A Pilot Study of a Culturally Grounded Breastfeeding Intervention for Pregnant, Low-Income African American Women

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Increasing breastfeeding rates among low-income African American women may work toward the achievement of health equity. The dynamic breastfeeding assessment process (D-BAP) is a community-grounded, equity-focused intervention designed to increase prenatal breastfeeding self-efficacy.

Research aim:

The aims of the pilot study were (a) to determine the effect of the D-BAP on breastfeeding self-efficacy among pregnant, low-income African American women, (b) to examine the findings among women with no previous breastfeeding experience, and (c) to compare the findings between women with prior breastfeeding experience and those without it.


A pre/post, paired-samples design was utilized. Convenience sampling was used to recruit pregnant, low-income African American women (N = 25). Participants completed the Breastfeeding Self-Efficacy Scale–Short Form prior to and following the D-BAP.


The Wilcoxon signed rank test indicated that participation in the D-BAP had a statistically significant influence on breastfeeding self-efficacy (z = −2.01, p = .04). Among a subsample of participants with no previous breastfeeding experience (n = 12), completion of the D-BAP resulted in a statistically significant increase in breastfeeding self-efficacy (z = −2.36, p = .02). There was no statistically significant difference between those with prior breastfeeding experience and those without it.


Breastfeeding among low-income African American women is a health equity issue for which culturally responsive, effective breastfeeding interventions are needed. This research demonstrates an association between completion of the D-BAP and an increase in prenatal breastfeeding self-efficacy.

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