Lactation Support in Fresno, County

Funding Requested: $100,000

Duration: 1 year

Maria Nadal Jose, Sophie Willett, Micaela Wu

FSN 416
November 4, 2019
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Form A
Applicant Information

Agency Name:
California Worksite Lactation Support Group (CWLSG)

Eligible Entity Category (please check only one box):

⛀ State Health Department
⛀US Territory Health Department
⛀ Non-profit organization
⛀ Federally recognized Indian Tribe, Tribal Organization,
⛀Tribal Epidemiology Center, and/or Urban Indian Organization
Please specify which type(s): _________________________________

Mailing Address:
122 W Main St. Fresno, CA 93650

Proposal Contact Title: Program Director

Email Address: programdirector@clswg.org

Phone: (559) 621-7640 Fax: (559) 621-7640

Proposal Abstract:
Breastfeeding rates in Fresno County of the Central Valley in California are significantly
lower than state and national averages. While the national average of women who
exclusively breastfeed 3 months postpartum is approximately 46.2%, only 18.2% of
Fresno county women exclusively breastfeed 3 months postpartum. One predictor of low
breastfeeding rates and retention throughout infancy is mother terminating breastfeeding
to return to work. Creating structural support for lactating women in the workplace is
imperative for prolonging breastfeeding through the recommended 6 months or longer.
Walmart, Inc. is one such employer that lacks adequate support for breastfeeding
employees, and employs a significant amount of women in Fresno County (approximately
1,550 women). After conducting a needs assessment in the 10 Walmarts of Fresno
County, it was determined that the biggest barrier to supporting lactating mothers was lack
of private, clean space to expel milk. Through a partnership with the Mamava, a mobile
lactation unit manufacturer, we hope to install lactation pods in optimal locations within
the Walmart stores to foster a supportive built environment and improve health outcomes
of both mother and infant.

Total Amount Requested: $ 100,000

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Form B
Health of Population
Breastfeeding, especially during the first six months, is essential for optimal infant growth
and development, establishing maternal-infant bonding and reducing the risk of disease including
sudden infant death syndrome, asthma and diabetes.² For working mothers, returning to work
often results in the termination of or complication of breastfeeding.¹ One study found that in the
month a mother returns to work, she has 2.18 increased likelihood of quitting breastfeeding as her
nonworking counterparts.² Of the many barriers to breastfeeding in working women, unsupportive
work environment, inadequate time to express and lack of privacy are major contributors.² Fresno
County has one of the lowest rates of breastfeeding in California. In 2011, according to the
California Department of Public Health, 48.8% of women leaving Fresno hospitals were
exclusively breastfeeding⁹. According to Walmart’s 2014 Diversity and Inclusion Report, there
are approximately 1,550 women working for Walmart in Fresno County who could be affected by
Walmart’s lactation policies and procedures. Of the ten Walmarts in Fresno, only one had a
designated lactation room. This lactation room contains one chair and an outlet, but no other
amenities and is accessible to both customers and employees.²⁰ Therefore, it is imperative that
Walmart’s in the Fresno County area improve their lactation support to improve the breastfeeding
likelihood of their female employees.

Project Team
● Program Director (1)
○ Role:
■ Responsible for initiating and setting goals for the program to achieve
strategic objectives of the organization.
■ Management of budget and logistics.
■ Assist in the hiring of Implementation Supervisors and interns
■ Collaborate with Walmart HR administrators to develop policies and
strategies to support breastfeeding in the workplace.
■ Develop employee training materials with Implementation Supervisors.
■ Devise evaluation strategies to monitor performance and determine the
need for improvements.
■ Collaborate with team on development of final report.
○ Education: Minimum of a B.S. in relevant field (Business Management)
○ Experience: 3+ years in project management or another managerial role, research
experience
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● Implementation Supervisor (x2)

○ Roles:
■ Manage operations and communication with 5 Walmarts within Fresno
County and Mamava.
■ Oversee strategic placement and ensure successful installation of 5
Mamava units in stores.
■ Product testing and troubleshooting, optimizing Mamava amenities to meet
the specific needs of the employees
■ Collaborate with Walmart managers to create employee reservation system
for Mamava pods.
■ Represent CWLSG and Mamava at a Walmart employee health fair
■ Assist Program Director in employee training programs and marketing
■ Develop evaluations to monitor performance and determine the need for
improvements.
■ Collaborate with team on development of final report.
○ Education: Minimum of a B.S. in relevant field (Business Management)
○ Experience: 1+ year in project management or another managerial role, research
experience
● Data Collection Interns (x3)
○ Roles:
■ Collect quantitative data on frequency, usage and duration of Mamava
pods.
■ Develop and collect qualitative data user surveys from employees
regarding quality and effectiveness of Mamava pods and program.
■ Consolidate and organize data through a variety of software applications
(SPSS, SAS, Excel, Microsoft Office Suite), perform statistical analyses
■ Create detailed reports and simplified presentations of findings.
○ Education: Current undergraduate or graduate student in related field (Statistics,
Data Science, Business Administration, etc.)
○ Experience: 1+ year of research experience

