Working Paper: NBER ID: w21013
Authors: Onur Altindag; Theodore J Joyce; Julie A Reeder
Abstract: In an effort to improve breastfeeding, the Oregon WIC Program tested whether a relatively low-cost telephone peer counseling initiative to support breastfeeding could increase the initiation and duration of exclusive breastfeeding among its participants. They conducted a large randomized field experiment (RFE) with over 1900 women from four WIC agencies in the state. In this study we use data from the RFE along with administrative data from the rest of the state to assess whether the results from the RFE can be extended to other agencies in the state. We find small or non-existent effects of peer counseling in the non-experimental settings, which suggest that the experimental estimates may reflect Hawthorne effects. We present evidence of selection into RFE in that exclusive breastfeeding among the controls is significantly greater than among women who were offered but declined to participate in the RFE as well as from women in the rest of the state who had no access to peer counseling. We conclude that despite the strong internal validity of the RFE, extending the program to other agencies in the state would have a limited impact at best on exclusive breastfeeding.
Keywords: breastfeeding; peer counseling; WIC; randomized field experiment
JEL Codes: I12; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Self-selection (C52) | Exclusive breastfeeding (J13) |
| Control group participants (C90) | Exclusive breastfeeding (J13) |
| Peer counseling (C92) | Exclusive breastfeeding (J13) |
| Peer counseling increases exclusive breastfeeding for Spanish-speaking clients (J13) | Exclusive breastfeeding (J13) |
| Peer counseling does not significantly affect exclusive breastfeeding for English-speaking clients (I00) | Exclusive breastfeeding (J13) |