1
|
Knox O, Parker D, Johnson D, Dombrowski SU, Thomson G, Clarke J, Hoddinott P, Jolly K, Ingram J. Text message conversations between peer supporters and women to deliver infant feeding support using behaviour change techniques: A qualitative analysis. Midwifery 2023; 127:103838. [PMID: 37839159 DOI: 10.1016/j.midw.2023.103838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE To analyse text message conversations between peer supporters (called Infant Feeding Helpers - IFHs) and new mothers using qualitative methods to understand how peer support can influence and support women's feeding experiences. DESIGN Qualitative analysis of text messages conversations using both inductive thematic and deductive content approaches to coding. Thematic analysis of the text message transcripts and deductive content analysis was used to code if Behaviour Change Techniques (BCTs) were employed by IFHs in their interactions with women. BCTs coded in text messages were then compared with those tabulated from antenatal meeting recordings and documented in interview transcripts. PARTICIPANTS AND SETTING 18 primiparous women and 7 Infant Feeding Helpers from one community site in South-West England. FINDINGS Three key themes were identified in the18 text message conversations (1679 texts): 'breastfeeding challenges', 'mother-centred conversations', and 'emotional and practical support'. The core BCTs of 'social support' and 'changing the social environment' were found at least once in 17 (94 %) and 18 (100 %) text message conversations respectively. Meanwhile, 'instruction to perform the behaviour' was used at least once in over 50 % of conversations. Generally, the use of BCTs was greatest between birth and two weeks during a period of daily texts when women reported many feeding challenges. The number and range of BCTs used in text messages were similar to those documented in audio-recorded meetings and interview accounts. CONCLUSION AND IMPLICATIONS Infant Feeding Helpers were able to provide engaging and successful breastfeeding peer support through text messages. Messaging was shown to be an appropriate and accessible method of delivering BCTs focussing on 'social support' and 'changing the social environment'. Peer supporters delivering BCTs via text messages is acceptable and appropriate to use if in-person support is limited due to unforeseen circumstances such as the COVID-19 pandemic.
Collapse
Affiliation(s)
- Olivia Knox
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol UK
| | - Denise Parker
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol UK
| | - Debbie Johnson
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol UK
| | | | - Gill Thomson
- School of Community Health & Midwifery, University of Central Lancashire, UK
| | - Joanne Clarke
- Institute of Applied Health Research, University of Birmingham, UK
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professionals Research Unit, University of Stirling, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, UK
| | - Jenny Ingram
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol UK.
| |
Collapse
|
2
|
Yu Y, Liu Q, Xiong X, Luo Y, Xie W, Song W, Fu M, Yang Q, Yu G. Breastfeeding needs of mothers of preterm infants in China: a qualitative study informed by the behaviour change wheel. Int Breastfeed J 2023; 18:50. [PMID: 37658411 PMCID: PMC10472562 DOI: 10.1186/s13006-023-00587-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/25/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Although breastfeeding is strongly recommended, the breastfeeding rate of preterm infants in China remains significantly low. In addition to the global structural challenges to breastfeeding and the physiological immaturity of preterm infants, Chinese mothers of preterm infants face unique challenges of maternal-infant separation after birth. Moreover, little is known about Chinese mothers' specific needs in coping with the difficulties posed by these challenges. This study utilized the Behaviour Change Wheel to investigate the breastfeeding needs of Chinese preterm mothers that may facilitate its practice in the future. METHOD A qualitative descriptive design was implemented in Wuhan in 2022. Based on purposeful sampling, 13 preterm mothers were recruited from a NICU in a Grade III Class A hospital in Wuhan, China. Face-to-face semi-structured interviews were conducted to collect data using the interview guide developed by the Theoretical Domains Framework. Theoretical Thematic Analysis was used to review the data in 6 steps to identify themes. RESULTS Five major themes emerged: (1) capability: ability to interpret infants' cues and identify problems, and need for breastfeeding knowledge and skills training; (2) physical opportunity: cleanliness and quietness in household environment, private lactation spaces and breastfeeding tools in workplaces and hospitals; (3) social opportunity: family support, peer support, and authoritative support from healthcare providers; (4) reflective motivation: information on health impacts of breastfeeding; (5) automatic motivation: maternal-infant bonding, free of aversive stimulus. CONCLUSION Preterm mothers' needs to enable breastfeeding were diverse, including increasing their capability, physical and social opportunities, and reflective and automatic motivation. People, resources and environments associated with these needs should be engaged together to stablish a conducive structural environment for breastfeeding. The policy change for "zero separation" and implementation of kangaroo care should also be implemented in Chinese neonatal intensive care units. Future studies are needed to design effective interventions according to mothers' specific needs.
