State, Local and/or Tribal Agencies

Appendix E3: Peer Counselor Interview Guide 3:
Study Period

Abt Associates Inc.

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WIC Peer Counseling Study:
Peer Counselor Interview Guide 3: During the Study Period
INTERVIEWER NAME

DATE

LOCATION

NAME OF LWA

SITE ID

Time start

OMB Clearance Number: 0584-0548

Time end

Expiration Date: xx/xx/20xx

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is
not required to respond to a collection of information unless it displays a valid OMB control number. The
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concerning the accuracy of time estimates or suggestions for improving this form, please contact: U. S.
Department of Agriculture, Food and Nutrition Service, Office of Research & Analysis, Room 1014,
Alexandria, VA 22302.

Introduction
Thank you for taking the time today to participate in this focus group. As part of the WIC
Breastfeeding Peer Counseling Study for the U.S. Department of Agriculture, Food and Nutrition
Service (FNS), we are talking to Peer Counselors involved in the implementation of the Loving
Support Breastfeeding Peer Counseling program. The purpose of this phase of our study is to describe
learn about how the study and the implementation of the Enhanced model of the Loving Support
Breastfeeding Peer Counseling program, especially in-person visits with program participants. We’ll
spend about two hours together for our discussion.
You and your agency’s name and location will not be identified in reports prepared for this study or
in data files provided to FNS. None of your responses during the interview will be released in a form
that identifies you or any other staff member by name, except as required by law. Although we may
report direct quotations from the interview, you and your agency will be given pseudonyms. Because
of the small number of peer counselors selected to participate in this interview, it is possible that you
may be identifiable to other people on the basis of what you have said. Please note that this study is
not part of an audit or management review of WIC. Your participation in the interview is completely
voluntary. Do you have any questions before we begin?

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Module A: Contact with WIC Participants in Peer Counseling During Pregnancy

Intro: Let’s talk about contacts you have had with WIC participant women who are
pregnant. For our discussion, I’d like you to think about contacts by telephone, inperson, or maybe using email or a text message. I don’t want you to think about
contacts by mail, for example, times when you may have mailed a brochure or
document to a participant.
A1.

Thinking about the past month, about what proportion of the time did you interact
with pregnant women in the peer counseling program by phone or in-person? Would
you say that you:





Talked with pregnant WIC participants mostly by phone
Talked with pregnant WIC participants mostly in-person
Talked with pregnant WIC participants about half by phone and half in-person
Other (it depends on the following):

A2.

About how long do telephone conversations with pregnant women in the peer
counseling program, usually last?

A3.

Where do in-person meetings with pregnant women in the peer counseling program
usually take place and how long did these in-person meetings usually last?

A4.

What topics do you usually discuss with pregnant WIC participants?

A5.

How does your communication with aWIC participant who is pregnant change over
the course of her pregnancy? That is, are there differences in the peer counseling you
provide women in their first, second, or third trimesters? (If necessary: Think about
contacts during this past month.) Probe for differences in mode of contact (phone,
in-person) and content of discussion.

Module B: Contact with WIC Participants in Peer Counseling At Delivery

Intro: Now let’s talk about contacts with WIC participant women in peer counseling who’ve
given birth in the past month. Now that the study has been going on, one group of
women in the study– that is, the women randomly assigned to the Enhanced model of
the Loving Support Peer Counseling program – are supposed to receive contact while
they’re in the hospital after delivery, and an in-person visit within the first week to 10
days after they’ve given birth. I’d like you to tell me about these types of contacts
and how you arrange them.
B1.

First, how do you find out when a woman in your peer counseling caseload goes into
the hospital to deliver her baby?

B2.

What are the biggest challenges you face when contacting WIC participants in the
hospital after delivery? What steps have you taken to overcome this challenge?

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B3.

About what proportion of the time do you make contact in-person versus by phone
with WIC participants when they are in the hospital after delivery?





Mostly by telephone
Mostly in-person
About half phone, half in-person
Other (e.g., depends on the hospital) Specify:

B4.

