Table 2.
Quantitative measures, results and sources for the RE‐AIM analysis of CHAMPS.
| RE‐AIM component | Outcome measures | Results | Data source(s), timeframe |
|---|---|---|---|
| Reach | Primary outcome measure: Proportion of Mississippi birthing women giving birth at CHAMPS hospitals, by race. | 98% of eligible birthing women reached | MSDH vital statistics report, 2019 |
| |||
| Community‐level outcome measure: Proportion of MS WIC peer counsellors exposed to CHAMPS. | 65% of MS WIC breastfeeding peer counsellors exposed to CHAMPS. | MS WIC regional coordinators, 2019 | |
| Effectiveness | Primary outcome measure: Changes in rates of breastfeeding initiation and exclusivity, and changes in racial inequities in breastfeeding at CHAMPS hospitals. | Average breastfeeding initiation rate at CHAMPS hospitals increased from 56% to 66% (p < 0.05). | CHAMPS hospital data (Burnham et al., 2022), January 2015–December 2019 |
| Exclusive breastfeeding rate at CHAMPS hospitals increased from 26% to 37% (p < 0.05). | |||
| Gap in racial disparities in breastfeeding initiation between Black and White dyads at CHAMPS hospitals decreased by 17 percentage points. | |||
| Secondary outcome measure: changes in rates of compliance with Steps 4 (skin‐to‐skin) and 7 (rooming‐in) at CHAMPS hospitals. | Skin‐to‐skin rates after vaginal birth at CHAMPS hospitals increased from 31% to 91% (p < 0.01). | CHAMPS hospital data (Burnham et al., 2022), January 2015–December 2019 | |
| Skin‐to‐skin rates after caesarean birth at CHAMPS hospitals increased from 20% to 86% (p < 0.01). | |||
| Rooming‐in rates at CHAMPS hospitals increased from 19% to 86% (p < 0.01). | |||
| Community‐level primary outcome measure: Changes in MS WIC rates of breastfeeding within CHAMPS’ years of operation. | Proportion of MS WIC families doing 'any breastfeeding' increased from 5.1% to 15% (p < 0.05). | USDA WIC breastfeeding data: Local agency reports, 2010–2019 | |
| Adoption | Hospital‐level primary outcome measure: Proportion of eligible MS birthing hospitals who enrolled in CHAMPS. | 95% of eligible MS hospitals enrolled in CHAMPS (39/41). | MS CHAMPS programme records, enrolment to August 2020. |
| Community‐level primary outcome measure: Proportion of organizations addressing breastfeeding in MS who engaged with CHAMPS. | 25 organizations engaged as implementers, catalysts and active partners. | Internet searches, Facebook, discussions with CHAMPS partners; enrolment to August 2020 | |
| Implementation | Hospital‐level primary outcome measure: Proportion of CHAMPS hospitals that entered D3, D4 and/or was designated. | CHAMPS hospitals in the third or fourth stage of the pathway or designated increased from 15% at enrolment to 90% by August 2020. | MS CHAMPS programme records/Baby‐Friendly USA, enrolment to August 2020 |
| 51% (20) CHAMPS hospitals were fully designated by August 2020 compared to zero at enrolment. | |||
| Hospital‐level secondary outcome measure: Level of compliance with BFHI requirements. | Hospitals paying fair market value for infant formula increased from 3% at enrolment to 77% by August 2020. | MS CHAMPS programme records, enrolment to August 2020 | |
| Hospitals distributing formula industry sample packs decreased from 79% at enrolment to 13% by August 2020. | |||
| >1600 staff and trainers trained at 95 trainings by August 2020. | |||
| Community‐level primary outcome measure: Proportion of MS counties where WIC peer counsellors have engaged with CHAMPS. | 80% of WIC districts employed WIC peer counsellors who had engaged with CHAMPS. | MS WIC regional coordinators, 2019 | |
| Maintenance | Hospital‐level primary outcome measure: Proportion of CHAMPS hospitals who retained Baby‐Friendly designation. | 100% of designated CHAMPS hospitals retained their Baby‐Friendly status. | MS CHAMPS programme records/Baby‐Friendly USA, enrolment to August 2020 |
| Hospital‐level secondary outcome measure: Proportion of CHAMPS hospitals who maintained participation in CHAMPS. | 100% of hospitals maintained enrolment in CHAMPS. | MS CHAMPS records, enrolment to August 2020 |
Abbreviations: BFUSA, Baby‐Friendly USA; CHAMPS, Communities and Hospitals Advancing Maternity Practices; MS, Mississippi; MSDH, Mississippi State Department of Health; MS WIC, Mississippi Special Supplemental Nutrition Programme for Women, Infants and Children; RI, rooming‐in; STS, skin‐to‐skin; USDA, United States Department of Agriculture.