CWLS’s Previous Experience

The California Worksite Lactation Support Group is a not-for-profit state-wide
organization that assists workplaces implement sustainable and successful policies and programs
to support breastfeeding employees. The California Worksite Lactation Support Group has
successfully helped improve breastfeeding policies and programs of companies in the Greater Los
Angeles and San Francisco Bay Area. The majority of the projects that the CWLSG have
managed improved the infrastructure within companies and partnered with the company’s human
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resources department. The Central Valley Branch of CWLSG has improved the policies of
companies in Fresno County, most of which are engineering and agriculture-related organizations.
The specific project of designating lactation space and implementing Mamava units is the first
program outside policymaking to be implemented by the CWLSG. The Central Valley Branch
will be partnering with Mamava, a portable lactation unit manufacturer, to implement units in 10
Walmarts of Fresno County. This project will be a pilot and, if successful, may be implemented in
larger cities like Greater Los Angeles and the San Francisco Bay Area.

Program Director’s Role

The individual leading this project will be the Program Director. The Program Director is
responsible for communicating between all of the partnering organizations including the
California Worksite Lactation Support Group, Walmarts, and Mamava. With the CWLSG Central
Valley Branch board, the Program Director will assist in the hiring of team members. They are
responsible for managing the two Implementation Specialists and 3 Data Collection Interns and
mobilizing all parties to achieving strategic objectives. The Program Director will oversee the
budget and operations, logistics and timeline of the implementation projects. They will collaborate
with Walmart HR administrators to develop policies and sustainable strategies and create
employee training materials to support breastfeeding in the workplace. The Program Director will
be the mastermind of developing evaluation strategies to monitor performance and determining
improvements. Finally they will develop a final report of the effectiveness, limitations,
achievements and evaluations of the program to present to the CWLSG National Board.

Partners with CWLS

Other than the Program Director, the personnel involved in this program will include the
Implementation Supervisor, Data Collection Interns, Mamava sales and service staff, Walmart
Human Resources department and managers of the stores in Fresno County. The roles of the
Implementation Supervisor and Data Collection Interns are outlined above. The policy formation
element of the project will entail meetings with Walmart Corporate (Global HR Operations, VP of
HR and Head of Talent Management, HR Strategy and Support, and more). We will collaborate
to refine existing policy to support all female employees, not only the salaried or full-time
employees. Within Fresno County, we will be partnering with the managers, assistant managers,
HR manager, HR training coordinators, people lead, and administrative assistants of each
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Walmart to create and implement employee trainings for the lactation units. Additionally,
independent lactation consultants will be contracted to meet with employees outside of work
hours.
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Form C - Project Description Page

1. Identify each Healthy People 2020 framework component, population health

improvement concept, topic areas, specific objectives, or topics that address the
determinants of health (social and physical environment, biology and genetics, health
services, or individual behavior) that your project will address. Explain why you chose
each component, concept, and/or topic.

Our project aims to address the social and physical environment of female Walmart
employees who are breastfeeding or are planning on breastfeeding. By creating infrastructure to
support breastfeeding, mothers may feel more comfortable continuing to breastfeed after returning
to work. We will be targeting female employees in Walmart Supercenters in Fresno County of
California, including the cities of Clovis, Firebaugh, Kingsburg, Fowler, Coalinga, Dos Palos,
Huron, Kerman, Mendota, Orange Cove, Parlier, Reedly, San Joaquin, Sanger, and Selma.
According to Walmart’s 2014 Diversity and Inclusion Report, 57% of Walmart’s associates are
females. If Walmart associates who are female holds true in Fresno County, there are
approximately 1,550 women working for Walmart in Fresno County who would benefit from the
implementation of Mamava Units.

Our main strategy is implementing Mamava lactation pods in Walmart stores and
encouraging mothers to use them freely. If a barrier to providing a private space to lactating
mothers was lack of space, these pods are an efficient method to achieving the HP 2020 goal. Our
specific goals include:

A. Increase lactation room utilization rates in Walmart stores of Fresno county by 50%
through the implementation of Mamava lactation units.
B. Improve breastfeeding retention rates by 50% through 6 months, but preferably up to 12
months.
C. One Mamava will be implemented in each Walmart of Fresno County within one year of
implementing the program.

