen's boyfriend and mother, given the impact of these individuals on the teen's breastfeeding attitudes. Once a teen decides to breastfeed, significant support is required following delivery to ensure a positive experience. Studies show a "lactation support team" may make significant changes in increasing the use of breastfeeding.

Prenatal education for pregnant adolescents.

Providing services to pregnant adolescents poses a unique challenge for health professionals. Several programs have emerged tailored specifically to this special population. Prenatal education is an integral component of these programs. This paper describes prenatal education classes offered at Teen Pregnancy Service, including special modifications required to meet the learning needs of participants. Outcome data provided for 66 pregnant teens show significant changes in prenatal knowledge following the class series. Information is included about the teens' backgrounds, their perceptions regarding potential problems infants may experience, and how they remembered being reared by their parents.