Collapse
Affiliation(s)
- Yaqi Yu
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, China
| | - Qianru Liu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, China
- Nursing Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277, Jiefang Avenue, Wuhan, China
| | - Xiaoju Xiong
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China
| | - Ying Luo
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China
| | - Wen Xie
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, China
| | - Wenshuai Song
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, China
| | - Maoling Fu
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, China
| | - Qiaoyue Yang
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, China
| | - Genzhen Yu
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China.
| |
Collapse
|
3
|
Moran C, Thomson G, Moran V, Fallon V. The content, experiences and outcomes of interventions designed to increase early skin-to-skin contact in high-income settings: A mixed-methods systematic review. Acta Paediatr 2023; 112:200-221. [PMID: 36260059 PMCID: PMC10100171 DOI: 10.1111/apa.16575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/18/2022] [Indexed: 01/13/2023]
Abstract
AIM To explore the content, experiences and outcomes of interventions designed to increase early skin-to-skin contact (SSC) in high-income settings. METHODS A mixed-methods systematic review was undertaken across six bibliographic databases. References of all included studies were hand-searched. All papers were quality appraised using a mixed-method appraisal tool. A narrative synthesis was used to synthesise both quantitative and qualitative findings. RESULTS Database searches generated 1221 hits, and two studies were identified via hand-searching. Ten studies were included; most (n = 7) were designed to improve SSC following a caesarean section, and half were of low/poor quality. Outcomes related to SSC prevalence and/or duration (n = 7), breastfeeding prevalence, (n = 4) and six explored mothers' and/or health professionals' experiences of the intervention. While the interventions had 'some' impact on the prevalence of SSC, the duration was often limited and not in line with WHO recommendations. Breastfeeding rates (exclusive/any) were found to improve but generally not to a significant extent. Mother and healthcare professionals were positive about the interventions, with barriers to implementation noted. Most interventions targeted healthcare professionals, rather than mothers. CONCLUSION High-quality interventions that increase SSC in line with WHO recommendations, and that target both health professionals and parents are needed.
Collapse
Affiliation(s)
- Chloe Moran
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Gill Thomson
- MAINN Research Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
| | - Victoria Moran
- Reader in Maternal & Child Nutrition, MAINN Research Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
| | - Victoria Fallon
- Department of Psychology, University of Liverpool, Liverpool, UK
| |
Collapse
|
4
|
McIsaac JLD, MacQuarrie M, Barich R, Morris S, Turner JC, Rossiter MD. Responsive Feeding Environments in Childcare Settings: A Scoping Review of the Factors Influencing Implementation and Sustainability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11870. [PMID: 36231167 PMCID: PMC9564844 DOI: 10.3390/ijerph191911870] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Children benefit from responsive feeding environments, where their internal signals of hunger and satiety are recognized and met with prompt, emotionally supportive and developmentally appropriate responses. Although there is existing research on responsive feeding environments in childcare, there is little synthesized literature on the implementation practices using a behavior change framework. This scoping review sought to explore the factors influencing the implementation and sustainability of responsive feeding interventions in the childcare environment, using the behavior change wheel (BCW). A total of 3197 articles were independently reviewed and 39 met the inclusion criteria. A thematic analysis identified the factors influencing the implementation and sustainability of responsive feeding, including the following: (1) pre-existing nutrition policies, (2) education and training, (3) provider beliefs and confidence, (4) partnership development and stakeholder engagement and (5) resource availability. The most common BCW intervention functions were education (n = 39), training (n = 38), environmental restructuring (n = 38) and enablement (n = 36). The most common policy categories included guidelines (n = 39), service provision (n = 38) and environmental/social planning (n = 38). The current literature suggests that broader policies are important for responsive feeding, along with local partnerships, training and resources, to increase confidence and efficacy among educators. Future research should consider how the use of a BCW framework may help to address the barriers to implementation and sustainability.
