Exploring the use and experience of an infant feeding genogram to facilitate an assets-based approach to support infant feeding

Abstract Background A lack of perceived social support influences women’s infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women’s and infant feeding helpers’ experiences and use of an infant feeding genogram delivered to the intervention group of the Assets-based infant feeding help Before and After birth (ABA) randomised feasibility trial. Methods 103 primiparous mothers aged 16+ years were recruited to the trial in two sites (Site A and Site B) with low breastfeeding prevalence in the UK. Infant feeding helpers co-constructed a genogram at the first antenatal meeting for the intervention group, and then provided proactive, woman-centered support from ~32 weeks gestation to up to 5 months postnatal. Infant feeding helpers and women’s experiences of the infant feeding genogram were collected via interviews or focus groups. Completed genograms were shared with researchers. Content analysis of the genograms and qualitative data from the interviews and focus groups were analysed thematically. Results Data comprised 32 completed genograms, and qualitative insights from all 13 infant feeding helpers (two focus groups; 4 interviews) and interviews with a purposive sample of 21 of 50 intervention group women between 4-21 weeks after birth. Content analysis of the genograms highlighted variations, with more personal, individualised genograms completed at Site B compared to Site A. The perceived impact of the genogram was related to the IFHs’ application of the tool. The genogram was either used as intended to raise women’s awareness of available assets and motivate help-seeking behaviour, or as a data collection tool with limited perceived utility. Negative and positive unintended consequences of genogram use were highlighted.Discussion/Conclusion The genogram has the potential to offer a woman, family and community-centred approach that focusses on building assets for infant feeding. However, variations in genogram application indicate that revised training is required to clarify the purpose and ensure it is used as intended.

Download Full-text

Exploring the use and experience of an infant feeding genogram to facilitate an assets-based approach to support infant feeding

10.21203/rs.2.15943/v2 ◽

2020 ◽

Author(s):

Gill Thomson ◽

Jenny Ingram ◽

Joanne L Clarke ◽

Debbie Johnson ◽

Heather Trickey ◽

...

Keyword(s):

Content Analysis ◽

Focus Groups ◽

Infant Feeding ◽

Help Seeking ◽

Intervention Group ◽

Unintended Consequences ◽

Feasibility Trial ◽

Before And After ◽

Help Seeking Behaviour ◽

The Uk

Abstract Background: A lack of perceived social support influences women’s infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women’s and infant feeding helpers’ experiences and use of an infant feeding genogram delivered to the intervention group of the Assets-based infant feeding help Before and After birth (ABA) randomised feasibility trial. Methods: 103 primiparous mothers aged 16+ years were recruited to the trial in two sites (Site A and Site B) with low breastfeeding prevalence in the UK. Infant feeding helpers (IFHs) co-constructed a genogram at the first antenatal meeting for the intervention group (n=50), and then provided proactive, woman-centered support from ~32 weeks gestation to up to 5 months postnatal. Infant feeding helpers and women’s experiences of the infant feeding genogram were collected via interviews or focus groups. Completed genograms were shared with researchers. Content analysis of the genograms and qualitative data from the interviews and focus groups were analysed thematically. Results: Data comprised 32 completed genograms, and qualitative insights from all 13 infant feeding helpers (two focus groups; 4 interviews) and interviews with a purposive sample of 21 of 50 intervention group women between 4-21 weeks after birth. Content analysis of the genograms highlighted variations, with more personal, individualised genograms completed at Site B compared to Site A. The perceived impact of the genogram was related to the IFHs’ application of the tool. The genogram was either used as intended to raise women’s awareness of available assets and motivate help-seeking behaviour, or as a data collection tool with limited perceived utility. Negative and positive unintended consequences of genogram use were highlighted. Conclusions: The genogram has the potential to offer a woman, family and community-centred approach that focusses on building assets for infant feeding. However, variations in genogram application indicate that revised training is required to clarify the purpose and ensure it is used as intended.

Download Full-text

Exploring the use and experience of an infant feeding genogram to facilitate an assets-based approach to support infant feeding

10.21203/rs.2.15943/v3 ◽

2020 ◽

Author(s):

Gill Thomson ◽

Jenny Ingram ◽

Joanne L Clarke ◽

Debbie Johnson ◽

Heather Trickey ◽

...

