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Alahmed S, Frost S, Fernandez R, Win K, Mutair AA, Harthi MA, Meedya S. Evaluating a woman-centred web-based breastfeeding educational intervention in Saudi Arabia: A before-and-after quasi-experimental study. Women Birth 2024; 37:101635. [PMID: 38964228 DOI: 10.1016/j.wombi.2024.101635] [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: 09/26/2023] [Revised: 06/11/2024] [Accepted: 06/11/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Although digital educational resources are used worldwide to educate new parents, the impact of digital resources tailored specifically to women's needs on breastfeeding practices is not well explored. AIM The study aimed to evaluate the effectiveness of using a women-centred Web-Based Breastfeeding Educational Resource (WEBBER) in increasing the rate of exclusive breastfeeding at one month after birth. METHODS A quasi-experimental study with before and after intervention was conducted in one metropolitan hospital in Saudi Arabia. Participants were primiparous women (n=290) aged 18 or above who intended to breastfeed. The intervention involved introducing the WEBBER to pregnant women and reinforcing its uses as a routine breastfeeding educational resource. Women's characteristics and infant feeding data were collected at one month after birth via an online survey. FINDINGS The rate of exclusive breastfeeding at one month postpartum among the women who received the WEBBER intervention was nearly three times higher compared to the women prior to the introduction of the intervention (66 % vs. 26 %, p-value <.001). Furthermore, other predictors of exclusive breastfeeding at one month were the mother being unemployed, the baby not receiving infant formula in the hospital, and the mother having postnatal intention to continue breastfeeding for 6 months or more. DISCUSSION AND CONCLUSION Using WEBBER as a routine breastfeeding educational resource increased the rate of exclusive breastfeeding one month after birth. Embedding woman-centred digital resources into routine breastfeeding education is an effective intervention for women in Saudi Arabia.
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Affiliation(s)
- Salma Alahmed
- School of Nursing, University of Wollongong, Australia; College of Nursing, King Saud University, Riyadh, Saudi Arabia.
| | - Steve Frost
- School of Nursing, University of Wollongong, Australia
| | - Ritin Fernandez
- School of Nursing and Midwifery, University of Newcastle, Australia
| | - Khin Win
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Australia
| | - Abbas Al Mutair
- School of Nursing, University of Wollongong, Australia; Research Center, Almoosa Specialist Hospital, Saudi Arabia; College of Nursing, Princess Nourah Bent Abdulrahman University, Riyadh, Saudi Arabia
| | - Muna Al Harthi
- Breastfeeding Committee, Maternity and Children Hospital, Dammam, Eastern Province, Saudi Arabia
| | - Shahla Meedya
- School of Nursing, University of Wollongong, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Australia
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Roldão C, Lopes R, Silva JM, Neves N, Gomes JC, Gavina C, Taveira-Gomes T. Can Breastfeeding Prevent Long-Term Overweight and Obesity in Children? A Population-Based Cohort Study. Nutrients 2024; 16:2728. [PMID: 39203864 PMCID: PMC11356795 DOI: 10.3390/nu16162728] [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: 06/12/2024] [Revised: 07/22/2024] [Accepted: 07/31/2024] [Indexed: 09/03/2024] Open
Abstract
The aims of this study were to assess the impact of exclusive breastfeeding up to 6 months of age on reducing the incidence of overweight and obesity in children up to 10 years of age and to estimate the annual incidence of obesity and overweight in the study population. Our retrospective cohort analysis using electronic health records included children from zero to ten years old, born between 1 January 2006 and 31 December 2022, followed up at the Unidade Local de Saúde de Matosinhos (ULSM). Information on their comorbidity history was collected, and positive or negative control results were defined. In the first year of life, around 29% of the children on exclusive breastfeeding were obese and 20% were overweight. This trend was reversed by the age of 9. Asthma and allergic rhinitis were used as positive control outcomes and allergic dermatitis as a negative control outcome. There seems to be no relationship between exclusive and non-exclusive breastfeeding and the development of overweight or obesity at the age of 10. The results showed that breastfeeding is associated with a lower risk of asthma in the future.
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Affiliation(s)
- Carolina Roldão
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (J.M.S.); (N.N.); (C.G.)
| | - Rita Lopes
- MTG Research and Development Laboratory, 4200-604 Porto, Portugal; (R.L.); (T.T.-G.)
| | - Joana Matos Silva
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (J.M.S.); (N.N.); (C.G.)
| | - Natália Neves
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (J.M.S.); (N.N.); (C.G.)
| | - Joana Costa Gomes
- USF Caravela, Matosinhos Local Health Unit, 4460-352 Sra. da Hora, Portugal;
- The School of Medicine and Biomedical Sciences; University of Porto, 4050-313 Porto, Portugal
| | - Cristina Gavina
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (J.M.S.); (N.N.); (C.G.)
- Pedro Hispano Hospital—ULS Matosinhos, 4464-513 Matosinhos, Portugal
- The Cardiovascular R&D Unit (UnIC), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Tiago Taveira-Gomes
- MTG Research and Development Laboratory, 4200-604 Porto, Portugal; (R.L.); (T.T.-G.)