Collapse
Affiliation(s)
- Jessie-Lee D. McIsaac
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Madison MacQuarrie
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Rachel Barich
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| | - Sarah Morris
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Joan C. Turner
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Melissa D. Rossiter
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| |
Collapse
|
5
|
Leeming D, Marshall J, Hinsliff S. Self-conscious emotions and breastfeeding support: A focused synthesis of UK qualitative research. MATERNAL AND CHILD NUTRITION 2021; 18:e13270. [PMID: 34651437 PMCID: PMC8710115 DOI: 10.1111/mcn.13270] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/09/2021] [Accepted: 09/01/2021] [Indexed: 11/26/2022]
Abstract
Research on women's experiences of infant feeding and related moral discourse suggests that self‐conscious emotions may be highly relevant to breastfeeding support interactions. However, the emotional impact of receiving support has not been fully explored. The aim of this review is to re‐examine qualitative UK research on receiving breastfeeding support, in order to explore the role of self‐conscious emotions and related appraisals in interactions with professional and peer supporters. From 2007 to 2020, 34 studies met criteria for inclusion. Using template analysis to identify findings relevant to self‐conscious emotions, we focused on shame, guilt, embarrassment, humiliation and pride. Because of cultural aversion to direct discussion of self‐conscious emotions, the template also identified thoughts about self‐evaluation, perceptions of judgement and sense of exposure. Self‐conscious emotions were explicitly mentioned in 25 papers, and related concerns were noted in all papers. Through thematic synthesis, three themes were identified, which suggested that (i) breastfeeding ‘support’ could present challenges to mothering identity and hence to emotional well‐being; (ii) many women managed interactions in order to avoid or minimise uncomfortable self‐conscious emotions; and (iii) those providing support for breastfeeding could facilitate women's emotion work by validating their mothering, or undermine this by invalidation, contributing to feelings of embarrassment, guilt or humiliation. Those supporting breastfeeding need good emotional ‘antennae’ if they are to ensure they also support transition to motherhood. This is the first study explicitly examining self‐conscious emotions in breastfeeding support, and further research is needed to explore the emotional nuances of women's interactions with supporters.
Collapse
Affiliation(s)
- Dawn Leeming
- Department of Psychology, School of Human & Health Sciences, University of Huddersfield, Queensgate, Huddersfield, UK
| | - Joyce Marshall
- Division of Maternal Health, School of Human & Health Sciences, University of Huddersfield, Queensgate, Huddersfield, UK
| | - Sophie Hinsliff
- Division of Maternal Health, School of Human & Health Sciences, University of Huddersfield, Queensgate, Huddersfield, UK
| |
Collapse
|
6
|
Musgrave LM, Baum A, Perera N, Homer CS, Gordon A. Baby Buddy App for Breastfeeding and Behavior Change: Retrospective Study of the App Using the Behavior Change Wheel. JMIR Mhealth Uhealth 2021; 9:e25668. [PMID: 33856351 PMCID: PMC8085747 DOI: 10.2196/25668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/09/2020] [Accepted: 03/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background Breastfeeding plays a major role in the health of mothers and babies and has the potential to positively shape an individual’s life both in the short and long term. In the United Kingdom (UK), although 81% of women initiate breastfeeding, only 1% of women breastfeed exclusively to 6 months as recommended by the World Health Organization. In the UK, women who are socially disadvantaged and younger are less likely to breastfeed at 6 to 8 weeks postpartum. One strategy that aims to improve these statistics is the Baby Buddy app, which has been designed and implemented by the UK charity Best Beginnings to be a universal intervention to help reduce health inequalities, including those in breastfeeding. Objective This study aimed to retrospectively examine the development of Baby Buddy by applying the Behavior Change Wheel (BCW) framework to understand how it might increase breastfeeding self-efficacy, knowledge, and confidence. Methods Retrospective application of the BCW was completed after the app was developed and embedded into maternity services. A three-stage process evaluation used triangulation methods and formalized tools to gain an understanding of the potential mechanisms and behaviors used in apps that are needed to improve breastfeeding rates in the UK. First, we generated a behavioral analysis by mapping breastfeeding barriers and enablers onto the Capability, Opportunity, and Motivation-Behavior (COM-B) system using documents provided by Best Beginnings. Second, we identified the intervention functions and policy categories used. Third, we linked these with the behavior change techniques identified in the app breastfeeding content using the Behavior Change Techniques Taxonomy (BCTTv1). Results Baby Buddy is a well-designed platform that could be used to change breastfeeding behaviors. Findings from stage one showed that Best Beginnings had defined breastfeeding as a key behavior requiring support and demonstrated a thorough understanding of the context in which breastfeeding occurs, the barriers and enablers of breastfeeding, and the target actions needed to support breastfeeding. In stage two, Best Beginnings had used intervention and policy functions to address the barriers and enablers of breastfeeding. In stage three, Baby Buddy had been assessed for acceptability, practicability, effectiveness, affordability, safety, and equity. Several behavior change techniques that could assist women with decision making around breastfeeding (eg, information about health consequences and credible sources) and possibly affect attitudes and self-efficacy were identified. Of the 39 videos in the app, 19 (49%) addressed physical capabilities related to breastfeeding and demonstrated positive breastfeeding behaviors. Conclusions Applying a theoretical framework retrospectively to a mobile app is possible and results in useful information to understand potential health benefits and to inform future development. Future research should assess which components and behavioral techniques in the app are most effective in changing behavior and supporting breastfeeding.
