School of Public Health Associate Professor Receives Grant To Study New Laws Impact on Health Outcomes

Janine Jurkowski
Health Policy

Sponsor: Robert Wood Johnson Fund/Health Research, Inc.
Dates: December 1, 2012 – November 30, 2013
Amount: $35,016

How NYS Public Health Laws Regulating Maternity Hospitals Impact Health Outcomes

The aim of this study is to determine how two, new Public Health Laws (PHLs) work to improve public health outcomes. Specifically, how do a Breastfeeding (BF) Mothers Bill of Rights and a law requiring public reporting of hospital-specific BF rates work to affect changes in hospital BF policies and maternity care practices to increase BF rates? This project has three sequential phases. The 1st is an exploratory, formative study of a small number of selected hospitals to identify individual and organizational factors that influence interpretation and response to these two PHLs. In the 2nd phase, these findings will inform the development of semi-structured interviews to be conducted with key staff at purposively selected hospitals (N=20). Qualitative analysis will be used to explore attitudes and incentives that motivate hospital decision-makers to make changes, and staff to implement hospital policies and make behavioral changes to improve BF practices. In the 3rd phase, these findings will inform the development of structured survey questions, measuring theoretical constructs that influence hospital decision-makers and impact staff behaviors to support BF, that will be added to a Hospital BF Practice Survey or included in a new Hospital Decision-maker Survey to be completed by all NY Maternity Hospitals (N=132). These data will be merged with repeat measures of hospital BF practices, BF policies, and BF outcomes (ascertained before, during and post- implementation of these PHLs; 2009-2013). This dataset will be used in multi-level, quantitative analyses to determine the influence of these two PHLs on key decision-makers, changes in hospital BF policies and practices, and changes in BF outcomes. The findings will provide insight into how two different PHLs work and how they compare. These findings will guide the development and implementation of future regulatory approaches to improve public health outcomes, such as BF, in NY, other states and at the federal level.