- Faculty of Health Sciences, Fernando Pessoa University, 4249-004 Porto, Portugal
- Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University Porto, 4200-319 Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal
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Kurnaz D, Şenoğlu A, Karaçam Z. The impact of antenatal telehealth services on maternal and neonatal outcomes, a comparison of results before and during the COVID-19 pandemic: A systematic review and meta-analysis (The impact of telehealth services on maternal and neonatal outcomes). Midwifery 2024; 134:104017. [PMID: 38714075 DOI: 10.1016/j.midw.2024.104017] [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: 12/16/2023] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/09/2024]
Abstract
OBJECTIVE This review was conducted to examine the effectiveness of antenatal follow-up using telehealth in the pre-COVID-19 and active pandemic periods. DESIGN A systematic review and meta-analysis of randomized controlled trials. METHODS Searches were conducted from inception to September 2023 through PubMed, the Cochrane Library, EBSCO, Embase, Web of Science, all via Ovid SP, the National Thesis Center, TR Index, Turkiye Clinics, and DergiPark Academic. Data were combined in the meta-analysis. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool and quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation guidelines. RESULTS The meta-analysis examining the effectiveness of antenatal telehealth services included 35 studies with a total sample size of 16 033. The combined results of the studies revealed that antenatal telehealth services were similar to face-to-face follow-ups for many maternal and newborn health outcomes. Maternal outcomes included abortion, preterm delivery, gestational diabetes, weight gain, hypertensive disorders, maternal hospitalization, number of antenatal follow-ups, use of induction, vaginal and instrumental delivery, planned and emergency cesarean section, shoulder dystocia, episiotomy, perineal laceration, childbirth under the supervision of qualified personnel, breastfeeding problems and postpartum depression. Neonatal outcomes included an APGAR score of <7, neonatal hypoglycemia, hyperbilirubinemia, admission into the neonatal intensive care unit, respiratory distress syndrome, neonatal death, birth weight, low birth weight and macrosomia. However, statistically significant reductions in excessive weight gain (p<0.001) and a 1.23-fold increase in vaccination administration (p=0.001) were observed with telehealth services. Additionally, the effects of telehealth services on preterm and cesarean delivery rates were similar in the pre-pandemic and pandemic periods. CONCLUSION AND IMPLICATIONS FOR PRACTICE AND RESEARCH This review reveals that while antenatal telehealth services are comparable to face-to-face care in terms of multiple pregnancy, delivery, and neonatal outcomes, they contribute to improvements in preventing extreme weight gain and vaccination hesitancy. These findings suggest that the telehealth method can be used as an alternative to face-to-face monitoring in antenatal follow-ups.
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Affiliation(s)
- Döndü Kurnaz
- Assist. Prof. Dr. Döndü Kurnaz, PhD, Marmara University Faculty of Health Sciences Midwifery Department, Istanbul, Turkey.
| | - Ayşe Şenoğlu
- PhD., Ministry of Health Adana Provincial Directorate of Health Emergency Health Services, Adana,Turkey.
| | - Zekiye Karaçam
- Prof. Dr., Aydın Adnan Menderes University, Faculty of Health Sciences, Division of Midwifery, Aydın, Turkey.
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Baransel ES, Çalışkan BE. Effects of Face-to-Face Education Followed by Mobile Messaging to Primiparas on Maternal-Neonatal Care, Breastfeeding, and Motherhood Experience: A Randomized Controlled Trial. Z Geburtshilfe Neonatol 2024; 228:278-285. [PMID: 38286412 DOI: 10.1055/a-2222-6568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
OBJECTIVE This study aims to investigate the effectiveness of education on breastfeeding and basic maternal-neonatal care and mobile message support given to primiparous women in the postpartum period on breastfeeding and motherhood experiences. METHODS This prospective randomized controlled study was conducted in a hospital located in a city in Turkey, with 130 primiparous patients in the postpartum period (65 individuals in the experimental group and 65 individuals in the control group). Participants in the experimental group were provided with education on breastfeeding and basic maternal-neonatal care at the hospital, and mobile messages were sent with the same content as an education program for six weeks after discharge. RESULTS Mean scores of the breastfeeding self-efficacy (58.95 vs. 54.87; P<.05) and breastfeeding attitude (60.80 vs. 57.55; P<.05) are significantly higher in the experimental group compared to the control group. Similarly, the mean score of satisfaction with the motherhood experience is significantly improved in the experimental group compared to the control group (22.95 vs. 26.46; P<.05). It was determined that 89.2% of the women in the experimental group were still breastfeeding; 93.8% of them did not have nipple problems, and 60% of them did not use a bottle or pacifier in the six-month postpartum period (P<.05). CONCLUSION Education on breastfeeding and basic maternal-neonatal care given in the early postpartum period and mobile messages sent for six weeks after discharge may help to improve breastfeeding self-efficacy, breastfeeding attitude, and maternal experience satisfaction among primiparous women.
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Xie H, Cong S, Wang R, Sun X, Han J, Ni S, Zhang A. Effect of eHealth interventions on perinatal depression: A meta-analysis. J Affect Disord 2024; 354:160-172. [PMID: 38490593 DOI: 10.1016/j.jad.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 02/29/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Perinatal depression (PND) is a common mental health problem, and eHealth interventions may provide a strategy for alleviating PND. AIM This meta-analysis aimed to determine the effect of eHealth interventions on PND. METHODS Six databases were searched to retrieve published randomized controlled trials (RCTs) on the effect of eHealth interventions on PND. A meta-analysis was performed on the data of these studies using a random effects model. RESULTS A total of 21 RCTs were included in the meta-analysis, which revealed that eHealth interventions significantly reduced antenatal depression (WMD = -1.64, 95 % CI [-2.92, -0.35], P = .013), postpartum depression (SMD = -0.41, 95 % CI [-0.52, -0.29], P < .001), anxiety (SMD = -0.39, 95 % CI [-0.51, -0.28], P < .001), stress (WMD = -2.93, 95 % CI [-4.58, -1.27], P = .001), and improved self-efficacy (SMD = 0.42, 95 % CI [0.21, 0.63], P < .001) compared with the control group. However, eHealth interventions did not significantly improve social support (SMD = 0.27, 95 % CI [-0.01, 0.56], P = .058). For antenatal depression, significant subgroup differences were observed in the digital platform and material presentation format. In addition, for postpartum depression, significant subgroup differences were found in the type of therapy. CONCLUSIONS The meta-analysis results suggest that eHealth interventions can relieve depression, anxiety, and stress symptoms and improve self-efficacy in perinatal women. However, these interventions did not improve social support. Additional high-quality studies on eHealth interventions in PND are needed to validate these results.
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Affiliation(s)
- Hongyan Xie
- School of Nursing, Nanjing Medical University, Jiangsu, China
| | - Shengnan Cong
- Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Jiangsu, China
| | - Rui Wang
- Central South University Xiangya School of Nursing, Hunan, China
| | - Xiaoqing Sun
- Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Jingjing Han
- School of Nursing, Suzhou University, Jiangsu, China
| | - Shiqian Ni
- School of Nursing, Nanjing Medical University, Jiangsu, China
| | - Aixia Zhang
- Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Jiangsu, China.