Collapse
Affiliation(s)
- Loretta M Musgrave
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo NSW, Australia.,Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Camperdown NSW, Australia
| | | | | | - Caroline Se Homer
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo NSW, Australia.,Burnet Institute, Melbourne VIC, Australia
| | - Adrienne Gordon
- Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Camperdown NSW, Australia.,Royal Prince Alfred Hospital, Sydney Local Health District, NSW Health, Camperdown NSW, Australia
| |
Collapse
|
7
|
Workman A, Jones PJ, Wheeler AJ, Campbell SL, Williamson GJ, Lucani C, Bowman DM, Cooling N, Johnston FH. Environmental Hazards and Behavior Change: User Perspectives on the Usability and Effectiveness of the AirRater Smartphone App. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073591. [PMID: 33808395 PMCID: PMC8036707 DOI: 10.3390/ijerph18073591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/28/2022]
Abstract
AirRater is a free smartphone app developed in 2015, supporting individuals to protect their health from environmental hazards. It does this by providing (i) location-specific and near real-time air quality, pollen and temperature information and (ii) personal symptom tracking functionality. This research sought to evaluate user perceptions of AirRater's usability and effectiveness. We collected demographic data and completed semi-structured interviews with 42 AirRater users, identified emergent themes, and used two frameworks designed to understand and support behavior change-the Behavior Change Wheel (BCW) and the Protective Action Decision Model (PADM)-to interpret results. Of the 42 participants, almost half indicated that experiencing symptoms acted as a prompt for app use. Information provided by the app supported a majority of the 42 participants to make decisions and implement behaviors to protect their health irrespective of their location or context. The majority of participants also indicated that they shared information provided by the app with family, friends and/or colleagues. The evaluation also identified opportunities to improve the app. Several study limitations were identified, which impacts the generalizability of results beyond the populations studied. Despite these limitations, findings facilitated new insights into motivations for behavior change, and contribute to the existing literature investigating the potential for smartphone apps to support health protection from environmental hazards in a changing climate.
Collapse
Affiliation(s)
- Annabelle Workman
- Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia; (A.W.); (P.J.J.); (A.J.W.); (S.L.C.)
| | - Penelope J. Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia; (A.W.); (P.J.J.); (A.J.W.); (S.L.C.)
| | - Amanda J. Wheeler
- Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia; (A.W.); (P.J.J.); (A.J.W.); (S.L.C.)
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne 3065, Australia
| | - Sharon L. Campbell
- Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia; (A.W.); (P.J.J.); (A.J.W.); (S.L.C.)
- Public Health Services, Department of Health, Hobart 7000, Australia
| | - Grant J. Williamson
- School of Natural Sciences, University of Tasmania, Hobart 7000, Australia; (G.J.W.); (C.L.); (D.M.J.S.B.)
| | - Chris Lucani
- School of Natural Sciences, University of Tasmania, Hobart 7000, Australia; (G.J.W.); (C.L.); (D.M.J.S.B.)
| | - David M.J.S. Bowman
- School of Natural Sciences, University of Tasmania, Hobart 7000, Australia; (G.J.W.); (C.L.); (D.M.J.S.B.)
| | - Nick Cooling
- School of Medicine, University of Tasmania, Hobart 7000, Australia;
| | - Fay H. Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia; (A.W.); (P.J.J.); (A.J.W.); (S.L.C.)
