Volume 24, Issue 5: October, 1997

Abstract

USING CULTURAL KNOWLEDGE IN HEALTH PROMOTION: BREASTFEEDING AMONG THE NAVAJO

Anne L. Wright, PhD
Audrey Naylor, MD, PhD
Ruth Wester, RN, CPNP
Mark Bauer, PhD
Emily Sutcliffe, MD

Address reprint requests to Anne L. Wright, PhD, Arizona Health Sciences Center, Department of Pediatrics, 1501 N. Campbell Avenue, Tucson, AZ 85724; phone: (520) 626-6754; fax: (520) 626-6970; e-mail: awright@resp- sci.arizona.edu.

Although many attempts have been made to promote breastfeeding in a variety of contexts, few programs have explicitly incorporated cultural beliefs in these efforts. This article describes a breastfeeding promotion program conducted on a Navajo reservation. This program was designed to be culturally appropriate. Background information regarding beliefs and factors affecting infant feeding practices in this setting is provided, followed by a description of the intervention. The intervention, which incorporated both social marketing and community participation techniques, consisted of three components: an intervention in the health care system, a community intervention, and an individual intervention. Based on medical records review of feeding practices of all the infants born the year before (n = 988) and the year after (n = 870) the intervention, the program was extremely successful. This combination of techniques, including qualitative and quantitative research in local definitions of the problem, collaboration with local institutions and individuals, reinforcement of traditional understandings about infant feeding, and institutional change in the health care system, is an effective way of facilitating behavioral change.