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Assets-based infant feeding help Before and After birth: a randomised controlled feasibility trial for improving breastfeeding initiation and continuation

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Assets-based infant feeding help Before and After birth : a randomised controlled feasibility trial for improving breastfeeding initiation and continuation. / Clarke, Joanne; Ingram, Jenny; Johnson, Debbie; Thomson, Gill; Trickey, Heather; Dombrowski, Stephan U.; Stitch, Alice ; Dykes, Fiona; Feltham, Max G.; MacArthur, Christine; Roberts, Tracy; Hoddinott, Pat; Jolly, Kate.

In: Public Health Research, 20.05.2019.

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Clarke, J, Ingram, J, Johnson, D, Thomson, G, Trickey, H, Dombrowski, SU, Stitch, A, Dykes, F, Feltham, MG, MacArthur, C, Roberts, T, Hoddinott, P & Jolly, K 2019, 'Assets-based infant feeding help Before and After birth: a randomised controlled feasibility trial for improving breastfeeding initiation and continuation', Public Health Research.

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Clarke, Joanne ; Ingram, Jenny ; Johnson, Debbie ; Thomson, Gill ; Trickey, Heather ; Dombrowski, Stephan U. ; Stitch, Alice ; Dykes, Fiona ; Feltham, Max G. ; MacArthur, Christine ; Roberts, Tracy ; Hoddinott, Pat ; Jolly, Kate. / Assets-based infant feeding help Before and After birth : a randomised controlled feasibility trial for improving breastfeeding initiation and continuation. In: Public Health Research. 2019.

Bibtex

@article{ef2fd522b53243a18353680d30487789,
title = "Assets-based infant feeding help Before and After birth: a randomised controlled feasibility trial for improving breastfeeding initiation and continuation",
abstract = "Background The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on positive capabilities of individuals and communities, rather than their deficits and problems. The Assets-based feeding help Before and After birth (ABA) intervention offers an assets-based approach based on behaviour change theory. Objective To investigate the feasibility of delivering the ABA infant feeding intervention within a randomised controlled trial. Design Individually randomised controlled feasibility trial; women randomised on a 1:1 ratio to either the intervention or the comparator (usual care). Setting Two separate English sites, selected for having an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage, and low rates of breastfeeding. Participants Women aged 16 years or older, pregnant with their first child, irrespective of feeding intention (n=103), recruited by researchers in antenatal clinics. Intervention Proactive, woman-centred support, using an assets-based approach and including Behaviour Change Techniques, provided by an Infant Feeding Helper (a breastfeeding peer supporter trained in ABA intervention), delivered through face-to-face contact, telephone conversations and text messages. The intervention commenced at around 30 weeks gestation and could continue until 5 months postnatally. Main outcome measures Feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, Infant Feeding Helpers and maternity services; feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow up rates at 3 days, 8 weeks and 6 months postnatal, with collection of outcomes for a future full trial via participant questionnaires. A mixed methods process evaluation included qualitative interviews with women, Infant Feeding Helpers and maternity services; Infant Feeding Helper logs; and audio recordings of antenatal contacts to check intervention fidelity. Results Of 135 eligible women approached, 103 (76.3{\%}) agreed to participate. The study was successful in recruiting teenagers (8.7{\%}) and women living in areas of socioeconomic disadvantage (37.3{\%} resided in the most deprived 40{\%} of small areas in England). Postnatal follow up rates were 68.0{\%}, 85.4{\%} and 80.6{\%} at 3 days, 8 weeks and 6 months respectively. Feeding status at 8-weeks was obtained for 95.1{\%} of participants. Recruitment took place February-August 2017. It was possible to recruit and train existing peer supporters to the Infant Feeding Helper role. The intervention was delivered with relatively high fidelity to most women. Of 50 women, 39 received antenatal visits and 40 received postnatal support. Qualitative data showed the intervention to be acceptable. There was no evidence of intervention-related harms. Limitations Birth notification delays resulted in delays in collection of postnatal feeding status data, and the offer of postnatal support. In addition, the intervention needs to better consider all infant feeding types and did not adequately accommodate women who delivered prematurely. Conclusions It is feasible to deliver the intervention and trial. The intervention should be tested in a fully powered randomized controlled trial.",
author = "Joanne Clarke and Jenny Ingram and Debbie Johnson and Gill Thomson and Heather Trickey and Dombrowski, {Stephan U.} and Alice Stitch and Fiona Dykes and Feltham, {Max G.} and Christine MacArthur and Tracy Roberts and Pat Hoddinott and Kate Jolly",
year = "2019",
month = "5",
day = "20",
language = "English",
journal = "Public Health Research",
issn = "2050-4381",
publisher = "NIHR Journals Library",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - Assets-based infant feeding help Before and After birth

T2 - a randomised controlled feasibility trial for improving breastfeeding initiation and continuation

AU - Clarke, Joanne

AU - Ingram, Jenny

AU - Johnson, Debbie

AU - Thomson, Gill

AU - Trickey, Heather

AU - Dombrowski, Stephan U.

AU - Stitch, Alice

AU - Dykes, Fiona

AU - Feltham, Max G.