Implementation of Mamava mobile lactation units in all Fresno County Walmart Centers.
Mamavas include benches, fold-down table, mirror, dual outlet and USB port, occupancy-
activated lighting, ceiling vents and exhaust fan, fridge-ready units available and can be reserved
with the Smart Access Mamava app. The Mamava pods will be set up near running water that is
not in a bathroom, preferably by an employee kitchen or breakroom.
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2. Describe the activities you will implement under each (or multiple) framework
component, concept or topic you selected. Please support your choice of activities from
the public health and/or scientific literature, planning tools, or past success with
implementing this activity for strategic/health improvement planning purposes.

Meeting with Walmart Director and Managers

The program director will meet with the Walmart regional director to inform him or her
about the intentions of the plan to implement Mamava Lactation pods in 10 local Fresno
Walmarts. The program director will discuss the budget, discuss the timeline, and go over what
will be discussed at the manager meetings. The program director will also discuss the health fair
events and explain the project’s plan to market for Mamava at these events. Finally, the program
director will present the director with examples of the surveys and resources - such as instruction
manuals - that will be important to implementing Mamava pods into 10 Walmarts in the Fresno
area.
Once the program director has discussed the overarching project to the regional director of
Walmart, the program director as well as the implementation supervisors will attend a local
Walmart manager meetings to facilitate discussion on breastfeeding policies. The program
director or implementation supervisors will bring copies of the Walmart breastfeeding policies to
distribute to the managers and will discuss the importance of encouraging employees to
breastfeed. The program director or implementation supervisor will address the local Fresno
department of public health’s flyer on breastfeeding which explain a mother’s rights to breastfeed
as well as gives local resources to breastfeeding mothers
(https://www.co.fresno.ca.us/home/showdocument?id=33090). The logistics of employees using
the pods will be discussed including the following policy: In addition to getting a paid 15-minute
break every 4 hours worked, lactating employees are entitled to 1 paid 25-minute break and 1
unpaid 15-minute break for every 4 hours worked. Theoretically, an employee working 8 hours a
day would receive two 15-minute breaks, two paid 25-minute breaks, and 2 unpaid 15-minute
breaks. Breastfeeding employees can choose at their discretion whether they need to take the two
unpaid breaks, or to continue working. The program director or implementation supervisor will
then show a video (https://www.youtube.com/watch?v=7W6TyB9Z1G0) about what Mamava is
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as well as a video on how to install the Mamava pods (https://vimeo.com/245014482). Placement

of the pods will be discussed and the supervisors will discuss with the managers the regulations of
where it can be placed. For instance, the pods must be close to running water that is not from a
bathroom and have access to power (further guidelines are in Walmart’s policies as well as in the
Mamva installation manuals, both of which will be discussed in these meetings). The managers
will be informed of their responsibility to appoint associates to build these pods under the
direction of our implementation supervisors. The managers will also be given resources to help
them train their employees on maintenance of the Mamava pods. The program director or
implementation supervisors will also discuss the Mamava and project’s presence at the annual
Walmart health fairs. The managers will be informed of how important their presence and support
is of this project so that the employees feel safe to ask questions and inquire about using Mamava
pods to breastfeed. Finally, the program director or implementation supervisors will address the
questions and concerns of the managers. It will then be the implementation supervisor’s
responsibility to follow up with the managers as the project proceeds.

Health Fair Outreach

A crucial part of marketing Mamava pods to the Walmart employees is the project’s
presence at the annual Walmart health fairs. In Fresno county there are two health fairs, one on
the northern side of town at the Walmart Supercenter on 7065 N Ingram Ave, Fresno, CA 93650,
and the other is on the southern end of town at the Walmart Supercenter on 5125 E Kings Canyon
Rd, Fresno, CA 93727. These two health fairs occur within a month in October 2020. The
implementation supervisors will attend each health fair. To each health fair, the implementation
supervisors will bring a fold up table with a tablecloth, a retractable Mamava banner to set up
next to the table, Mamva flyers with Mamava information on it, and Mamava stickers. The
implementation supervisors will also bring a TV monitor connected to one of the supervisor’s
laptops. This TV will show employees what a Mamava pod looks like via a slideshow of pictures.
The supervisors will collect emails from employees who wish to be informed on the Mamava
installation process, and will give away free breastfeeding items - including milk pads, bottles,
and diapers - if employees partake in breastfeeding trivia. The supervisors will also ask
employees to partake in a breastfeeding focus group, for employees to voice their opinions and
concerns about breastfeeding while working at Walmart and using/maintaining the Mamava pods.
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Focus groups

