Reimagining USDA’s breastfeeding campaign for a new generation of WIC moms

Background:

Through its WIC program, the U.S. Department of Agriculture's (USDA) Food and Nutrition Service (FNS) provides health and nutrition services to low-income pregnant, postpartum, and breastfeeding women—a population that is diverse, vulnerable, and often challenging to reach. USDA FNS engaged Hager Sharp to update Loving Support Makes Breastfeeding Work, a social marketing campaign launched in 1997 to improve breastfeeding initiation and duration rates among mothers enrolled in WIC. While rates have improved over two decades, WIC participants continue to have lower breastfeeding exclusivity and duration rates than the general U.S. population, likely due to various socioecological factors.

Program background:

We conducted formative research to explore WIC moms’ knowledge, attitudes, beliefs, and behaviors around breastfeeding; their preferred communications channels; and how to better engage this hard-to-reach population. The research included an environmental scan, in-depth interviews, mobile ethnography, a digital audit, focus groups, and triads, resulting in key insights:

• WIC moms understand the benefits of breastfeeding, but lack knowledge about the fundamentals of breastfeeding which leads to a lack of skills and confidence.
• WIC moms are more likely to breastfeed if it is the norm in their family or community.
• Breastfeeding is a lot harder than moms expect and many intrapersonal barriers (e.g., exhaustion, feeling “tethered” to baby) prevent them from breastfeeding successfully.
• The external environment greatly impacts a woman’s ability to breastfeed.

Using these insights, we developed a new campaign strategy focused on reducing health disparities and improving access: position WIC as the go-to resource for breastfeeding information and support by tapping into a feeling of empowerment and letting WIC moms know they are not alone on their breastfeeding journey. This led to a new brand (complete with new campaign name, tagline, and graphic identity) and a social marketing plan that used the 4Ps framework. The plan detailed innovative tactics, including a suite of materials, first-person narrative videos, a buddy program, and a comprehensive, engaging website, that focused on helping moms take breastfeeding minute-by-minute, day-by-day, and week-by-week. We also helped moms set small, manageable goals and assured them that learning to breastfeed is like learning any new skill—they might have challenges early on, but it gets easier.

Evaluation Methods and Results:

We proposed a monitoring and evaluation program that included baseline and follow-up surveys among WIC participants and WIC staff and in-depth interviews among WIC staff. While evaluation measures are not yet available, once collected, results will be used to assess whether the campaign is meeting its objectives and identify areas for refinements.

Conclusions:

By conducting robust formative research, we were able to immerse ourselves in the lives of the audience to understand the emotional and physical challenges and triumphs of breastfeeding, in the moments they were happening. In turn, we were able to create a social marketing campaign that truly resonated—a campaign that WIC moms see themselves in and is providing the support and encouragement they need to breastfeed successfully.

Implications for research and/or practice:

This campaign is an excellent example how robust, innovative research generates key insights that ultimately drive campaign development—branding, strategy, tactics, implementation, and evaluation.