- Public Health Services, Department of Health, Hobart 7000, Australia
- Correspondence:
| |
Collapse
|
8
|
Hunt L, Thomson G, Whittaker K, Dykes F. Adapting breastfeeding support in areas of socio-economic deprivation: a case study approach. Int J Equity Health 2021; 20:83. [PMID: 33743718 PMCID: PMC7980580 DOI: 10.1186/s12939-021-01393-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/21/2021] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND There are inequalities in breastfeeding initiation and continuation rates, whereby socio-economically disadvantaged mothers are least likely to breastfeed. Breastfeeding peer support (BPS) interventions are recommended as a solution, and in the UK non-profit organisations are commissioned to deliver BPS services in areas of socio-economic deprivation. BPS interventions have a mixed evidence base, offering limited knowledge about the interaction between context and intervention and how this affects women's experiences. METHODS This interpretive study used a case study methodology to explore how and why two BPS services developed their services in socio-economically deprived contexts. Methods aimed to generate holistic understanding of BPS service development. Data collected across both cases comprised; observation (n = 1), and semi-structured interviews with: mothers who had (n = 10) and had not (n = 9) engaged with the BPS services, peer supporters (PSs) (n = 9), community health professionals (n = 5), infant feeding co-ordinators (n = 2), non-profit organisation managers (n = 3), and public health commissioners (n = 2). Inductive grounded theory analytic techniques of open coding and constant comparisons, followed by cross case comparisons, were used to analyse the data. RESULTS The over-arching theme - 'the transcending influence of society' - offers insights into the underlying context and drivers impacting service development. It reflects how funding and data sharing arrangements determined service operation and the peer's access to women. Four underpinning themes explain how: peer supporters were resourceful in adapting their services ('adapting and modifying the support'); BPS organisations worked to enable women's access to supportive breastfeeding environments, but did not necessarily focus service development on the needs of women living in areas of deprivation ('supporting women's journeys to access'); the BPS-professional connections for supporting access and how BPS could result in more supportive community environments ('embedding within healthcare practice'); and how management practices precluded meaningful use of data to provide context led service development ('ways of using knowledge'). CONCLUSIONS Findings suggest that while PSs are commissioned to focus on those most in need, there is limited discussion, collection, or use of knowledge about women's lives to develop needs-led service delivery. The key recommendation is the development of a social ecological tool to facilitate the use and application of contextual knowledge.
Collapse
Affiliation(s)
- Louise Hunt
- Maternal and Infant Nutrition and Nurture Unit (MAINN). School of Community Health and Midwifery, University of Central Lancashire (UCLan), Preston, PR12HE, UK.
| | - Gill Thomson
- Maternal and Infant Nutrition and Nurture Unit (MAINN). School of Community Health and Midwifery, University of Central Lancashire (UCLan), Preston, PR12HE, UK
| | | | - Fiona Dykes
- Maternal and Infant Nutrition and Nurture Unit (MAINN). School of Community Health and Midwifery, University of Central Lancashire (UCLan), Preston, PR12HE, UK
| |
Collapse
|
9
|
Blair M, Downe S, Gordon A, Musgrave L, Homer C, Etherington C. Baby Buddy app evaluation-effective uplift in breast feeding despite unclear mechanism. Mhealth 2021; 7:16. [PMID: 33634199 PMCID: PMC7882275 DOI: 10.21037/mhealth-19-233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/02/2020] [Indexed: 11/06/2022] Open
Affiliation(s)
- Mitch Blair
- Department of Primary Care and Public Health, Imperial College, London, UK
| | - Soo Downe
- Research in Childbirth and Health (ReaCH) Group, University of Central Lancashire, Preston, UK
| | - Adrienne Gordon
- Department of Obstetrics, Gynaecology and Neonatology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Loretta Musgrave
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Caroline Homer
- Department of Maternal, Child and Adolescent Health, Burnet Institute, Sydney, NSW, Australia
| | | |
Collapse
|