期刊论文详细信息
BMC Pregnancy and Childbirth
A mixed methods evaluation of peer support in Bristol, UK: mothers’, midwives’ and peer supporters’ views and the effects on breastfeeding
Jenny Ingram1 
[1] Centre for Child and Adolescent Health, School of Social and Community Medicine, Oakfield House, Clifton, Bristol BS8 2BN, UK
关键词: Evaluation;    Qualitative;    Survey;    Self-efficacy;    Peer support;    Breastfeeding;   
Others  :  1137841
DOI  :  10.1186/1471-2393-13-192
 received in 2013-05-31, accepted in 2013-10-14,  发布年份 2013
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【 摘 要 】

Background

International studies suggest that breastfeeding interventions in primary care are more effective than usual care in increasing short and long term breastfeeding rates. Interventions that combine pre- and postnatal components have larger effects than either alone, and those that including lay support in a multicomponent intervention may be more beneficial. Despite the mixed reports of the effectiveness of breastfeeding peer support in the UK, targeted peer support services are being established in many areas of the UK. In 2010, NHS Bristol Primary Care Trust commissioned a targeted breastfeeding peer support service for mothers in 12 lower socio-economic areas of the city, with one antenatal visit and postnatal contact for up to 2 weeks.

Methods

Mothers receiving the peer support service were invited to complete an on-line survey covering infant feeding; breastfeeding support; and confidence in breastfeeding (using the Breastfeeding Self-Efficacy Scale). Semi-structured interviews and a focus group explored perceptions of mothers, midwives and peer supporters. The effects of the service on breastfeeding rates were documented and compared.

Results

163 mothers completed the on-line survey; 25 participants were interviewed (14 mothers, 7 peer supporters and 4 maternity health professionals); exclusive and total breastfeeding rates for initiation and at 8 weeks were compared for 12 months before and after the service started.

The targeted peer support service was associated with small non-significant increases in breastfeeding rates, (particularly exclusive breastfeeding), compared to the rest of the city. The service was very positively evaluated by mothers, health professionals and peer supporters. Mothers felt that peer support increased their confidence to breastfeed; peer supporters found the contacts rewarding, enjoyable and important for mothers; midwives and maternity support workers were positive about the continuity of an antenatal visit and postnatal support from the same local supporter.

Conclusions

The introduction of a targeted peer support service was associated with psycho-social benefits for mothers, health professionals and peer supporters. Continuity of peer support with an antenatal visit and postnatal support from the same local supporter was also thought to be beneficial.

