Strategy. Telelactation
Approach. Provide telelactation services to increase convenient access to professional breastfeeding support
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Overview. Telelactation is one tool that can be leveraged to increase access to International Board Certified Lactation Consultants (IBCLCs) in rural settings. Telelactation services connect breastfeeding women to remotely located IBCLCs through audio-visual technology. Research indicates that telelactation via personal electronic devices that allows for face-to-face, synchronous interaction with IBCLCs may have promise. At a minimum, these services are likely to increase access to IBCLCs and increase convenience for women seeking support.[1]
Evidence. Emerging Evidence.
Strategies with this rating typically trend positive and have good potential to work. They often have a growing body of recent, but limited research that documents effects. However, further study is needed to confirm effects, determine which types of health behaviors and conditions these interventions address, and gauge effectiveness across different population groups. (Clarifying Note: The WWFH database calls this "mixed evidence").
Access the peer-reviewed evidence
through the MCH Digital Library or related evidence source.
(Read more about understanding evidence ratings).
Source. Peer-Reviewed Literature
Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):
- Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.
- Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
- Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.
Intervention Type. Consultation (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).
Intervention Level. Community-Focused
Examples from the Field.
Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).
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Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")
- Number of IBCLCs trained and certified to provide telelactation services. (Measures workforce capacity)
- Number of telelactation service platforms or systems established to connect breastfeeding women with remote IBCLCs. (Assesses infrastructure development)
- Number of telelactation consultations provided to breastfeeding women. (Evaluates service delivery)
- Total number of breastfeeding women who accessed telelactation services. (Captures service utilization)
- Number of women who reported increased access to professional breastfeeding support as a result of telelactation services. (Measures access improvement)
- Number of rural or underserved communities reached through telelactation services. (Assesses geographic reach)
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Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")
- Percent of telelactation consultations that met quality standards for audio-visual clarity, security, and IBCLC competency. (Measures service quality)
- Percent of telelactation consultations that followed evidence-based protocols and guidelines for assessment and management of breastfeeding issues. (Evaluates clinical fidelity)
- Percent of breastfeeding women who received follow-up support and resources after their initial telelactation consultation. (Assesses continuity of care)
- Percent of women who reported high satisfaction with the convenience, accessibility, and helpfulness of telelactation services. (Measures user experience)
- Percent of breastfeeding challenges or concerns that were resolved through telelactation consultations, as reported by women. (Captures problem resolution)
- Percent of women who continued breastfeeding at 3, 6, and 12 months postpartum after receiving telelactation support. (Assesses breastfeeding duration)
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Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")
- Number of partnerships formed between healthcare organizations, community agencies, and technology providers to implement and sustain telelactation services. (Measures collaborative networks)
- Number of marketing and outreach campaigns conducted to promote awareness and utilization of telelactation services among target populations. (Assesses demand generation)
- Number of research studies or evaluations conducted to assess the effectiveness, acceptability, and scalability of telelactation services. (Evaluates evidence generation)
- Number of breastfeeding women who reported increased confidence and self-efficacy in managing breastfeeding challenges after receiving telelactation support. (Captures empowerment)
- Number of primary care providers who reported increased capacity to support breastfeeding patients through collaboration with telelactation IBCLCs. (Measures healthcare system impact)
- Number of employer benefits, such as reduced absenteeism and increased productivity, associated with providing telelactation services to breastfeeding employees. (Assesses business impact)
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Quadrant 4:
Measuring Quality of Effect ("How are they better off?")
- - Percent of telelactation services provided to women from racial, ethnic, or socioeconomic groups with historically lower breastfeeding rates. (Measures equitable utilization)
- - Percent of telelactation IBCLCs who completed cultural competency training to provide culturally sensitive and responsive care. (Assesses cultural competence)
- - Percent of telelactation service costs covered by insurance, Medicaid, or other financing mechanisms to reduce financial barriers for women. (Evaluates financial accessibility)
- - Percent reduction in breastfeeding disparities between women who received telelactation support and those who did not, stratified by race, ethnicity, and socioeconomic status. (Measures equity impact)
- - Percent of rural or underserved communities that reported increased breastfeeding initiation and duration rates after the implementation of telelactation services. (Captures community-level change)
- - Percent increase in exclusive breastfeeding rates at 3 and 6 months postpartum among populations served by telelactation services, compared to baseline rates. (Assesses population health impact)
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Note. When looking at your ESMs, SPMs, or other strategies:
- Move from measuring quantity to quality.
- Move from measuring effort to effect.
- Quadrant 1 strategies should be used sparingly, when no other data exists.
- The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.
Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.
References
1 Uscher-Pines, L., Ghosh-Dastidar, B., Bogen, D. L., Ray, K. N., Demirci, J. R., Mehrotra, A., & Kapinos, K. A. (2020). Feasibility and effectiveness of telelactation among rural breastfeeding women. Academic pediatrics, 20(5), 652-659.
