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Principal Investigator: Courtney N. Slater
Organization: UNIVERSITY OF PENNSYLVANIA
Fiscal Year: 2024
Award: $48,974
Funding agency: National Institute of Nursing Research
Project Summary/Abstract:
The purpose of this individual National Research Service Award (NRSA) application is to provide the
applicant with rigorous research training to develop into an independent investigator focusing on barriers and
facilitators to healthy infant feeding practices. This award will ensure the applicant achieves competence in
establishing a conceptual understanding of the impact of social determinants of health (SDOH) on infant
feeding practices, develops foundational skills needed to launch an independent program of rigorous and
ethical research with groups that have been marginalized, and gains professional development skills needed to
advance in a research-focused academic setting. This training will occur in a resource-rich academic
environment with support from a world-renowned advising team ideally suited to the applicant’s topic and
training plan. This intensive research training will extend the applicant’s clinical expertise and facilitate rapid
translation of evidence into clinical practice.
There exists a racial disparity in breastfeeding rates between U.S. Black and White mother-infant dyads, with
Black dyads exhibiting significantly lower rates of exclusive breastfeeding at both three and six months of age.
Several factors have been associated with the racial disparity in breastfeeding rates. SDOH, including low
socioeconomic status (SES), early maternal return to work, poor feeding support in childcare facilities, housing
instability, food insecurity, and low-resource neighborhoods have all been cited as potential barriers to
initiating or meeting breastfeeding recommendations. Additionally, the introduction to solid foods before four
months of age and poor maternal mental health have both been associated with suboptimal breastfeeding
durations. Prior research has focused on the relationship between each risk factor and infant feeding practice
in isolation. To date, little is known about the additive effects of multiple adverse SDOH on the impact of
infant feeding practices and whether their impact is mediated by maternal mental health status or the timing
of introduction to solid foods. This NRSA application proposes to fill this gap through the following aims: 1)
identify the impact of select SDOH (SES, employment, food access, housing stability, child care support) on
breastfeeding outcomes, 2) examine if the relationship between SDOH and infant feeding practices is mediated
by maternal mental health and the timing of introduction to solid foods, and 3) investigate the impact of Black
mothers’ experiences with adverse SDOH and their perceived lactation resource availability on infant feeding
practices. This multi-methods research project will provide the applicant with training in multivariable
regression models (Aim 1), structural equation modeling (Aim 2) and grounded theory qualitative research
methods (Aim 3). This study is expected to generate critically important new knowledge about the relationship
between breastfeeding outcomes and adverse SDOH. The proposed research also aligns with NINR’s strategic
plan to conduct nursing research that will solve pressing health challenges and advance health equity.
Terms: <Academy><Address><Affect><Age><Age Months><American><Award><Birth><Black><Black race><Breast Feeding><Breast fed><Breastfed><Breastfeeding><Child Care><Chronic Disease><Chronic Illness><Clinical><Competence><County><Data Analyses><Data Analysis><Data Collection><Death Rate><Employment><Ensure><Environment><Equation><Ethics><Exclusive Breast Feeding><Exclusive Breastfeeding><Exhibits><Fellowship><Food><Food Access><Foundational Skills><Funding><General Population><General Public><Generalized Growth><Glean><Goals><Growth><Health><Health Benefit><Health Disparities Research><Health Facilities><Health Status><Health care facility><Health disparities related research><Healthcare Facility><Housing><Individual><Individual National Research Service Award><Inequity><Infant><Intervention><Intervention Strategies><Interview><Investigation><Investigators><Knowledge><Lactation><Level of Health><Life><Literature><Long-term cohort study><Longitudinal cohort study><Longterm cohort study><Maternal Health><Mediating><Mental Depression><Mental Health><Mental Hygiene><Methods><Microbiomics><Modeling><Mothers><NIH><NIH National Research Service Award for Individual><NRSA><National Institutes of Health><National Research Service Awards><Neighborhoods><Nursing Research><Outcome><Parturition><Pediatrics><Philadelphia><Policies><Population><Psychological Health><Puericulture><Qualitative Research><R-Series Research Projects><R01 Mechanism><R01 Program><Recommendation><Research><Research Grants><Research Methodology><Research Methods><Research Personnel><Research Project Grants><Research Projects><Research Resources><Research Training><Researchers><Resources><Risk Factors><Role><Sampling><Socio-economic status><Socioeconomic Status><Solid><Strategic Planning><Structure><Tissue Growth><Training><Translations><United States><United States National Institutes of Health><Woman><Women's study><Work><ages><black female><black women><care facilities><career><chronic disorder><clinical practice><data interpretation><depression><disease risk><disorder risk><disparities in race><disparity due to race><disparity in health><ethical><exclusively breast fed><exclusively breast feeding><exclusively breastfed><exclusively breastfeeding><experience><feeding><female study><food insecurity><health disparities science><health disparity><health equity><health level><housing instability><inequality due to race><inequity due to race><infant morbidity><infant morbidity/mortality><innovate><innovation><innovative><instably housed><interventional strategy><lactating><lactational><longitudinal data set><longitudinal dataset><low SES><low socio-economic position><low socio-economic status><low socioeconomic position><low socioeconomic status><marginalization><meeting><meetings><microbiome research><microbiome science><microbiome studies><mortality rate><mortality ratio><ontogeny><perceived stress><perception of stress><pre-doc><pre-doctoral><predoctoral><pregnant><programs><prospective><race based disparity><race based inequality><race based inequity><race disparity><race related disparity><race related inequality><race related inequity><racial disparity><racial inequality><racial inequity><racially unequal><research and methods><self-reported stress><skill acquisition><skill development><social disadvantage><social disparities><social health determinants><social inequality><social role><socio-economic position><socioeconomic position><stress perception><study among females><study among women><study in females><study in women><study on females><study on women><study within women><theories><training opportunity><translation><unstable housing><unstably housed><virtual>