Potential Public Health Impact
Reach: This is state-level policy, which has potential for broad reach to employees across Texas. Collectively, the 30 employers that participated in the Mother-Friendly Employer Technical Assistance Pilot Project represented hundreds of worksites across the state employing over 118,500 employees. The MFWP outside of the technical assistance pilot is reaching hundreds of thousands of employees. Data are not available on the policy’s impact on breastfeeding. Data collected during the formative stage revealed that it may be harder for lower-income and hourly workers to breastfeed after returning to work.
Effectiveness: The intervention has been successful at getting worksites to adopt breastfeeding policies that meet established criteria for flex time and women’s access to a pump room, sink, and milk storage. In the 30 pilot sites, the policy led to the specified improvements in the work environments. Evidence is not yet available on population awareness and attitudes towards breastfeeding at work or on the possible impact of the policy on women’s breastfeeding practices. Questions about breastfeeding have been added to the BRFSS and the Texas WIC IFPS which will provide future data on changes in worksite breastfeeding attitudes and practices.
Adoption: Since they implemented the marketing campaign, the number of adopting worksites has increased from 233 in 2010 to 1,120 in 2012. Since 2012 the number has continued to rise. Participating worksites are scattered throughout Texas, with most of them in the more populated regions.
Implementation: Data from the pilot sites indicate that they are implementing the policy as intended. Data suggest that participants find the technical assistance tools and support useful. Most of the pilot sites were provided grants and all were provided with extensive technical assistance to develop and implement their policies. Through the pilot work, implementation guidance and tools were developed that might make it easier for future worksites to implement the policy. However, it is not clear how well sites that do not have grants and technical assistance will implement the policy.
Maintenance: The state level policy and recognition system have broad potential for sustainability. Partnerships and communication strategies developed during the Mother-Friendly Worksite Policy Initiative have expanded the state program’s capacity for outreach and recruitment of additional worksites. Many local WIC and public health agencies have incorporated Texas Mother-Friendly Worksite outreach activities and indicators into their local program planning efforts. Texas can build on its initial investments. Major work has been done to develop a marketing campaign and a set of tools and resources. The high level of technical assistance provided to the pilot sites will be difficult to maintain, but it is anticipated that the MFWPI-developed tools and resources will provide much of the support needed to implement the policies, and therefore less direct technical assistance will be required. The connections with many partners, including the Building Healthy Texans Statewide Agency Wellness Program, DSHS Nutrition Education Branch (Texas WIC),the DSHS Texas Ten Step Program, the DSHS Healthy Texas Babies Initiative, the DSHS Texas Nutrition, Physical Activity, and Obesity Prevention Program, the DSHS Transforming Texas Initiative, the DSHS Cardiovascular Disease and Stroke Program and local public health partners should also help to increase long-term sustainability.