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Knop MR, Nagashima-Hayashi M, Lin R, Saing CH, Ung M, Oy S, Yam ELY, Zahari M, Yi S. Impact of mHealth interventions on maternal, newborn, and child health from conception to 24 months postpartum in low- and middle-income countries: a systematic review. BMC Med 2024; 22:196. [PMID: 38750486 PMCID: PMC11095039 DOI: 10.1186/s12916-024-03417-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/01/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Mobile health (mHealth) technologies have been harnessed in low- and middle-income countries (LMICs) to address the intricate challenges confronting maternal, newborn, and child health (MNCH). This review aspires to scrutinize the effectiveness of mHealth interventions on MNCH outcomes during the pivotal first 1000 days of life, encompassing the period from conception through pregnancy, childbirth, and post-delivery, up to the age of 2 years. METHODS A comprehensive search was systematically conducted in May 2022 across databases, including PubMed, Cochrane Library, Embase, Cumulative Index to Nursing & Allied Health (CINAHL), Web of Science, Scopus, PsycINFO, and Trip Pro, to unearth peer-reviewed articles published between 2000 and 2022. The inclusion criteria consisted of (i) mHealth interventions directed at MNCH; (ii) study designs, including randomized controlled trials (RCTs), RCT variations, quasi-experimental designs, controlled before-and-after studies, or interrupted time series studies); (iii) reports of outcomes pertinent to the first 1000 days concept; and (iv) inclusion of participants from LMICs. Each study was screened for quality in alignment with the Cochrane Handbook for Systematic Reviews of Interventions and the Joanne Briggs Institute Critical Appraisal tools. The included articles were then analyzed and categorized into 12 mHealth functions and outcome domain categories (antenatal, delivery, and postnatal care), followed by forest plot comparisons of effect measures. RESULTS From the initial pool of 7119 articles, we included 131 in this review, comprising 56 RCTs, 38 cluster-RCTs, and 37 quasi-experimental studies. Notably, 62% of these articles exhibited a moderate or high risk of bias. Promisingly, mHealth strategies, such as dispatching text message reminders to women and equipping healthcare providers with digital planning and scheduling tools, exhibited the capacity to augment antenatal clinic attendance and enhance the punctuality of child immunization. However, findings regarding facility-based delivery, child immunization attendance, and infant feeding practices were inconclusive. CONCLUSIONS This review suggests that mHealth interventions can improve antenatal care attendance and child immunization timeliness in LMICs. However, their impact on facility-based delivery and infant feeding practices varies. Nevertheless, the potential of mHealth to enhance MNCH services in resource-limited settings is promising. More context-specific implementation studies with rigorous evaluations are essential.
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Affiliation(s)
- Marianne Ravn Knop
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Michiko Nagashima-Hayashi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Ruixi Lin
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Chan Hang Saing
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Mengieng Ung
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Sreymom Oy
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Esabelle Lo Yan Yam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Marina Zahari
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Siyan Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
- KHANA Center for Population Health Research, Phnom Penh, Cambodia.
- Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, CA, USA.
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Parker LA, Varma D, Bendixen MM, Sullivan S, Cacho N, Martina M. Biomarker-based text messages to promote lactation success in mothers of critically Ill infants: a randomized controlled pilot study. J Perinatol 2024:10.1038/s41372-024-01975-7. [PMID: 38705950 DOI: 10.1038/s41372-024-01975-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/27/2024] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE Infrequent breast pumping limits mother's own milk production in mothers of infants admitted to the neonatal intensive care unit. We aimed to determine the feasibility and benefit of biomarker-based personalized text messages on pumping frequency and milk sodium levels. A secondary aim examined lactation outcomes. STUDY DESIGN In this randomized controlled pilot study, 51 mothers were randomized to receive personalized text messages regarding pumping frequency or standard care. RESULTS There were no differences in pumped milk volume or sodium level, however, there was a trend towards the intervention group pumping more frequently, which was significant on day 5 (p = 0.035), and they lactated nearly 9 days longer. Post-hoc analysis found the intervention group tended to be more likely to pump ≥ 500 mL by day14 (p = 0.08), a marker of long-term lactation success. CONCLUSION Personalized biomarker-based text messages are feasible and may support lactation in mothers of critically ill infants.
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Furman L, McAleer S, Brooks L, Ronis S. A Pilot Breastfeeding-Supportive Texting Program for African American and Black Mothers. Breastfeed Med 2024; 19:325-332. [PMID: 38469623 PMCID: PMC11238827 DOI: 10.1089/bfm.2023.0300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Background: Exclusive breastfeeding is recommended through age 6 months, and 24.9% of all U.S. mothers, but only 19.8% of African American or Black (AA/B) mothers, achieved this goal (2020). Smartphone technology, specifically short message service (SMS or texting), may provide a strategy to reach and engage AA/B women who otherwise face barriers related to racism in accessing breastfeeding resources. Unfortunately, few mobile health applications are designed for AA/B women. Methods: We created a culturally sensitive breastfeeding promotion and support text message library that begins at 28 weeks prenatally and continues through 10 weeks postpartum. We tested feasibility and acceptability with a proof-of-concept (POC) trial that enrolled 20 AA/B women, and we tested content and perceived usefulness with a pilot study that enrolled 28 AA/B women. Results: In the POC trial, 95% of participants received all messages, demonstrating feasibility, and none requested fewer or to stop messages, demonstrating acceptability. In the pilot, >85% of participants responded positively regarding the number and helpfulness of the texts received, and whether the information was needed. Using a validated measure for online content for parents, >70% of POC and pilot study participants found that the information was very relevant or relevant, completely understandable, taught them something new, and "will help me improve the health or well-being of my child." Conclusion: A new breastfeeding-supportive text messaging program intended for AA/B mothers appears feasible, acceptable, informative, and relevant. This is the first breastfeeding text messaging application of which we are aware that is tailored for the AA/B population.