Focus groups would then occur to understand how employees in Fresno are feeling about
breastfeeding while working at Walmart and understand what some barriers to using the Mamava
pod would be. Focus groups will occur at three of the Walmart Supercenters during employees
lunch breaks. Managers will email employees about the opportunity, and data collection interns
will design flyers to post around the Walmart employee breakroom to inform employees about
when and where the focus group will occur. To incentivise participation in the focus groups, a
free lunch of sandwiches, salad, chips, and fruit will be provided to the employees obtained from
a local Panera Bread restaurant. Both implementation supervisors will attend each focus group. At
the beginning of the focus group, a quick survey, to assess barriers and general lactation
knowledge, will be passed around explaining what the purpose of the focus group is and ensuring
that whatever people say will not be a threat to their status as an employee. One supervisor will
lead the discussion and the other will take notes on what the employees feelings and thoughts are.
If the employees are comfortable, the audio of the session will be recorded on one of the
supervisor’s phones. Employees will go around and introduce themselves, then the supervisor will
briefly explain the purpose of the focus group. Questions to guide the conversation are as
following:

1. How many of you have children or are planning on having children?

2. Have you or your partner breastfed or had any experience with breastfeeding?
3. Would you or do you feel comfortable breastfeeding or pumping while at work? If you are
not breastfeeding, how do you feel about your colleagues breastfeeding at work?
4. How could Walmart help you feel more comfortable breastfeeding at work?
5. Have you ever encountered a Mamava pod or a similar designated lactation space? (show
them video from managers meeting if they have not seen one)
6. Would you be likely to use a Mamva pod if breastfeeding? If not breastfeeding, would you
encourage your breastfeeding cohort to use one? Why or why not?

Following the focus group, the supervisors will thank the participants and encourage them
to reach out individually if they have any more questions, concerns, or comments by emailing one
of the supervisors.

Mamava Installation/Maintenance/User/Scheduling Logistics

Implementation Supervisors will be assigned to oversee the Mamava installation in 5

Walmarts each. Supervisors will meet with the Store Managers and HR Supervisors of each
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Walmart to determine optimal locations for Mamavas to be installed. The location must be 30 feet
from a bathroom or running water source, in a place that will not disrupt the flow of customers,
employees or machinery, and preferably close to the Walmart office and breakroom areas.
Supervisors will take measurements of the area designated for the Mamava, mark optimal
location(s) on a blueprint of the store for recordkeeping. Blueprints to be scanned and kept in a
physical file cabinet and uploaded to CWLSG’s cloud drive. Information will be sent to the
Program Director who will order the Mamava after confirmation from Implementation
Supervisor.
Implementation Supervisors will coordinate with Store Managers on the best date/time to
install Mamavas depending on peak hours, time of store deliveries, volume of staff, etc.
Implementation Supervisors will communicate with Mamava Delivery and oversee the entire
installation process which should take less than 1 day to complete. After Mamavas are
successfully installed, Implementation Supervisors will test-run with Mamava staff and create a
customized “How-To” guide for employees to be posted in every Mamava. This includes how to
reserve and unlock Mamava, how to use amenities, and closing procedures before leaving the
lactation pod (such as cleaning, restoring original settings, etc.) Each Mamava will be outfitted
with a shower caddy with paper towels, disinfectant cleaning spray, tissues and hand sanitizer.
After specific policy regarding Mamava is solidified, the Program Director and
Implementation Supervisors will speak at the nearest upcoming associate meeting to discuss the
logistics of using Mamava. The HR Supervisors will meet with breastfeeding employees
interested in using the service to determine the best time for the employee to take their break to
lactate and whether the mother wants to meet with a Lactation Consultant outside of working
hours. The HR Supervisors will use Mamava’s reservation system to schedule employees to use
the Mamava. Given the volume of employees that need to use the room, break times may have to
shift and be flexible. Because the policy offers an unpaid 15-minute break, a breastfeeding
employee may not always choose to take that break, but her breaktime will always be scheduled
into the Mamava system so she has the option and space to lactate. A 10 minute buffer time will
be scheduled in-between every Mamava appointment. To unlock and lock the Mamava at the time
of her reservation, the employee will obtain a key from the HR Supervisor’s office.
Lactation Consultants will be contracted with independent consultants referred to by
Fresno County’s Department of Public Health: Jennifer Lynn Haning, IBCLC, RC; Noreen
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Siebenalar, MSN, RN, IBCLC; Melissa Hunter, CCE(BFW), CD/PCD(DONA), CLC; Tess
Johnson, RN, PHN, IBCLC. Consultants typically meet 1.5-2 hours with mother and charge
anywhere between $80-120 for the first consultation. Walmart’s match with our program will
allow mothers to meet with a Lactation Consultant for a first appointment for free; any
appointment after will not be covered.

Data Collection/Evaluation

At the end of the program, a post survey will be conducted by the program supervisors to
be completed by women who are breastfeeding at Walmart, in order to assess the barriers and
knowledge in regards to lactating in the working place. Program supervisors will collect data to
be compared to the previous data collected in the pre survey conducted in the focus group at the
beginning of the program.