AU - MacArthur, Christine

AU - Roberts, Tracy

AU - Hoddinott, Pat

AU - Jolly, Kate

PY - 2019/5/20

Y1 - 2019/5/20

N2 - Background The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on positive capabilities of individuals and communities, rather than their deficits and problems. The Assets-based feeding help Before and After birth (ABA) intervention offers an assets-based approach based on behaviour change theory. Objective To investigate the feasibility of delivering the ABA infant feeding intervention within a randomised controlled trial. Design Individually randomised controlled feasibility trial; women randomised on a 1:1 ratio to either the intervention or the comparator (usual care). Setting Two separate English sites, selected for having an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage, and low rates of breastfeeding. Participants Women aged 16 years or older, pregnant with their first child, irrespective of feeding intention (n=103), recruited by researchers in antenatal clinics. Intervention Proactive, woman-centred support, using an assets-based approach and including Behaviour Change Techniques, provided by an Infant Feeding Helper (a breastfeeding peer supporter trained in ABA intervention), delivered through face-to-face contact, telephone conversations and text messages. The intervention commenced at around 30 weeks gestation and could continue until 5 months postnatally. Main outcome measures Feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, Infant Feeding Helpers and maternity services; feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow up rates at 3 days, 8 weeks and 6 months postnatal, with collection of outcomes for a future full trial via participant questionnaires. A mixed methods process evaluation included qualitative interviews with women, Infant Feeding Helpers and maternity services; Infant Feeding Helper logs; and audio recordings of antenatal contacts to check intervention fidelity. Results Of 135 eligible women approached, 103 (76.3%) agreed to participate. The study was successful in recruiting teenagers (8.7%) and women living in areas of socioeconomic disadvantage (37.3% resided in the most deprived 40% of small areas in England). Postnatal follow up rates were 68.0%, 85.4% and 80.6% at 3 days, 8 weeks and 6 months respectively. Feeding status at 8-weeks was obtained for 95.1% of participants. Recruitment took place February-August 2017. It was possible to recruit and train existing peer supporters to the Infant Feeding Helper role. The intervention was delivered with relatively high fidelity to most women. Of 50 women, 39 received antenatal visits and 40 received postnatal support. Qualitative data showed the intervention to be acceptable. There was no evidence of intervention-related harms. Limitations Birth notification delays resulted in delays in collection of postnatal feeding status data, and the offer of postnatal support. In addition, the intervention needs to better consider all infant feeding types and did not adequately accommodate women who delivered prematurely. Conclusions It is feasible to deliver the intervention and trial. The intervention should be tested in a fully powered randomized controlled trial.

AB - Background The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on positive capabilities of individuals and communities, rather than their deficits and problems. The Assets-based feeding help Before and After birth (ABA) intervention offers an assets-based approach based on behaviour change theory. Objective To investigate the feasibility of delivering the ABA infant feeding intervention within a randomised controlled trial. Design Individually randomised controlled feasibility trial; women randomised on a 1:1 ratio to either the intervention or the comparator (usual care). Setting Two separate English sites, selected for having an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage, and low rates of breastfeeding. Participants Women aged 16 years or older, pregnant with their first child, irrespective of feeding intention (n=103), recruited by researchers in antenatal clinics. Intervention Proactive, woman-centred support, using an assets-based approach and including Behaviour Change Techniques, provided by an Infant Feeding Helper (a breastfeeding peer supporter trained in ABA intervention), delivered through face-to-face contact, telephone conversations and text messages. The intervention commenced at around 30 weeks gestation and could continue until 5 months postnatally. Main outcome measures Feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, Infant Feeding Helpers and maternity services; feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow up rates at 3 days, 8 weeks and 6 months postnatal, with collection of outcomes for a future full trial via participant questionnaires. A mixed methods process evaluation included qualitative interviews with women, Infant Feeding Helpers and maternity services; Infant Feeding Helper logs; and audio recordings of antenatal contacts to check intervention fidelity. Results Of 135 eligible women approached, 103 (76.3%) agreed to participate. The study was successful in recruiting teenagers (8.7%) and women living in areas of socioeconomic disadvantage (37.3% resided in the most deprived 40% of small areas in England). Postnatal follow up rates were 68.0%, 85.4% and 80.6% at 3 days, 8 weeks and 6 months respectively. Feeding status at 8-weeks was obtained for 95.1% of participants. Recruitment took place February-August 2017. It was possible to recruit and train existing peer supporters to the Infant Feeding Helper role. The intervention was delivered with relatively high fidelity to most women. Of 50 women, 39 received antenatal visits and 40 received postnatal support. Qualitative data showed the intervention to be acceptable. There was no evidence of intervention-related harms. Limitations Birth notification delays resulted in delays in collection of postnatal feeding status data, and the offer of postnatal support. In addition, the intervention needs to better consider all infant feeding types and did not adequately accommodate women who delivered prematurely. Conclusions It is feasible to deliver the intervention and trial. The intervention should be tested in a fully powered randomized controlled trial.

M3 - Article

JO - Public Health Research

JF - Public Health Research

SN - 2050-4381

ER -