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Affiliation(s)
- Lydia Furman
- University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USA
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Sarah McAleer
- University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USA
- Center for Child Health Policy, Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USA
| | - Lasheena Brooks
- University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USA
- Center for Child Health Policy, Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USA
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Gilano G, Sako S, Molla B, Dekker A, Fijten R. The effect of mHealth on childhood vaccination in Africa: A systematic review and meta-analysis. PLoS One 2024; 19:e0294442. [PMID: 38381753 PMCID: PMC10880990 DOI: 10.1371/journal.pone.0294442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/31/2023] [Indexed: 02/23/2024] Open
Abstract
INTRODUCTION Vaccine-preventable diseases are the public health problems in Africa, although vaccination is an available, safe, simple, and effective method prevention. Technologies such as mHealth may provide maternal access to health information and support decisions on childhood vaccination. Many studies on the role of mHealth in vaccination decisions have been conducted in Africa, but the evidence needs to provide conclusive information to support mHealth introduction. This study provides essential information to assist planning and policy decisions regarding the use of mHealth for childhood vaccination. METHODS We conducted a systematic review and meta-analysis for studies applying mHealth in Africa for vaccination decisions following the Preferred Reporting Items for Systematic and Meta-Analysis [PRISMA] guideline. Databases such as CINAHL, EMBASE, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, Global Health, HINARI, and Cochrane Library were included. We screened studies in Endnote X20 and performed the analysis using Revman 5.4.1. RESULTS The database search yielded 1,365 articles [14 RCTs and 4 quasi-experiments] with 21,070 participants satisfied all eligibility criteria. The meta-analysis showed that mHealth has an OR of 2.15 [95% CI: 1.70-2.72; P<0.001; I2 = 90%] on vaccination rates. The subgroup analysis showed that regional differences cause heterogeneity. Funnel plots and Harbord tests showed the absence of publication bias, while the GRADE scale showed a moderate-quality body of evidence. CONCLUSION Although heterogeneous, this systematic review and meta-analysis showed that the application of mHealth could potentially improve childhood vaccination in Africa. It increased childhood vaccination by more than double [2.15 times] among children whose mothers are motivated by mHealth services. MHealth is more effective in less developed regions and when an additional incentive party with the messaging system. However, it can be provided at a comparably low cost based on the development level of regions and can be established as a routine service in Africa. REGISTRATION PROSPERO: CRD42023415956.
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Affiliation(s)
- Girma Gilano
- Department of Public Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Sewunet Sako
- Department of Public Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Berihun Molla
- Department of Public Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Andre Dekker
- Department of Radiation Oncology [Maastro], GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Rianne Fijten
- Department of Radiation Oncology [Maastro], GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Fan Y, Li J, Wong JYH, Fong DYT, Wang KMP, Lok KYW. Text messaging interventions for breastfeeding outcomes: A systematic review and meta-analysis. Int J Nurs Stud 2024; 150:104647. [PMID: 38056353 DOI: 10.1016/j.ijnurstu.2023.104647] [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: 04/03/2023] [Revised: 10/31/2023] [Accepted: 11/15/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Given the health benefits of breastfeeding for infants and mothers, breastfeeding has become a significant public health issue. The global growth of mobile phone usage has created new options for breastfeeding promotion, including text messaging. OBJECTIVE We aimed to evaluate the efficacy of text messaging interventions on breastfeeding outcomes and to identify the efficacy moderators of such interventions. METHODS Ten electronic databases were searched from the inception of the databases to 5 July 2023. Studies were included if they used randomized controlled trials or quasi-experimental designs to evaluate the effect of text messaging interventions on breastfeeding outcomes. Two reviewers screened the included studies, assessed the risk of bias, and extracted the data. Pooled results were obtained by the random-effects model, and subgroup analyses were conducted on intervention characteristics to identify potential moderators. The protocol of this study was registered on PROSPERO (ID: CRD42022371311). RESULTS Sixteen studies were included. Text messaging interventions could improve the exclusive breastfeeding rate (at <3 months: OR = 2.04; 95 % CI: 1.60-2.60, P < 0.001; at 3-6 months: OR = 1.66; 95 % CI: 1.18-2.33, P = 0.004; at ≥6 months: OR = 2.13; 95 % CI: 1.47-3.08, P < 0.001), and the breastfeeding self-efficacy (SMD = 0.30, 95 % CI: 0.14-0.45, P < 0.001). Text messaging interventions that covered antenatal and postnatal periods, delivered weekly were most effective in improving the exclusive breastfeeding rate. CONCLUSIONS Text messaging interventions may improve breastfeeding practice compared with no or general health information. We suggest text messaging conducted from the pre- to postnatal periods in a weekly manner can effectively increase exclusive breastfeeding rates and breastfeeding self-efficacy. Further studies should investigate the relation between new theories (such as the health action process approach and the theory of message-framing) and efficacy of breastfeeding interventions, using text components.
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Affiliation(s)
- Yingwei Fan
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Junyan Li
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan, Hong Kong, China
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Vila-Candel R, Mena-Tudela D, Franco-Antonio C, Quesada JA, Soriano-Vidal FJ. Effects of a mobile application on breastfeeding maintenance in the first 6 months after birth: Randomised controlled trial (COMLACT study). Midwifery 2024; 128:103874. [PMID: 37979550 DOI: 10.1016/j.midw.2023.103874] [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: 07/07/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/20/2023]
Abstract
PROBLEM It is necessary to continue promoting breastfeeding rates. BACKGROUND Information and communication technologies have significantly impacted healthcare services and are transforming the sector. There is little evidence of the usefulness of mobile applications to support breastfeeding and increase its duration. AIM To assess whether mobile application-LactApp® (Barcelona, Spain)-usage compared with standard care increases the 6-month postpartum breastfeeding rate. METHODS A multicentre, randomised, controlled clinical trial of parallel groups was conducted. The study was conducted in four public hospitals in Spain from January 2022 to January 2023. 270 Women were randomly assigned to each parallel group. The women in the intervention group received free access to the mobile application LactApp®, which provides personalised and convenient support to women about BF. Women in the control group received standard care, which included individual counselling about the benefits of maintaining BF for the first 6 months of the baby's life. FINDINGS The rate of breastfeeding abandonment at 15 days was 6.4 % in the control group vs 0.0 % in the intervention group (p = 0.105). LactApp® usage did not increase the 6-month postpartum breastfeeding rate compared with standard care (CG = 41.6% vs. IG = 43.6 %; p = 0.826). DISCUSSION Further studies must explore how technologies can help improve long-term breastfeeding maintenance. The mobile app seems to reduce early weaning in the first 15 days slightly. CONCLUSION Mobile application usage did not increase the breastfeeding rate compared with standard practice but may reduce breastfeeding abandonment in the first 2 weeks postpartum.
