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The Impact of Telelactation Services on Breastfeeding Outcomes among Minority Mothers: Siteless Tele-MILC Trial

Award Number: R01NR018837
ORGANIZATION: NATIONAL INSTITUTE OF NURSING RESEARCH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/15/2020
PERIOD OF PERFORMANCE END DATE: 07/31/2025

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The Impact of Telelactation Services on Breastfeeding Outcomes among Minority Mothers: Siteless Tele-MILC Trial - Project Summary Breastfeeding offers many medical and neurodevelopmental advantages for mothers and infants; however, the majority of mothers stop breastfeeding before it is recommended, with less than half of infants receiving breast milk at six months of age. Professional lactation support by International Board Certified Lactation Consultants (IBCLCs) increases breastfeeding duration and exclusivity (i.e., proportion of breast milk in an infant’s diet); however, many communities lack access to IBCLCs. Racial and ethnic minority mothers have lower breastfeeding rates, and limited access to professional lactation support may contribute to this disparity. Virtual “telelactation” consults that use two-way video have the potential to increase access to IBCLCs among underserved populations. Telelactation is convenient because it does not require a new mother to travel with her infant and can be provided on demand. Telelactation is also less costly than an in-person visit. Since 2015, several companies have begun to offer telelactation through a direct-to-consumer (DTC) model, where women initiate video calls with providers using their personal devices (e.g., mobile phones); however, no published research has linked telelactation with breastfeeding outcomes. To address this evidence gap, we will expand on a successful pilot study that demonstrated the feasibility and perceived value of telelactation in a rural community, and conduct an innovative “siteless” randomized controlled trial to evaluate the impact of DTC telelactation on breastfeeding outcomes. We will recruit 2400 primiparous pregnant women age >18 who plan to breastfeed and live in the 17 states most underserved by IBCLCs. Recruitment will occur via Ovia, a popular pregnancy tracker mobile phone application. Women will be randomized to: 1) on-demand telelactation video calls on personal devices or 2) usual care. Quantitative data on breastfeeding rates, as well as qualitative data on experiences with telelactation, will be captured via surveys and in-depth interviews and compared across racial and ethnic groups. The specific aims are: 1) Assess the impact of DTC telelactation breastfeeding duration and exclusivity, compare effectiveness by race/ethnicity and rural/urban location, and explore whether self-efficacy serves as an explanatory mechanism; 2) Explore how acceptability of and experiences with telelactation vary across subpopulations of mothers. This research aims to improve children’s health and reduce disparities in key maternal and child health outcomes. It will also inform the design and execution of future siteless trials among pregnant and postpartum women to enhance minority participation in research and reduce the time and resources required to surface evidence on the impacts of new eHealth interventions. Study results will inform policy debates about reimbursement of telelactation and will identify strategies to further tailor these services to meet the needs and preferences of racial and ethnic minority women.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $0 )
2026	2024	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	000	5	12/29/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2025 ( Subtotal = $523,522 )
2025	2025	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	000	6	8/12/2025	COMPETING CONTINUATION	$523,522
														Subtotal = $523,522

Issue Date FY: 2024 ( Subtotal = $913,052 )
2024	2024	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	001	5	7/3/2024	NON-COMPETING CONTINUATION	$485,167
2024	2024	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	002	5	7/8/2024	SUPPLEMENT FOR EXPANSION	$310,602
2024	2024	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	000	4	4/19/2024	SUPPLEMENT FOR EXPANSION	$117,283
														Subtotal = $913,052

Issue Date FY: 2023 ( Subtotal = $445,384 )
2023	2023	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	001	4	7/21/2023	NON-COMPETING CONTINUATION	$445,384
2023	2022	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	000	3	4/20/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $445,384

Issue Date FY: 2022 ( Subtotal = $623,809 )
2022	2022	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	002	3	7/22/2022	SUPPLEMENT FOR EXPANSION	$168,048
2022	2022	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	001	3	7/21/2022	NON-COMPETING CONTINUATION	$455,761
2022	2021	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	000	2	1/28/2022	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $623,809

Issue Date FY: 2021 ( Subtotal = $594,158 )
2021	2021	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	000	2	8/16/2021	NON-COMPETING CONTINUATION	$444,671
2021	2021	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	001	2	8/17/2021	SUPPLEMENT FOR EXPANSION	$149,487
														Subtotal = $594,158

Issue Date FY: 2020 ( Subtotal = $510,317 )
2020	2020	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Nursing Research	000	1	9/15/2020	NEW	$510,317
														Subtotal = $510,317

Grand Total All Awards = $3,610,242

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The Impact of Telelactation Services on Breastfeeding Outcomes among Minority Mothers: Siteless Tele-MILC Trial

Award Number: R01NR018837

ORGANIZATION: NATIONAL INSTITUTE OF NURSING RESEARCH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/15/2020

PERIOD OF PERFORMANCE END DATE: 07/31/2025

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