Keyword(s):

Content Analysis ◽

Focus Groups ◽

Infant Feeding ◽

Help Seeking ◽

Intervention Group ◽

Unintended Consequences ◽

Feasibility Trial ◽

Before And After ◽

Help Seeking Behaviour ◽

The Uk

Abstract Background: A lack of perceived social support influences women’s infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women’s and infant feeding helpers’ experiences and use of an infant feeding genogram delivered to the intervention group of the “Assets-based infant feeding help Before and After birth (ABA)” randomised feasibility trial. Methods: 103 primiparous mothers aged 16+ years were recruited to the trial (trial registration number ISRCTN ISRCTN14760978) in two sites (Site A and Site B) with low breastfeeding prevalence in the UK. Infant feeding helpers (IFHs) co-constructed a genogram at the first antenatal meeting for the intervention group (n=50), and then provided proactive, woman-centered support from ~32 weeks gestation to up to 5 months postnatal. Infant feeding helpers and women’s experiences of the infant feeding genogram were collected via interviews or focus groups. Completed genograms were shared with researchers. Content analysis of the genograms and qualitative data from the interviews and focus groups were analysed thematically. Results: Data comprised 32 completed genograms, and qualitative insights from all 13 infant feeding helpers (two focus groups; 4 interviews) and interviews with a purposive sample of 21 of 50 intervention group women between 4-21 weeks after birth. Content analysis of the genograms highlighted variations, with more personal, individualised genograms completed at Site B compared to Site A. The perceived impact of the genogram was related to the IFHs’ application of the tool. The genogram was either used as intended to raise women’s awareness of available assets and motivate help-seeking behaviour, or as a data collection tool with limited perceived utility. Negative and positive unintended consequences of genogram use were highlighted. Conclusions: The genogram has the potential to offer a woman, family and community-centred approach that focusses on building assets for infant feeding. However, variations in genogram application indicate that revised training is required to clarify the purpose and ensure it is used as intended.

Download Full-text

Exploring the use and experience of an infant feeding genogram to facilitate an assets-based approach to support infant feeding

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03245-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Gill Thomson ◽

◽

Jenny Ingram ◽

Joanne L. Clarke ◽

Debbie Johnson ◽

...

Keyword(s):

Content Analysis ◽

Focus Groups ◽

Infant Feeding ◽

Help Seeking ◽

Intervention Group ◽

Unintended Consequences ◽

Trial Registration ◽

Feasibility Trial ◽

Before And After ◽

The Uk

Abstract Background A lack of perceived social support influences women’s infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women’s and infant feeding helpers’ experiences and use of an infant feeding genogram delivered to the intervention group of the “Assets-based infant feeding help Before and After birth (ABA)” randomised feasibility trial. Methods 103 primiparous mothers aged 16+ years were recruited to the trial (trial registration number) in two sites (Site A and Site B) with low breastfeeding prevalence in the UK. Infant feeding helpers (IFHs) co-constructed a genogram at the first antenatal meeting for the intervention group (n = 50), and then provided proactive, woman-centered support from ~ 32 weeks gestation to up to 5 months postnatal. Infant feeding helpers' and women’s experiences of the infant feeding genogram were collected via interviews or focus groups. Completed genograms were shared with researchers. Content analysis of the genograms and qualitative data from the interviews and focus groups were analysed thematically. Results Data comprised 32 completed genograms, and qualitative insights from all 13 infant feeding helpers (two focus groups; 4 interviews) and interviews with a purposive sample of 21 of 50 intervention group women between 4 and 21 weeks after birth. Content analysis of the genograms highlighted variations, with more personal, individualised genograms completed at Site B compared to Site A. The perceived impact of the genogram was related to the IFHs’ application of the tool. The genogram was either used as intended to raise women’s awareness of available assets and motivate help-seeking behaviour, or as a data collection tool with limited perceived utility. Negative and positive unintended consequences of genogram use were highlighted. Conclusions The genogram has the potential to offer a woman, family and community-centred approach that focusses on building assets for infant feeding. However, variations in genogram application indicate that revised training is required to clarify the purpose and ensure it is used as intended. Trial registration ISRCTN ISRCTN14760978; Registered 30 January 2017.

Download Full-text

An assets-based intervention before and after birth to improve breastfeeding initiation and continuation: the ABA feasibility RCT

Public Health Research ◽

10.3310/phr08070 ◽

2020 ◽

Vol 8 (7) ◽

pp. 1-156

Author(s):

Joanne L Clarke ◽

Jenny Ingram ◽

Debbie Johnson ◽

Gill Thomson ◽

Heather Trickey ◽

...