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Affiliation(s)
- Rafael Vila-Candel
- Health Science Faculty, Universidad Internacional de Valencia - VIU, 46002 Valencia, Spain; Department of Primary Health, La Ribera Health Department, 46600 Alzira, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Desirée Mena-Tudela
- Department of Nursing, Feminist Institute, Universitat Jaume I, 12071 - Castellón de la Plana, Spain
| | - Cristina Franco-Antonio
- Department of Nursing, Universidad de Extremadura, 10003 Cáceres, Spain; Health and Care Research Group (GISyC), University of Extremadura, 10003 Cáceres, Spain.
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 03550, Alicante, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Obstetrics and Gynaecology, Xàtiva-Oninyent Health Department, 46800 Xàtiva, Spain; Department of Nursing, Universitat de Valencia, 46010, Valencia, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
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Gilano G, Sako S, Dileba T, Dekker A, Fijten R. Assessing the effect of mHealth on child feeding practice in African countries: systematic and meta-analysis. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:138. [PMID: 38066659 PMCID: PMC10704613 DOI: 10.1186/s41043-023-00487-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Poor child feeding practice is a public health problem in Africa. Mobile health (mHealth) is a supportive intervention to improve this problem; however, the evidence available in the current literature is inconsistent and inconclusive in Africa. Some studies state that exclusive breastfeeding is not different between controls and mHealth interventions in the first month. Other studies state that health providers need additional training for the success of mHealth interventions. OBJECTIVE This systematic review and meta-analysis aims to provide the summarized effect of mHealth on child-feeding practices in Africa to improve future planning and decisions. METHOD We conducted a systematic review and meta-analysis based on the published and unpublished evidence gathered from PubMed, Web of Science, Cochrane Library, and Embase databases between January 1, 2000, and March 1, 2022. Studies included were randomized control trials and experimental studies that compared mHealth to standards of care among postpartum women. Preferred Reporting Items for Systematic Review and Meta-analysis guidelines followed for the reporting. RESULTS After screening 1188 studies, we identified six studies that fulfilled the study criteria. These studies had 2913 participants with the number of total intervention groups 1627 [1627/2913 = 56%]. Five studies were completed within 24 weeks while one required 12 weeks. We included two RCTs, two cluster RCTs, and two quasi-experimental studies all used mHealth as the major intervention and usual care as controls. We found significant improvement in child-feeding practices among intervention groups. CONCLUSION This systematic review and meta-analysis showed that the application of mHealth improved child-feeding practices in Africa. Although the finding is compelling, the authors recommend high-quality studies and mHealth interventions that consider sample size, design, regional differences, and environmental constraints to enhance policy decisions. The place of residence, access, low socioeconomic development, poor socio-demographic characteristics, low women empowerment, and low women's education might cause high heterogeneity in the included regions and need consideration during interventions. REGISTRATION NUMBER PROSPERO: CRD42022346950.
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Affiliation(s)
- Girma Gilano
- Department of Public Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, P.O Box: 21, Arba Minch, Ethiopia.
| | - Sewunet Sako
- Department of Public Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, P.O Box: 21, Arba Minch, Ethiopia
| | - Temesgen Dileba
- Department of Public Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, P.O Box: 21, Arba Minch, Ethiopia
| | - Andre Dekker
- Department of Radiation Oncology [Maastro], GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Mastro Clinic, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Rianne Fijten
- Department of Radiation Oncology [Maastro], GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Mastro Clinic, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
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Al-Shami K, Awadi S, Khamees A, Alsheikh AM, Al-Sharif S, Ala’ Bereshy R, Al-Eitan SF, Banikhaled SH, Al-Qudimat AR, Al-Zoubi RM, Al Zoubi MS. Estrogens and the risk of breast cancer: A narrative review of literature. Heliyon 2023; 9:e20224. [PMID: 37809638 PMCID: PMC10559995 DOI: 10.1016/j.heliyon.2023.e20224] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/10/2023] Open
Abstract
In female mammals, the development and regulation of the reproductive system and non-reproductive system are significantly influenced by estrogens (oestrogens). In addition, lipid metabolism is another physiological role of estrogens. Estrogens act through different types of receptors to introduce signals to the target cell by affecting many estrogen response elements. Breast cancer is considered mostly a hormone-dependent disease. Approximately 70% of breast cancers express progesterone receptors and/or estrogen receptors, and they are a good marker for cancer prognosis. This review will discuss estrogen metabolism and the interaction of estrogen metabolites with breast cancer. The carcinogenic role of estrogen is discussed in light of both conventional and atypical cancers susceptible to hormones, such as prostate, endometrial, and lung cancer, as we examine how estrogen contributes to the formation and activation of breast cancer. In addition, this review will discuss other factors that can be associated with estrogen-driven breast cancer.
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Affiliation(s)
- Khayry Al-Shami
- Faculty of Medicine, Yarmouk University, P.O Box 566, 21163, Irbid, Jordan
| | - Sajeda Awadi
- Faculty of Medicine, Yarmouk University, P.O Box 566, 21163, Irbid, Jordan
| | - Almu'atasim Khamees
- Faculty of Medicine, Yarmouk University, P.O Box 566, 21163, Irbid, Jordan
- Department of General Surgery, King Hussein Cancer Center, Amman, 11941, Jordan
| | | | - Sumaiya Al-Sharif
- Faculty of Medicine, Yarmouk University, P.O Box 566, 21163, Irbid, Jordan
| | | | - Sharaf F. Al-Eitan
- Faculty of Medicine, Yarmouk University, P.O Box 566, 21163, Irbid, Jordan
| | | | - Ahmad R. Al-Qudimat
- Department of Public Health, College of Health Sciences, QU-Health, Qatar University, Doha, 2713, Qatar
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Raed M. Al-Zoubi
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- Department of Biomedical Sciences, College of Health Sciences, QU-Health, Qatar University, Doha, 2713, Qatar
- Department of Chemistry, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan
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Gayesa RT, Ngai FW, Xie YJ. The effects of mHealth interventions on improving institutional delivery and uptake of postnatal care services in low-and lower-middle-income countries: a systematic review and meta-analysis. BMC Health Serv Res 2023; 23:611. [PMID: 37296420 DOI: 10.1186/s12913-023-09581-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Maternal mortality due to pregnancy, childbirth and postpartum is a global challenge. Particularly, in low-and lower-income countries, the outcomes of these complications are quite substantial. In recent years, studies exploring the effect of mobile health on the improvement of maternal health are increasing. However, the effect of this intervention on the improvement of institutional delivery and postnatal care utilization was not well analyzed systematically, particularly in low and lower-middle-income countries. OBJECTIVE The main aim of this review was to assess the effect of mobile heath (mHealth) interventions on improving institutional delivery, postnatal care service uptake, knowledge of obstetric danger signs, and exclusive breastfeeding among women of low and lower-middle-income countries. METHODS Common electronic databases like PubMed, EMBASE, the Web of Science, Medline, CINAHL, Cochrane library, Google scholar, and gray literature search engines like Google were used to search relevant articles. Articles that used interventional study designs and were conducted in low and lower-middle-income countries were included. Sixteen articles were included in the final systematic review and meta-analysis. Cochrane's risk of bias tool was used to assess the quality of included articles. RESULTS The overall outcome of the systematic review and meta-analysis showed that MHealth intervention has a positive significant effect in improving the institutional delivery (OR = 2.21 (95%CI: 1.69-2.89), postnatal care utilization (OR = 4.13 (95%CI: 1.90-8.97), and exclusive breastfeeding (OR = 2.25, (95%CI: 1.46-3.46). The intervention has also shown a positive effect in increasing the knowledge of obstetric danger signs. The subgroup analysis based on the intervention characteristics showed that there was no significant difference between the intervention and control groups based on the intervention characteristics for institutional delivery (P = 0.18) and postnatal care utilizations (P = 0.73). CONCLUSIONS The study has found out that mHealth intervention has a significant effect on improving facility delivery, postnatal care utilization, rate of exclusive breastfeeding, and knowledge of danger signs. There were also findings that reported contrary to the overall outcome which necessitates conducting further studies to enhance the generalizability of the effect of mHealth interventions on these outcomes.