When you contact WIC participants in the hospital, what do they seem most
interested in discussing with you? What do they seem least interested in discussing?

B5.

How easy or difficult is it to work with hospital staff?

B6.

In the hospitals where WIC participants you work with give birth, what kinds of
practices support or hinder breastfeeding?

B7.

What are the advantages or disadvantages of contacting WIC participants when they
are in the hospital for delivery?

Module C: Contact with WIC Participants in Peer Counseling After Delivery

Now let’s discuss the in-person meetings with women who’ve just given birth.
C1.

What are the major challenges you face in scheduling these in-person visits? What
practices seem to work the best?

C2.

I’d like you to describe your in-person meetings with WIC Participant women in the
treatment group who have given birth in the past month.
 Where are these in-person meetings held?
 How long do meetings tend to last?
 What are the topics most commonly discussed? Probe if needed:
 questions about latching/sucking;
 how often to feed the baby;
 how to know if the baby getting enough milk;
 discomfort or pain from breastfeeding;
 concern about the baby not sleeping long enough because she is hungry;
 how to breastfeed if mother plans to go back to work/school
 husband/boyfriend or other family members’ attitudes toward
breastfeeding
 concern about breastfeeding in public
 concern about other family members’ opportunity to bond with baby

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C3.

How do you decide when a lactation consultant might be helpful? How often do you
refer women to a lactation consultant or other specialist?

C4.

What are the advantages or disadvantages of providing peer counseling with a new
mother in-person versus over the telephone?

C5.

Do you ever meet in-person with new mothers assigned to the control group or new
mothers who are not in the study? Why/why not?

C6.

In addition to meeting in-person with new mothers who were assigned to the
treatment group, about how often this past month have you talked about breastfeeding
by telephone with women in the treatment group?

C7.

How often this past month have you talked about breastfeeding by telephone with
new mothers who are in the control group or who are not participating in the study?

C8.

Thinking back over the last month, did you ever communicate with women in your
peer counseling caseload using email, text messaging, or websites like Facebook?
What kinds of topics do you discuss using email, text messages, or Facebook with
your peer counseling clients?

Module D: Training, Supervision, and Assignment to WIC Participants

D1.

What type of training did you receive about holding in-person meetings with new
mothers?
 How were you trained? (When, for how long? What format did the training take?)
 Is there training you wish you had received?

D2.

What kind of support from other peer counselors or from WIC agency staff have you
received once you began to make in-person visits to new mothers?

D3.

What do you do if you feel that you’re not the best match for a particular WIC
participant? That is, what do you do if you feel that one of the other peer counselors
might communicate better with a woman you were assigned to provide peer
counseling?

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D4.

How do you keep track of your schedule and contacts with WIC participants? Are
there special procedures to keep track of which women were assigned to the
Enhanced Loving Support Peer Counseling program, and which women are supposed
to receive the Standard program?
 How easy or hard-to-use are the tracking or monitoring tools?
 What would make tracking study participants easier or more accurate?
 How do you deal with difficult-to-reach mothers?
 What do you do if a new mother from the control group or not in the study
requests to meet with you in-person?

Module E: Peer Counselor’s Perception of the Enhancements

E1.

In terms of supporting or promoting breastfeeding, do you think it’s helpful to
contact WIC participants right after delivery when they are still in the hospital?
Why/why not?

E2.

In terms of supporting or promoting breastfeeding, do you think it’s helpful to meet
in-person with new mothers during the first 10 days after they’ve given birth?

E3.

What sorts of things have you done to make the in-person meeting with new mothers
the most effective for supporting breastfeeding?

E4.

Do you think you’ve made a difference in WIC participants’ attitudes about
breastfeeding or determination to continue breastfeeding ? If so, what do you think
you did that made the difference?

E5.

Would you like to continue offering the enhanced Loving Support Peer Counseling
Program to women? That is, if it were up to you, would you continue trying to
contact women when they are in the hospital having just delivered? Why or why not?
Would you continue meeting in-person with women during the first week after
they’ve delivered? Why or why not?

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