Positive deviance: An innovative approach to researching breastfeeding disparities in African-American women in the United States

Despite the numerous benefits of breastfeeding, rates are lowest in the African-American community. Very few studies have been conducted examining characteristics of women, especially African American women, who have breastfed despite having risk factors associated with not breastfeeding. One useful approach to fill this gap is Positive Deviance, an inexpensive method to identify uncommon health behaviors that improve health in resource poor communities. Positive deviance was developed in the 1970's by nutrition experts and has been used primarily in international settings to address health issues, such as condom use, family planning, pregnancy outcomes, and child health. To date only one published study has examined breastfeeding using positive deviance in the United States, which used quantitative data. This presentation describes methodology for conducting positive deviance inquiry and how this methodology is being used in a qualitative research study on breastfeeding in African-American women in northern Georgia. The goals of the study are to understand African-American women's breastfeeding experiences and to explore the factors influencing their decision to initiate and sustain breastfeeding. Lessons learned from the study will be shared along with preliminary findings and suggestions for future research.