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Affiliation(s)
- Reta Tsegaye Gayesa
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong S.A.R, China.
- Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Fei Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong S.A.R, China
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong S.A.R, China
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Mena-Tudela D, Soriano-Vidal FJ, Vila-Candel R, Quesada JA, Aguilar L, Franco-Antonio C. Effect of Mobile-Based Counselling on Breastfeeding in Spain: A Randomized Controlled Trial Protocol (COMLACT Study). Healthcare (Basel) 2023; 11:healthcare11101434. [PMID: 37239720 DOI: 10.3390/healthcare11101434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/11/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
PURPOSE The primary aim of this study is to determine the influence of an intervention in women based on a free mobile application (LactApp®, Barcelona, Spain) in maintaining breastfeeding (BF) up to 6 months postpartum. The secondary aim is to assess the effect of health literacy (HL) on breastfeeding duration. METHODS A multicenter, randomized controlled clinical trial of parallel groups will be carried out. Women will be randomly assigned to each of the parallel groups. In the control group, usual clinical practice will be followed from the third trimester of pregnancy to promote BF. In the intervention group, and in addition to usual clinical practice, the women will use a free mobile application (LactApp®) from the third trimester to 6 months postpartum. The type of BF at birth, at 15 days and at 3 and 6 months postpartum and the causes of cessation of BF in both groups will be monitored. The hypothesis will be tested using inferential analysis, considering an alpha of 5%. The study protocol was approved by the Clinical Research Ethics Committee of Hospital de la Ribera (Alzira, Valencia, Spain) in February 2021. A per protocol analysis and an intention-to-treat analysis will be performed. DISCUSSION This study will identify the influence of a mobile application on improving BF rates. If the application proves effective, we will have a tool with free information available to any user at any time of day, which may be complemented by normal clinical practice and be integrated into our health care system. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05432700.
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Affiliation(s)
- Desirée Mena-Tudela
- Department of Nursing, Feminist Institute University Institute for Feminist and Gender Studies, Universitat Jaume I, 12071 Castellon de la Plana, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynecology, Xativa-Oninyent Health Department, 46800 Xativa, Spain
| | - Rafael Vila-Candel
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), 03550 Alicante, Spain
| | - Laia Aguilar
- Midwifery at Lactapp Women Health, 08011 Barcelona, Spain
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Laws RA, Cheng H, Rossiter C, Kuswara K, Markides BR, Size D, Corcoran P, Ong K, Denney‐Wilson E. Perinatal support for breastfeeding using mHealth: A mixed methods feasibility study of the My Baby Now app. MATERNAL & CHILD NUTRITION 2023; 19:e13482. [PMID: 36725007 PMCID: PMC10019053 DOI: 10.1111/mcn.13482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/20/2022] [Accepted: 01/13/2023] [Indexed: 02/03/2023]
Abstract
Despite the well-known benefits of breastfeeding, breastfeeding rates remain suboptimal, particularly for women with lower socioeconomic position. Although popular, breastfeeding apps are often poor quality; their impact on breastfeeding knowledge, attitudes, confidence and intentions is unknown. A mixed method pre-post feasibility study was conducted to: 1) explore the feasibility of the My Baby Now app in providing perinatal breastfeeding support; 2) examine the impact on breastfeeding knowledge, attitudes, confidence and intentions; 3) to examine any differences in acceptability and impact of the app according to maternal education. The My Baby Now app was offered to pregnant women 20-30 weeks gestation. Breastfeeding knowledge and intentions were collected at baseline (T1) and 36-38 weeks gestation (T2); attitudes and confidence were collected at baseline, T2 and T3 (8-12 weeks post-partum). App engagement was measured via app analytics. Qualitative interviews were conducted with a purposeful sample following T3. Of 266 participants recruited, 169 (64%) completed T2 and 157 (59%) completed T3. Mothers without university education rated the app to be higher quality, more useful and impactful than mothers with university education. From T1-T2, breastfeeding knowledge (59.6% vs. 66.5%, p < 0.001) and exclusive breastfeeding intentions (76.6% vs. 80.9%, p < 0.001) increased. Breastfeeding attitudes and confidence scores also increased significantly across T1-T2 and T1-T3. App engagement during pregnancy predicted changes in breastfeeding attitudes from T1-T2 among participants without university education. App engagement did not predict changes in breastfeeding knowledge, confidence or intentions. Future randomised controlled studies should examine the effectiveness of mHealth interventions on breastfeeding outcomes.
