{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:59:33Z","timestamp":1784300373181,"version":"3.55.0"},"reference-count":53,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"eunice kennedy shriver national institute of child health and human development","doi-asserted-by":"publisher","award":["R01HD076390"],"award-info":[{"award-number":["R01HD076390"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hum Lact"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Research exploring associations between exposure to social determinants of health and breastfeeding is needed to identify breastfeeding barriers. Housing insecurity and household conditions (chaos and crowding) may affect breastfeeding by increasing maternal stress and discomfort and decreasing time available to breastfeed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Aim:<\/jats:title>\n                    <jats:p>We aimed to examine the relationships between housing insecurity, breastfeeding exclusivity intention during the early postnatal period, and breastfeeding exclusivity at 6 months postpartum among a sample \u201cat risk\u201d for suboptimal breastfeeding rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study is a secondary data analysis of a longitudinal study at two time periods. Data were collected from English- and Spanish-speaking, Medicaid-eligible mother-infant dyads ( N = 361) at near-birth and child aged 6 months, in New York City and Pittsburgh. Structural equation modeling was used to examine direct and indirect effects of housing insecurity on breastfeeding exclusivity at child aged 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The path model showed that experiencing more markers of housing insecurity (i.e., foreclosure\/eviction threat, history of homelessness, late rent) was predictive of significantly lower breastfeeding exclusivity at 6 months. This was partially mediated through less exclusive breastfeeding intention during the early postnatal period. Greater household crowding was associated with 6-month breastfeeding exclusivity when mediated by intention. Household crowding had differential effects by study site and participant race\/ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Refinement of housing insecurity as a multi-dimensional construct can lead to the development of standardized data collection instruments, inform future methodological decisions in research addressing social determinants of health, and can inform the development of responsive individual- and structural-level interventions. The data used in this study were collected as part of the SMART Beginnings Randomized Controlled Trial (NCT02459327 registered at ClinicalTrials.gov).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08903344221108073","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T03:14:33Z","timestamp":1656645273000},"page":"760-770","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Housing Insecurity, Housing Conditions, and Breastfeeding Behaviors for Medicaid-Eligible Families in Urban Settings"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9174-2891","authenticated-orcid":false,"given":"Rebecca","family":"Reno","sequence":"first","affiliation":[{"name":"University of California, Berkeley School of Public Health, Berkeley, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mackenzie","family":"Whipps","sequence":"additional","affiliation":[{"name":"Steinhardt School of Culture, Education and Human Development, New York University, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4535-864X","authenticated-orcid":false,"given":"Jordyn T.","family":"Wallenborn","sequence":"additional","affiliation":[{"name":"University of California, Berkeley School of Public Health, Berkeley, CA, USA"},{"name":"Swiss Tropical and Public Health Institute, University of Basel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Demirci","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra L.","family":"Bogen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel S.","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, New York University Grossman School of Medicine, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan L.","family":"Mendelsohn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, New York University Grossman School of Medicine, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela A.","family":"Morris","sequence":"additional","affiliation":[{"name":"Steinhardt School of Culture, Education and Human Development, New York University, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,7,1]]},"reference":[{"key":"bibr1-08903344221108073","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6627a3"},{"key":"bibr2-08903344221108073","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-018-2584-0"},{"key":"bibr3-08903344221108073","doi-asserted-by":"publisher","DOI":"10.1207\/S15327906MBR3601_05"},{"key":"bibr4-08903344221108073","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2012.08.020"},{"key":"bibr5-08903344221108073","unstructured":"Centers for Disease Control and Prevention. 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