Each Mamava Pod will contain surveys for the users to rate their experience while using
the pod. This survey includes 5 faces going from very unsatisfied to extremely satisfied, amenities
used, and number of times having utilized Mamava. Additionally, there’s a section in which users
could describe what made them choose their level of satisfaction. Mothers will be encouraged to
fill out the satisfaction survey at least once a week with the goal of giving the program
supervisors feedback on things that are going as planned and/or areas of improvement and
concern. At the end of each week, the supervisors will collect the survey sheets and will inform
managers on things that are working out for the mothers, as well as areas that could use
improvement and possible solutions.

3. If not directly tied to your activity(s), describe how you will involve multi-sectoral and
interdisciplinary perspectives and contributions to your project?

The Regional Director will be involved in the education of Walmart managers about the
importance of enforcing lactation policies. The Regional Director will also help educate the
managers on what Mamava is, and how to set them up.
Walmart managers will help us put together Mamava outreach events and help inform
female employees about their rights as well as the importance of breastfeeding while working.
The managers will train the associates to build the Mamava pods, maintain them and create a
positive and encouraging environment for breastfeeding women. The Walmart managers will also
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help keep the program sustainable and continue to maintain the Mamava pods as well as
encourage their female employees who are mothers or expecting mothers to utilize these pods.
Local lactation consultants in the Fresno area will come to the Mamava outreach events to
help educate mothers on the importance and benefits of breastfeeding to mother, child, and
society as a whole. Lactation consultants will provide, by appointment, a private consultation with
mothers after Mamavas have been installed. Lactation consultants will also educate women on
further lactation support in the community such as WIC or La Leche League.
We will provide blueprints/layouts of each Walmart store with the optimal location for a lactation
space; project timeline; utilization data and survey data collected from users.

4. What measures will you use to demonstrate the impact of your activities? What is
your evaluation plan?

The impact of our activities will be monitored three times, first with a process evaluation,
second with a summative evaluation, and third with an impact evaluation. The process evaluation
will examine the Mamava pods and how they are received by Walmart employees via a survey
and focus group that will occur three at three of the different walmarts prior to the implementation
of the pods.
The Summative evaluation will have multiple parts. First measure whether or not the
Mamava pods are satisfactory for the breastfeeding employees at Walmart to use. One part of this
evaluation is a survey that has an area for any comments the mothers would like to share. This
satisfaction survey will occur once a week until the end of the project and at the end of each week,
the supervisors will collect the survey sheets and inform the managers on things that are working
for the mothers, as well as areas that could use improvement and possible solutions. At the end of
the project, all this data will be compiled and evaluated. The second part of the summative
evaluation will be a survey given to any mothers who used the Mamava pods at the end of the 6
months where they will be asked for their demographic data, and about their experience
breastfeeding and using the Mamava pods.
For an impact evaluation CWLS will send Walmart an electronic version of the post-
intervention survey to distribute to every mother who is registered to use the Mamava pods. These
surveys will return to CWLS where the director of CWLS will analyze the data and compare it to
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the survey sent 6 months prior at the end of the project. Specifically, the director will be
monitoring the larger impact that the Mamava pods had on the target population of women who
work at Walmart and would like to breastfeed. This data will then be returned to Walmart for their
own use and evaluation.

5. Describe how this project will complement your agency’s Healthy People 2020 state,
territorial or tribal planning activities in progress or under consideration.

The HP 2020 MICH-22 goal is to increase the proportion of employers that have worksite
lactation support programs. The baseline from 2009 was 25% of employers reported providing an
onsite lactation/mother’s room; the 2020 target is 38%. From 2009 to 2014 the percentage of
employers have increased to 34% in 2013 but decreased to 28% in 2014. The target-setting
method justification from HP2020 website states, “returning to work is a common reason mothers
cite for having to discontinue or reduce breastfeeding. Worksite lactation support is a strategy that
may help working mothers continue. According to data from the Society for Human Resource
Management, the trend for the proportion of employers providing worksite lactation support each
year from 2001 through 2009 predicts an increase of about 1.2 percentage points per year. The
proposed target of 38 percent is reasonable given this trend.”
Our target employer Walmart, Inc. lacks infrastructure to support pregnant and lactating
employees in the ten Walmart stores of Fresno County. Current corporate maternity benefits
allow mothers to take up to 16 weeks of protected paid maternity leave while receiving 100% of
their pay. However, these benefits only apply to salaried or full-time hourly associates who have
worked at Walmart for at least 12 months. With the majority of Walmart employees being part-
time, there are limited policies supporting breastfeeding for thousands of female employees.
Implementing Mamava portable lactation units in store spaces will ensure that Walmart
complies with federal regulations while providing mothers a private and well-outfitted
environment to breastfeed. With these spaces, female employees of childbearing age may feel
more comfortable breastfeeding at work and breastfeeding retention rates may be improved.
Walmart is a major employer and has 4,177 stores across the United States. If our pilot program is
successful in Fresno County, the CWLSG can implement this program in Walmarts throughout
the rest of the nation, and potentially improve the built environment for hundreds of thousands of
women.
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Additionally, as companies strive to be more socially-conscious and offer enhanced

benefits, Walmart’s efforts to support breastfeeding in the workplace may encourage other
companies and competitors like Target, Ikea, Costco, and CVS to follow suit. This is an
advantage of the competitive nature of capitalism and has the potential to increase the percentage
of employers offering worksite lactation programs.
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Form D - Partnership Description Page