【 授权许可】

   
2013 Ingram; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Chung M, Raman G, Trikalinos T, Lau J, Ip S: Interventions in primary care to promote breastfeeding: an evidence review for the US preventive services task force. Ann Intern Med 2008, 149:565-582.
  • [2]Renfrew MJ, McCormick FM, Wade A, Quinn B, Dowswell T: Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev 2012, (5):CD001141. DOI: 10.1002/14651858.CD001141.pub4
  • [3]Jolly K, Ingram L, Khan KS, Deeks JJ, Fremantle N, MacArthur C: Systematic review of peer support for breastfeeding continuation: meta-regression analysis of the effect of setting, intensity and timing. BMJ 2012, 344:d8287. doi:10.1136/bmj.d8287
  • [4]Ingram L, MacArthur C, Khan K, Deeks JJ, Jolly K: Effect of antenatal peer support on breastfeeding initiation: a systematic review. Can Med Assoc J 2010, 182(16):1739-1746. doi:10.1503/cmaj.091729
  • [5]Muirhead PE, Butcher G, Rankin J, Munley A: The effect of a programme of organised and supervised peer support on the initiation and duration of breastfeeding: a randomised trial. Br J Gen Pract 2006, 56:191-197.
  • [6]Sudfeld CR, Fawsi WW, Lahariya C: Peer support and exclusive breastfeeding duration in low and middle-income countries: a systematic review and meta-analysis. PLoS ONE 2012, 7(9):e45143. 10.1371/journal.pone.0045143
  • [7]Hoddinott P, Seyara R, Marais D: Global evidence synthesis and UK idiosyncrasy: why have recent UK trials had no significant effects on breastfeeding rates? Matern Child Nutr 2011, 7:221-227. 10.1111/j.1740-8709.2011.00336x
  • [8]Kaunonen M, Hannula L, Tarkka M-T: A systematic review of peer support interventions for breastfeeding. J Clinical Nursing 2012, 21:1943-1954. 10.1111/j.1365-2702.2012.04071.x
  • [9]Thomson G, Crossland N, Dykes F: Giving me hope: women’s reflections on a breastfeeding peer support service. Mater Child Nutr 2012, 8:340-353. 10.1111/j.1740-8709.2011.00358.x
  • [10]Wade D, Haining S, Day A: Breastfeeding peer support: are there additional benefits? Commun Pract 2009, 82:30-33.
  • [11]Kempenaar LE, Darwent KL: The impact of peer support training on mothers’ attitudes towards and knowledge of breastfeeding. Mater Child Nutri 2011. doi: 10.1111/j.1740-8709.2011.00373.x
  • [12]Ingram J, Rosser J, Jackson D: Breastfeeding peer supporters and a community support group: evaluating their effectiveness. Matern Child Nutri 2005, 1:111-118.
  • [13]Ingram J: Evaluation of the Real Baby Milk Peer Support Service in Cornwall (72-hour service). Cornwall: Report for Real Baby Milk; 2011.
  • [14]Hoddinott P, Chalmers M, Pill R: One-to-one or group-based peer support for breastfeeding? Women’s perceptions of a breastfeeding peer coaching intervention. Birth 2006, 33:139-146.
  • [15]Health and Social Care Information Centre: Infant Feeding Survey 2010. London: Health and Social Care Information Centre; 2012.
  • [16]National Institute for Health and Clinical Excellence (NICE): A Peer-Support Programme for Women who Breastfeed. Commissioning Guide. London: National Institute for Health and Clinical Excellence; 2008.
  • [17]Ingram J, Johnson D: Using community maternity care assistants to facilitate family-focused breastfeeding support. Matern Child Nutri 2009, 5:276-281.
  • [18]Ingram JC, Johnson DJ, Greenwood RJ: Breastfeeding in Bristol: teaching good positioning and the importance of fathers and families. Midwifery 2002, 18:87-101.
  • [19]Ingram J, Johnson D: A feasibility study of an intervention to enhance family support for breastfeeding in a deprived area in Bristol, UK. Midwifery 2004, 20:367-379.
  • [20]Bandura A: Self-efficacy: toward a unifying theory of behaviour change. Psych Review 1977, 84:191-215.
  • [21]Dennis C: The breastfeeding self-efficacy scale: psychometric assessment of the short form. JOGNN 2003, 32:734-744. 10.1177/0884217503258459
  • [22]Entwistle F, Kendall S, Mead M: Breastfeeding support – the importance of self-efficacy for low-income women. Matern Child Nutri 2010, 6:228-242.
  • [23]Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol 2006, 3(2):77-101.
  • [24]Silverman D: Doing qualitative research: a practical handbook. London: Sage publications; 2000.
  • [25]Creswell JW: Research designs: qualitative, quantitative and mixed-methods approaches. Thousand Oaks, CA: Sage; 2003.
  • [26]Gregory A, Penrose K, Morrison C, Dennis CL, MacArthur C: Psychometric properties of the breastfeeding self-efficacy scale- short form in an ethnically diverse UK sample. Public Health Nurs 2008, 25(3):278-284.
  • [27]Nulty DD: The adequacy of response rates to online and paper surveys: what can be done? Assess Eval High Educ 2008, 33(3):301-314. 10.1080/02602930701293231
  • [28]Schmied V, Beake S, Sheehan A, McCourt C, Dykes F: Women’s perceptions and experiences of breastfeeding support: a metasynthesis. Birth 2011, 38:49-60.
  • [29]Hoddinott P, Craig LCA, Britten J, McInnes RM: A serial qualitative interview study of infant feeding experiences: idealism meets realism. BMJ Open 2012, 2:e000504. 10.1136/bmjopen-2011-000504
  • [30]Nkonki LL, Daniels KL, Promise-ebf study group: Selling a service: experiences of peer supporters while promoting exclusive infant feeding in three sites in South Africa. Int Breastfeed J 2010, 5:17. doi:10.1186/1746-4358-5-17 BioMed Central Full Text
  • [31]Nankunda J, Tumwine JK, Nankabirwa V, Tylleskar T, Promise-ebf Study Group: “She would sit with me”: mothers’ experiences of individual peer support for exclusive breastfeeding in Uganda. Int Breastfeed J 2010., 5(16) Doi: 10.1186/1746-4358-5-16
  • [32]Hoddinott P, Pill R: Qualitative study of decisions about infant feeding among women in east end of London. BMJ 1999, 318:30-34.
  • [33]MacArthur C, Jolly K, Ingram L, Freemantle N, Dennis C, Hamburger R, et al.: Antenatal peer support workers and initiation of breastfeeding: cluster randomised controlled trial. BMJ 2009, 338:392-395. 10.1136/bmj.b131
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