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Affiliation(s)
- Rachel A. Laws
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition ScienceDeakin UniversityGeelongAustralia
| | - Heilok Cheng
- Susan Wakil School of Nursing and MidwiferyThe University of SydneyCamperdownAustralia
| | - Chris Rossiter
- Susan Wakil School of Nursing and MidwiferyThe University of SydneyCamperdownAustralia
| | - Konsita Kuswara
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition ScienceDeakin UniversityGeelongAustralia
| | - Brittany R. Markides
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition ScienceDeakin UniversityGeelongAustralia
| | - Donna Size
- Sydney Institute for Women, Children and their Families, Sydney Local Health DistrictSydneyAustralia
| | - Patricia Corcoran
- Sydney Institute for Women, Children and their Families, Sydney Local Health DistrictSydneyAustralia
- Canterbury Hospital Maternity Unit, Sydney Local Health DistrictSydneyAustralia
| | - Kok‐Leong Ong
- Department of Information Systems and Business Analytics, AISSCRMIT UniversityMelbourneAustralia
| | - Elizabeth Denney‐Wilson
- Susan Wakil School of Nursing and MidwiferyThe University of SydneyCamperdownAustralia
- Sydney Institute for Women, Children and their Families, Sydney Local Health DistrictSydneyAustralia
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Quifer-Rada P, Aguilar-Camprubí L, Gómez-Sebastià I, Padró-Arocas A, Mena-Tudela D. Spanish version of the mHealth App Usability Questionnaire (MAUQ) and adaptation to breastfeeding support apps. Int J Med Inform 2023; 174:105062. [PMID: 37037124 DOI: 10.1016/j.ijmedinf.2023.105062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 04/01/2023]
Abstract
INTRODUCTION Mobile applications (apps) are increasingly used during pregnancy, postpartum and lactation. To ensure the utility and usability of breastfeeding support apps, they need to be evaluated using a reliable scale specific to mHealth apps and breastfeeding users. OBJECTIVE To translate the original the mHealth App Usability Questionnaire (MAUQ) questionnaire into Spanish and to adapt it to breastfeeding support apps environment. MATERIALS AND METHODS The questionnaire was translated by one high English proficiency translator and was back translated. The items of the questionnaire were modified for Spanish readers and for breastfeeding users. The modified questionnaire was assessed for content validity with a panel of 5 experts and 12 users and the modified kappa statistic was used to determine the interrater agreement among the raters. The reliability of the questionnaire was assessed in a mobile application for breastfeeding support (LactApp) by 202 users. The structure of the questionnaire was validated using exploratory factor analysis. RESULTS All items of the questionnaire were relevant, clear or comprehensible with content validity index values higher than 0.79. The modified kappa agreement for each item of the modified MAUQ (m-MAUQ) proved an excellent agreement (κ = 0.9-1.0). Factor analysis of the m-MAUQ showed four subscales. The internal consistency of the complete questionnaire was high (Cronbach α = 0.89). CONCLUSIONS The Spanish and modified MAUQ demonstrated high reliability and validity and it might be used to evaluate the usability, utility and acceptability of mHealth apps aiming to support lactating women.
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Interventions and Programs to Promote Breastfeeding in Arabic-Speaking Countries: A Scoping Review. Matern Child Health J 2023; 27:774-794. [PMID: 36729325 PMCID: PMC9893976 DOI: 10.1007/s10995-023-03595-7] [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] [Accepted: 01/18/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Low prevalence of exclusive breastfeeding in the Arab world is concerning and suboptimal breastfeeding is a leading child health risk factor in several Arab States. Breastfeeding education has the capacity to improve breastfeeding knowledge and practice, thus positively impacting infant and maternal health. The purpose of this review is to identify and examine the impact of breastfeeding promotion interventions across the Arab world. METHOD A scoping review of the literature was conducted across seventeen databases for relevant publications published through October 2021 to find studies in Arab countries, that involved breastfeeding as an intervention component. Twenty-one articles met inclusion criteria and were reviewed. RESULTS Individual and community based educational interventions offer the opportunity to positively impact the knowledge, attitudes, and practices of breastfeeding in new mothers in Arab countries. Increased breastfeeding has the potential to lead to improved neonate and maternal health. In addition to significant benefits found across individual and community-based interventions in a variety of Arab countries, there is also evidence that interventions that improve the knowledge of health care professionals and/or the practices of a health care system can contribute to subsequent increases in breastfeeding rates. DISCUSSION Breastfeeding education is a low-cost and high-impact public health tool that can impact infant and maternal health and potentially increase breastfeeding adherence in the Arab world.
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Davis JA, Glasser M, Clemens M, Eichhorn B, Vats K, Demirci JR. Antenatal Milk Expression as a Lactation Support Intervention for Parents of Infants With Severe Birth Defects: A Case Series. J Perinat Neonatal Nurs 2022; 36:E25-E30. [PMID: 36288447 PMCID: PMC9623467 DOI: 10.1097/jpn.0000000000000680] [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] [Indexed: 01/03/2023]
Abstract
BACKGROUND A diet high in parent's own milk (parental milk) is a lifesaving intervention for critically ill infants. Lactating parents whose infants are born with birth defects that require surgical repair (surgical infants) shortly after birth often struggle to initiate and maintain a milk supply that meets their infant's nutritional needs. Antenatal milk expression has been identified as a safe, feasible, and potentially effective strategy that promotes parents' direct chest/breastfeeding or milk expression (lactation) confidence and helps parents attain their lactation goals. Two cases are presented to illustrate the potential for using antenatal milk expression as a lactation support intervention for parents of surgical infants. CASE PRESENTATION Cases were drawn from a pilot study exploring the feasibility of implementing antenatal milk expression among pregnant parents of surgical infants. Participants were healthy women recruited after 30 weeks of gestation who received a fetal diagnosis of a complex congenital heart defect. Despite variability in clinical course and length of stay, parental milk was provided for the duration of each infant's hospitalization. Participant perceptions of antenatal milk expression varied. CONCLUSION More research is needed to evaluate the feasibility, efficacy, and parent or provider perceptions of antenatal milk expression as a lactation support intervention for parents of surgical infants.