Agency Name: CWLSG

Mamava, LLC.
Length of Relationship: 6 months
Area of Expertise: Manufacturer and distributor of lactation pod equipment
Roles and Responsibilities: Effectively communicate with Implementation Supervisors;
installation and maintenance of units, disseminate usage data to Data Collection Interns
Resources: 10 Mamava lactation units

Walmart, Inc.
Length of Relationship: 2 years
Area of Expertise: Organization that offers significant potential in supporting lactating mothers.
Roles and Responsibilities: Create supportive and sustainable local policies and programs with
the expertise from the Program Director and CWLSG; integrate and utilize program to support
breastfeeding employees.
Resources: $100,000 from project matching grant

Lactation Consultants: independent consultants

Length of Relationship: 6 months
Area of Expertise: Lactation consultants are specialists trained to teach mothers about how to
breastfeed and troubleshoot issues like latching difficulties, painful nursing, and low milk
production. They also train women returning to work or school on using breastfeeding equipment,
how to safely store and express milk.
Contracted Lactation Consultants (referred by Fresno County’s Department of Public Health):
● Jennifer Lynn Haning, IBCLC, RC
● Noreen Siebenalar, MSN, RN, IBCLC
● Melissa Hunter, CCE(BFW), CD/PCD(DONA), CLC
● Tess Johnson, RN, PHN, IBCLC
Resources: $2,000, enough to cover 200 lactation consultant meetings
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Form E - Project Work Plan Page

Agency Name: CWLSG

Start Date End Date Person Responsible

Project Activities

Hiring of Program Sept. 1, 2020 Oct. 1, 2020 CWLSG

Director and Program Director
Implementation
Supervisors

Recruit interns from

CSU Fresno, Fresno City
College, Clovis
Community College

Apply for Walmart.org Sept. 1, 2020 Oct. 1, 2020 CWLSG

Grants RFPs Program Director
https://walmart.org/reque
st-for-proposal-rfp

Attend meetings with Oct. 1, 2020 Nov. 1, 2020 Program Director

Walmart Management, Implementation Supervisors
Fresno to determine a Data Collection Interns
more specific needs
assessment of employees

Policy formation Oct 1, 2020 Nov. 1, 2020 Program Director

(collaboration with Implementation Supervisors
Walmart HR Supervisor)

Attend Walmart Oct. 1, 2020 Nov. 1, 2020 Implementation Supervisors

employee Health fair to
effectively market
Mamava pods to target
audience

Hold focus groups at Nov. 1, 2020 Dec. 1, 2020 Implementation Supervisors

three of the Walmarts
and collect formative
surveys
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Analyze data (pre- Dec. 1, 2020 Dec. 31, 2020 Program Director
intervention) and decide
which amenities and
training plan will be
most effective

Contact Walmarts about Dec. 1, 2020 Dec. 5, 2020 Implementation Supervisors

the implementation of
Mamava in store spaces

Mamava pod ordering Dec. 6, 2020 Program Director

Installation begins Jan. 1, 2021 Implementation Supervisors

Mamava Representative

Installation complete in Jan. 15, 2021 Implementation Supervisors

all 10 Walmart stores Mamava Representative

Mamava pod testing Jan. 15, 2021 Jan. 30, 2021 Implementation Supervisors
integrating reservations Mamava Representative
into employee system
(employee cards to
unlock)

Video production on how

to use Mamava;
flyer/handout Data Collection Interns

Employee Training Jan. 15 2021 Jan. 30, 2021 Implementation Supervisors

(policies, how to use Program Director
Mamavas, breaktime and Walmart HR Supervisor
amount of breaks during
shift, etc, where to store
milk)
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Mamava launch! Feb. 1, 2021 Implementation Supervisors

Data collection (Mamava Feb. 1, 2021 June 30, 2021 Data Collection Interns
utilization, frequency, Program Director
etc.) administer surveys
(post-intervention)
Implementation Supervisors
Continuous evaluation
and program
maintenance

Data consolidation and July. 1, 2021 July 31, 2021 Data Collection Interns
organization Program Director

