Field Placement: Los Angeles County Department of Health Services -- Maternal, Child, and Adolescent Health
Preceptor: Diana Liu
Student Name: Neetu Chawla
Year: 2002

Data Use Institute Project; Breastfeeding Training Evaluation Project

At Los Angeles County Department of Health Services, I have worked on two projects during my internship: 1.) The Data Use Institute Project and 2.) The Breastfeeding Training Evaluation Project. The Data Use Institute (DUI) Project addressed program integration, program evaluation, and data summary. Its central goal was to evaluate each of the 8 programs under the Maternal, Child, and Adolescent Health division and to evaluate MCAH as a whole. The Breastfeeding Training Evaluation Project involved the evaluation of breastfeeding trainings conducted by L.A. county for Comprehensive Perinatal Services Program (CPSP) providers. This project was useful not only to evaluate the breastfeeding trainings specifically, but also to evaluate CPSP trainings overall. The central purpose was to examine the effectiveness of the CPSP breastfeeding trainings and to determine if methods of evaluation used could be utilized for the evaluation of other CPSP training.

The DUI project was a project designed to coordinate and integrate services provided by Maternal, Child, and Adolescent Health programs. The project involved working with each program manager to determine performance measures that best represented the efforts of his/her program and to determine how each individual program's activities represented the larger goals and objectives of MCAH as a whole. MCAH staff were selected to work with specific program managers. My work was with the Comprehensive Perinatal Services Program (CPSP). Through a series of meetings, 19 performance measures were determined for the CPSP program and information was presented at a larger group meeting where all MCAH program managers were present. The 8 MCAH programs were then divided into two groups: 1.) service-based programs and 2.) surveillance-based programs. The CPSP program was unique in the sense that it could fit under either group and it is currently being determined which group CPSP will be placed under. The next step was to determine headline performance measures for each of the two groups. These headline measures would ideally represent all of the programs within the grouping. The headline measures for the surveillance-based programs have already been determined and headline performance measures for the service-based programs are currently being finalized.

The Breastfeeding Training Evaluation Project involved the evaluation of four breastfeeding trainings sessions held once a month between December, 2001 and March 2002. First, an analysis of the pre- and post- test questions from the training sessions was conducted to determine if the training made a difference in the level of breastfeeding knowledge of the participants. Next, a list of participants was generated and the number of CPSP providers represented was determined. This step was necessary due to the fact that non-CPSP providers sometimes attended these trainings, though the training sessions were targeting only CPSP providers. After these initial analyses, it was determined that 78 CPSP-related participants attended the training and that these 78 participants represented 44 CPSP providers. The reason for the difference in number of participants and number of CPSP providers represented is due to the fact that the trainings sessions stipulated that a single CPSP provider was allowed to send up to two participants from his/her office. A list of the 44 CPSP providers represented at these training sessions was then generated and 22 were selected for evaluation site visits. There were two key components of the evaluation site visits conducted for each of the 22 selected providers: 1.) chart reviews examining 20 charts total, 10 pre-training charts and 10 post-training charts and 2.) exit interviews comprised of 5 questions targeting breastfeeding promotion practices of the office, barriers to breastfeeding promotion experienced, and overall effectiveness of CPSP breastfeeding training sessions in providing useful information that addressed the CPSP provider's breastfeeding interests. After the evaluation design was determined, 22 CPSP provider site visits were scheduled with providers all over Los Angeles County.

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