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Affiliation(s)
- Jessica A. Davis
- Predoctoral Scholar, University of Pittsburgh School of Nursing, Department of Health Promotion & Development, Pittsburgh, PA
| | - Melissa Glasser
- Research Coordinator, University of Pittsburgh School of Nursing, Department of Health Promotion & Development, Pittsburgh, PA
| | - Michele Clemens
- Genetic Counselor, University of Pittsburgh Medical Center (UPMC) Magee Women’s Hospital, Pittsburgh, PA
| | | | - Kalyani Vats
- Physician, UPMC Magee Women’s Hospital, Pittsburgh, PA
- Associate Professor, University of Pittsburgh School of Medicine, Department of Pediatrics, Division of Newborn Medicine, Pittsburgh, PA
| | - Jill R. Demirci
- Assistant Professor, University of Pittsburgh School of Nursing, Department of Health Promotion & Development, Pittsburgh, PA
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Wu CC, Huang CW, Wang YC, Islam MM, Kung WM, Weng YC, Su CH. mHealth Research for Weight Loss, Physical Activity, and Sedentary Behavior: Bibliometric Analysis. J Med Internet Res 2022; 24:e35747. [PMID: 35675126 PMCID: PMC9218882 DOI: 10.2196/35747] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/15/2022] [Accepted: 05/10/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Research into mobile health (mHealth) technologies on weight loss, physical activity, and sedentary behavior has increased substantially over the last decade; however, no research has been published showing the research trend in this field. OBJECTIVE The purpose of this study was to provide a dynamic and longitudinal bibliometric analysis of recent trends of mHealth research for weight loss, physical activity, and sedentary behavior. METHODS A comprehensive search was conducted through Web of Science to retrieve all existing relevant documents published in English between January 1, 2010, and November 1, 2021. We developed appropriate research questions; based on the proven bibliometric approaches, a search strategy was formulated to screen the title for eligibility. Finally, we conducted bibliometric analyses to explore the growth rate of publications; publication patterns; and the most productive authors, institutions, and countries, and visualized the trends in the field using a keyword co-occurrence network. RESULTS The initial search identified 8739 articles, of which 1035 were included in the analyses. Our findings show an exponential growth trend in the number of annual publications of mHealth technology research in these fields. JMIR mHealth and uHealth (n=214, 20.67%), Journal of Medical Internet Research (n=71, 6.86%), and BMC Public Health (n=36, 3.47%) were the top 3 journals, publishing higher numbers of articles. The United States remained the leading contributor in these areas (n=405, 39.13%), followed by Australia (n=154, 14.87%) and England (n=125, 12.07%). Among the universities, the University of Sydney (n=36, 3.47%) contributed the most mHealth technology research in these areas; however, Deakin University (n=25, 2.41%) and the National University of Singapore (n=23, 2.22%) were in the second and third positions, respectively. CONCLUSIONS Although the number of papers published on mobile technologies for weight loss, physical activity, and sedentary behavior was initially low, there has been an overall increase in these areas in recent years. The findings of the study indicate that mobile apps and technologies have substantial potential to reduce weight, increase physical activity, and change sedentary behavior. Indeed, this study provides a useful overview of the publication trends and valuable guidance on future research directions and perspectives in this rapidly developing field.
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Affiliation(s)
- Chieh-Chen Wu
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei, Taiwan
| | - Chih-Wei Huang
- International Center for Health Information Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Yao-Chin Wang
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
| | - Md Mohaimenul Islam
- International Center for Health Information Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- AESOP Technology, Taipei, Taiwan
| | - Woon-Man Kung
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
| | - Yung-Ching Weng
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei, Taiwan
| | - Chun-Hsien Su
- Graduate Institute of Sport Coaching Science, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
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Yu H, He J, Wang X, Yang W, Sun B, Szumilewicz A. A Comparison of Functional Features of Chinese and US Mobile Apps for Pregnancy and Postnatal Care: A Systematic App Store Search and Content Analysis. Front Public Health 2022; 10:826896. [PMID: 35252100 PMCID: PMC8891489 DOI: 10.3389/fpubh.2022.826896] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/24/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Pregnancy to postpartum (PtP) applications (apps) are becoming more common tools to document everything from pregnancy and delivery to nutrient allocation, life taboos, and infant medical examinations. However, the dependability, quality, and efficacy of these apps remain unclear. This study examined the features and functions of mobile PtP care apps accessible in China and the United States and to identify the major gaps that need to be addressed. METHODS Apps were selected by searching the Apple App Store and Android Markets (in the US and China) for the terms "pregnancy" and "postpartum" in Chinese and English. The apps' security, quality, and effectiveness were investigated, and chi-square tests and analysis of variance were performed to examine the differences in characteristics between apps available in the US and China. RESULTS A total of 84 mobile PtP care apps (45 from the US and 39 from China) were included. A total of 89.7% (35/39) of Chinese mobile apps did not provide safety statements or supporting evidence. The objective app quality ratings for Chinese and US apps were 3.20 ± 0.48 (mean ± standard deviation) and 3.56 ± 0.45, respectively (p > 0.05). A greater number of Chinese apps provided app-based monitoring functions, namely recording fetal size (n = 18, 46.2% in China vs. n = 3, 6.7% in the US), contractions (n = 11, 28.2% in China vs. n = 0, 0% in the US), pregnancy weight (n = 11, 28.2% in China vs. 0, 0% in the US), and pregnancy check-up reminders (n = 10, 25.6% in China vs. n = 0, 0% in the US). Meanwhile, a greater number of US apps provided exercise modules, namely pregnancy yoga (n = 2, 5.1% in China vs. n = 21, 46.7% in the US), pregnancy workouts (n = 2, 5.1% in China vs. n = 13, 28.9% in the US), and pregnancy meditation (n = 0, 0% in China vs. 10, 22.2% in the US) (p < 0.01). A medium security risk was identified for 40% (18/45) of apps in the US and 82.1% (32/39) of apps in China (p < 0.01). CONCLUSIONS The functionality and characteristics of in-store mobile apps for PtP care varied between China and the US. Both countries' apps, particularly Chinese apps, encountered issues related to a lack of evidence-based information, acceptable content risk, and program evaluations. Both countries' apps lacked proper mental health care functions. The findings suggest that the design of app features should be enhanced in both countries, and increased interaction between app creators and users is recommended.
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Affiliation(s)
- Hongli Yu
- Department of Sport, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
- Jiuling Primary School, Mianyang, China
| | - Juan He
- Department of Sport, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Xinghao Wang
- Department of Sport, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Weilin Yang
- Department of Sport, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Bo Sun
- Department of Sport, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Anna Szumilewicz
- Department of Sport, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
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