Follow-up evaluation Aug. 1, 2021 Aug. 31 2021 Program Director

report Implementation Specialists
Data Collection Interns
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Form F - Budget Form

Agency Name: CWLSG
Table I. Expenses
Direct Costs A. Salaries and Wages Program Director $45,000
(40 hours/week)

Implementation Supervisors $25,000/

x2 (20 hours/week) $50,000

Interns x3 $0

Up to 200 Lactation $100/

Consultant visits $2,000

B. Fringe Benefits Sick leave, subsidized meals $2,000

C. Equipment 10 Mamavas $95,000

Installation Fees $1,000

D. Materials and Supplies 4 Laptops for data entry and $2,000

communication between
Mamava and Walmart staff

10 caddies with paper $1,000

towels, disinfectant cleaning
spray, tissues, hand sanitizer
and extra supplies

E. Travel (between the 10 Gas reimbursements $1,600

Walmart stores in ($0.58/mi)
Fresno, County)

TOTAL $99,600

Table II. INCOME

Amount Requested from HP2020 Action Project $100,000

Walmart, Inc. Matching Grant $100,000

Walmart has local community grants (up to $2,500) and can match
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donations through Request for Proposals for the following programs --

Enhancing Sustainability: Worker Dignity, Strengthening Community:
Diversity, Equity and Inclusion.

TOTAL $200,000
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FORM G - Budget Information

Agency Name: CWLSG

Budget Information

Name of Person Responsible for Managing Project Funds: TBD

Position with Agency: Project Director

Mailing Address: 122 W Main St. Fresno, CA 93650

Email: programdirector@clswg.org

Phone: (559) 621-7640 Fax: (559) 621-7640

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REFERENCES
MICH-22 Data Details. (n.d.). Retrieved October 15, 2019, from
https://www.healthypeople.gov/node/4864/data_details.
Murtagh, L. D., & Moulton, A. D. (2011). Working Mothers, Breastfeeding, and the Law.
American Journal of Public Health, 101(2), 217–223. doi: 10.2105/ajph.2009.185280
Kozhimannil, K. B., Jou, J., Gjerdingen, D. K., & Mcgovern, P. M. (2016). Access to
Workplace Accommodations to Support Breastfeeding after Passage of the Affordable
Care Act. Womens Health Issues, 26(1), 6–13. doi: 10.1016/j.whi.2015.08.002
Centers for Disease Control and Prevention. National Center for Chronic Disease
Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity.
Data, Trend and Maps: Breastfeeding - Behavior in California. Retrieved Oct 15, 2019
from https://www.cdc.gov/nccdphp/dnpao/data-trends-maps/index.html.
Lauer, E., Armenti, K., Henning, M., & Sirois, L. (2019). Identifying Barriers and
Supports to Breastfeeding in the Workplace Experienced by Mothers in the New
Hampshire Special Supplemental Nutrition Program for Women, Infants, and Children
Utilizing the Total Worker Health Framework. International Journal of Environmental
Research and Public Health, 16(4), 529. doi: 10.3390/ijerph16040529
Dir, S. of C. D. of I. R. (2019, March). Lactation Accommodation. Retrieved from
https://www.dir.ca.gov/dlse/Lactation_Accommodation.htm.
County of Fresno. (n.d.). Retrieved October 15, 2019, from
https://www.co.fresno.ca.us/departments/board-of-supervisors/county-s-administrative-
policies.
College of Health and Human Services California State University, Fresno . (2017). First 5
Fresno County. First 5 Fresno County. Fresno, CA.
Global Office of Diversity and Inclusion. (2014). Walmart Stores Inc. Walmart Stores Inc.
Bentonville, AR.
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APPENDICES

PRE - INTERVENTION SURVEY CODE#

DEMOGRAPHIC DATA

Sex Age group Are you pregnant?

⃞ Male ⃞ Under 18 ⃞ Yes
⃞ Female ⃞ 18-24 years ⃞ No
⃞ 25-30 years
Gender Are you breastfeeding?
⃞ 31-35 years
⃞ Man ⃞ Yes
⃞ 36-40 years
⃞ Woman ⃞ No
⃞ 41-45 years
⃞ Other
⃞ 46+ years

Do you have any children? How long have you been working Please indicate the following:
⃞ Yes at Walmart? ⃞ Full-time (40 hours)
⃞ < 1 month
⃞ No ⃞ Part-time
⃞ < 6 months ________ hours/week
If yes, what ages? ⃞ < 1 year
⃞ Infant (0-1 years) ⃞ Opening shift
⃞ 1-2 years
⃞ Toddler (1-3 years) ⃞ Day shift
⃞ 2-3 years
⃞ 4 - 12 years ⃞ Closing shift
⃞ 3-4 years
⃞ 13-17 years ⃞ Overnight shift
⃞ 5+ years
⃞ Over 18 years
⃞ 10+ years
⃞ Weekdays
⃞ Weekends

QUESTIONS

On a scale of 1 to 5, how comfortable are you with breastfeeding?

