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Effects of Peer Counseling to Support Breastfeeding: Assessing the External Validity of a Randomized Field Experiment

Author

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  • 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.

Suggested Citation

  • Onur Altindag & Theodore J. Joyce & Julie A. Reeder, 2015. "Effects of Peer Counseling to Support Breastfeeding: Assessing the External Validity of a Randomized Field Experiment," NBER Working Papers 21013, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:21013
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    References listed on IDEAS

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    1. LaLonde, Robert J, 1986. "Evaluating the Econometric Evaluations of Training Programs with Experimental Data," American Economic Review, American Economic Association, vol. 76(4), pages 604-620, September.
    2. Angus Deaton, 2010. "Instruments, Randomization, and Learning about Development," Journal of Economic Literature, American Economic Association, vol. 48(2), pages 424-455, June.
    3. A. Smith, Jeffrey & E. Todd, Petra, 2005. "Does matching overcome LaLonde's critique of nonexperimental estimators?," Journal of Econometrics, Elsevier, vol. 125(1-2), pages 305-353.
    4. James J. Heckman & Jeffrey A. Smith, 1995. "Assessing the Case for Social Experiments," Journal of Economic Perspectives, American Economic Association, vol. 9(2), pages 85-110, Spring.
    5. Michael Woolcock, 2013. "Using Case Studies to Explore the External Validity of ‘Complex’ Development Interventions," CID Working Papers 270, Center for International Development at Harvard University.
    6. Oliveira, Victor & Frazao, Elizabeth & Smallwood, David M., 2010. "Rising Infant Formula Costs to the WIC Program: Recent Trends in Rebates and Wholesale Prices," Economic Research Report 59384, United States Department of Agriculture, Economic Research Service.
    7. repec:pri:rpdevs:deaton_instruments_randomization_learning_all_04april_2010 is not listed on IDEAS
    8. Abhijit V. Banerjee & Esther Duflo, 2009. "The Experimental Approach to Development Economics," Annual Review of Economics, Annual Reviews, vol. 1(1), pages 151-178, May.
    9. Rodrik, Dani, 2008. "The New Development Economics: We Shall Experiment, but How Shall We Learn?," Working Paper Series rwp08-055, Harvard University, John F. Kennedy School of Government.
    10. Guido W. Imbens, 2010. "Better LATE Than Nothing: Some Comments on Deaton (2009) and Heckman and Urzua (2009)," Journal of Economic Literature, American Economic Association, vol. 48(2), pages 399-423, June.
    11. Pritchett Lant & Sandefur Justin, 2014. "Context Matters for Size: Why External Validity Claims and Development Practice do not Mix," Journal of Globalization and Development, De Gruyter, vol. 4(2), pages 161-197, March.
    12. Alberto Abadie & Matthew M. Chingos & Martin R. West, 2013. "Endogenous Stratification in Randomized Experiments," NBER Working Papers 19742, National Bureau of Economic Research, Inc.
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    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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