Project Summary/Abstract
Rural U.S. mothers, especially those of lower socioeconomic status (SES), are more reluctant to breastfeed
than urban mothers of comparable SES. The question is whether the experience of living in a rural area is
influencing a rural woman’s decision on how to feed her infant. An understanding of the contextual factors
existing in a community that are influencing infant feeding choices is needed to guide future nursing
breastfeeding research The purpose of this study is to qualitatively explore rural habitus, or the community
influence on rural mothers’ decisions on how they feed their infants. The specific aims of this study are: 1) To
explore rural mothers’ intentions and decision-making around infant feeding their first child, including their
unique habitus, and other key community influencing factors; 2) To describe rural mothers’ perceptions of how
the rural community influenced their infant feeding decisions; and 3) To explore rural mothers’ priorities for
interventions to support breastfeeding, including needs for information, support, and resources. The
recruitment of participants will take place through rural Missouri WIC clinics as well as rural Federally Qualified
Health Centers (FQHCs) with obstetrical or pediatric services. The concepts of habitus and rurality will guide
this study, utilizing a qualitative descriptive approach to allow themes from the rural women’s own voices to be
generated regarding factors that formed their decision on how to feed their newborn. The findings will be
utilized in a post-doctoral fellowship to develop a quantitative instrument to survey a larger rural population of
women to further test how habitus influences breastfeeding. The applicant’s long-term goal will be to design an
effective nursing intervention to boost breastfeeding rates in underserved rural communities. A key strength of
this study is the research team the applicant has assembled. Drs. Bullock, Everett and Bloom have a long
history of research collaboration studying health disparities in rural Missouri. Dr. Bullock will provide senior
mentorship for the research team, as well as data collected with rural Missouri perinatal women that can be
explored for the concept of habitus. Dr. Everett’s current research has a strong overlap with the goal of this
study and can provide hands-on training for the applicant. Dr. Bloom has extensive research experience and
publications using qualitative methodology and will provide crucial mentoring in this area. Lastly, the team will
be complete with the support of a senior interdisciplinary scientist, Dr. Beth Olson, who has extensive research
experience in rural communities and in breastfeeding research. Overall, this proposal has multiple strengths: 1)
It is taking a unique approach of exploring habitus in addressing an aged old problem of increasing
breastfeeding, 2) It is addressing one of the nation’s most vulnerable and understudied populations, rural
women who have increased health disparities and few resources, and 3) It is highly responsive to NINR’s
strategic goals of enhancing wellness and developing culturally tailored interventions intended for
families and underrepresented communities.40