Least comfortable Most comfortable
1 2 3 4 5

On a scale of 1 to 5, how knowledgeable are you about breastfeeding?

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Least knowledgeable Most knowledgeable

1 2 3 4 5

On a scale of 1 to 5, how comfortable would or do you feel breastfeeding while at work?

Least comfortable Most comfortable
1 2 3 4 5

Please select what you would consider to be significant barriers to breastfeeding in the workplace:
⃞ Lack of sufficient time
⃞ Fear that you will be fired or backlash from manager/other employees
⃞ Lack of adequate space/privacy
⃞ Lack of knowledge on how to safely breastfeed at work
⃞ Lack of space to store breastmilk
⃞ Lack of equipment to breastfeed

Would you choose to breastfeed at work if you knew that you could be guaranteed adequate time and a private
space to expel milk?
⃞ Yes
If your answer is yes, how often?
⃞ Twice per shift
⃞ Once per shift
⃞ A couple times/week
⃞ Once a week
⃞ No
If your answer is no, please explain why:

Please write any questions, comments or concerns here:

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FOR CWLSG USE ONLY CODE# 4DAF89VI21

POST - INTERVENTION SURVEY CODE#

DEMOGRAPHIC DATA

Sex Age group Are you pregnant?

⃞ Male ⃞ Under 18 ⃞ Yes
⃞ Female ⃞ 18-24 years ⃞ No
⃞ 25-30 years
Gender Are you breastfeeding?
⃞ 31-35 years
⃞ Man ⃞ Yes
⃞ 36-40 years
⃞ Woman ⃞ No
⃞ 41-45 years
⃞ Other
⃞ 46+ years

Do you have any children? How long have you been working Please indicate the following:
⃞ Yes at Walmart? ⃞ Full-time (40 hours)
⃞ < 1 month
⃞ No ⃞ Part-time
⃞ < 6 months ________ hours/week
If yes, what ages? ⃞ < 1 year
⃞ Infant (0-1 years) ⃞ Opening shift
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⃞ Toddler (1-3 years) ⃞ 1-2 years ⃞ Day shift

⃞ 4 - 12 years ⃞ 2-3 years ⃞ Closing shift
⃞ 13-17 years ⃞ 3-4 years ⃞ Overnight shift
⃞ Over 18 years ⃞ 5+ years
⃞ Weekdays
⃞ 10+ years
⃞ Weekends

QUESTIONS

On a scale of 1 to 5, how comfortable are you with breastfeeding?

Least comfortable Most comfortable
1 2 3 4 5

On a scale of 1 to 5, how knowledgeable are you about breastfeeding?

Least knowledgable Most knowledgable
1 2 3 4 5

On a scale of 1 to 5, how comfortable would or do you feel breastfeeding while at work?

Least comfortable Most comfortable
1 2 3 4 5

Please select any significant barriers to breastfeeding in the workplace:

⃞ Lack of sufficient time
⃞ Fear that you will be fired or backlash from manager/other employees
⃞ Lack of adequate space/privacy
⃞ Lack of knowledge on how to safely breastfeed at work
⃞ Lack of space to store breastmilk
⃞ Lack of equipment to breastfeed

Are you more likely to breastfeed at work now because of the policies guaranteeing adequate time and a private
space (Mamava Lactation Units)?
⃞ Yes
⃞ Maybe
⃞ No
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Does the option of meeting with a lactation consultant encourage you or allow you to feel more comfortable
breastfeeding in the workplace?
⃞ Yes
⃞ Maybe
⃞ No

What amenities would increase your comfortability of breastfeeding in the workplace?

⃞ More benches
⃞ Separate mini-fridge for milk storage
⃞ Soundproof walls
⃞ Breast pumps for employee use
⃞ Running water close to the Mamava

On a scale of 1-5 how supported do you feel by Walmart HR as a result of this program?
Not supported at all Extremely supported
1 2 3 4 5

Please write any questions, comments or concerns here:

FOR CWLSG USE ONLY CODE# 4DAF89VI21

Satisfaction Survey For Mamava Users CODE#

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Date: Time: ___:___ AM / PM

Length of use of Mamava: _______ minutes
Previous Use:
⃞ First-time user
⃞ 2-3 time user
⃞ 3+ time user

1. Please take a moment to rate your experience:

Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied

2. Which amenities did you use?

⃞ Benches
⃞ Fold-down table
⃞ Mirror
⃞ Dual outlet and USB port
⃞ Occupancy-activated lighting

3. Please elaborate your degree of satisfaction of this service.

_____________________________________________________________________________
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_____________________________________________________________________________
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