Keyword(s):

Public Health ◽

Randomised Controlled Trial ◽

Infant Feeding ◽

Health Research ◽

Controlled Trial ◽

Intervention Group ◽

Public Health Research ◽

Breastfeeding Initiation ◽

Before And After ◽

Randomised Controlled

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 the 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 in a randomised controlled trial. Design This was an individually randomised controlled feasibility trial; women were randomised in a 1 : 1 ratio to either the intervention group or the comparator (usual care) group. Setting Two separate English sites were selected because they had an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage and low rates of breastfeeding. Participants Women aged ≥ 16 years who were pregnant with their first child, irrespective of feeding intention (n = 103), were recruited by researchers in antenatal clinics. Interventions Proactive, woman-centred support, using an assets-based approach and including behaviour change techniques, was provided by an infant-feeding helper (a breastfeeding peer supporter trained in the ABA intervention) and 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 The main outcome measures were feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, infant-feeding helpers and maternity services; and feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow-up rates at 3 days, 8 weeks and 6 months postnatally, and outcomes for a future full trial were collected 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 the 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 from February 2017 until August 2017. It was possible to recruit and train existing peer supporters to the infant-feeding helper role. The intervention was delivered to most women with relatively high fidelity. Among the 50 women in the intervention group, 39 received antenatal visits and 40 received postnatal support. Qualitative data showed that the intervention was acceptable. There was no evidence of intervention-related harms. Limitations Birth notification delays resulted in delays in the collection of postnatal feeding status data and in 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. Conclusion It is feasible to deliver the intervention and trial. Future work The intervention should be tested in a fully powered randomised controlled trial. Trial registration Current Controlled Trials ISRCTN14760978. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 7. See the NIHR Journals Library website for further project information.

Download Full-text

Protocol for a feasibility trial for improving breast feeding initiation and continuation: assets-based infant feeding help before and after birth (ABA)

BMJ Open ◽

10.1136/bmjopen-2017-019142 ◽

2018 ◽

Vol 8 (1) ◽

pp. e019142 ◽

Cited By ~ 7

Author(s):

Kate Jolly ◽

Jenny Ingram ◽

Joanne Clarke ◽

Debbie Johnson ◽

Heather Trickey ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Infant Feeding ◽

Feasibility Study ◽

Breast Feeding ◽

Controlled Trial ◽

Feasibility Trial ◽

Study Results ◽

Service Staff ◽

Before And After ◽

Randomised Controlled

IntroductionBreast feeding improves the health of mothers and infants; the UK has low rates, with marked socioeconomic inequalities. While trials of peer support services have been effective in some settings, UK trials have not improved breast feeding rates. Qualitative research suggests that many women are alienated by the focus on breast feeding. We propose a change from breast feeding-focused interactions to respecting a woman’s feeding choices, inclusion of behaviour change theory and an increased intensity of contacts in the 2 weeks after birth when many women cease to breast feed. This will take place alongside an assets-based approach that focuses on the positive capability of individuals, their social networks and communities.We propose a feasibility study for a multicentre randomised controlled trial of the Assets feeding help Before and After birth (ABA) infant feeding service versus usual care.Methods and analysisA two-arm, non-blinded randomised feasibility study will be conducted in two UK localities. Women expecting their first baby will be eligible, regardless of feeding intention. The ABA infant feeding intervention will apply a proactive, assets-based, woman-centred, non-judgemental approach, delivered antenatally and postnatally tailored through face-to-face contacts, telephone and SMS texts. Outcomes will test the feasibility of delivering the intervention with recommended intensity and duration to disadvantaged women; acceptability to women, feeding helpers and professionals; and feasibility of a future randomised controlled trial (RCT), detailing recruitment rates, willingness to be randomised, follow-up rates at 3 days, 8 weeks and 6 months, and level of outcome completion. Outcomes of the proposed full trial will also be collected. Mixed methods will include qualitative interviews with women/partners, feeding helpers and health service staff; feeding helper logs; and review of audio-recorded helper–women interactions to assess intervention fidelity.Ethics and disseminationStudy results will inform the design of a larger multicentre RCT. The National Research Ethics Service Committee approved the study protocol.Trial registration numberISRCTN14760978; Pre-results.

Download Full-text

Mental Health, Help-Seeking Behaviour and Social Support in the UK Armed Forces by Gender

Psychiatry ◽

10.1080/00332747.2019.1626200 ◽

2019 ◽

pp. 1-16

Author(s):

Norman Jones ◽

Neil Greenberg ◽

Ava Phillips ◽

Amos Simms ◽

Simon Wessely

Keyword(s):

Mental Health ◽

Social Support ◽

Help Seeking ◽

Armed Forces ◽

Help Seeking Behaviour ◽

The Uk

Download Full-text

Codeine use, dependence and help-seeking behaviour in the UK and Ireland: an online cross-sectional survey

QJM ◽

10.1093/qjmed/hcx076 ◽

2017 ◽

Vol 110 (9) ◽

pp. 559-564 ◽

Cited By ~ 11

Author(s):

A. Kimergård ◽

M. Foley ◽

Z. Davey ◽

J. Dunne ◽

C. Drummond ◽

...

Keyword(s):

Help Seeking ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Help Seeking Behaviour ◽

The Uk

Download Full-text

Changes in stigma and help-seeking in relation to postpartum depression: non-clinical parenting intervention sample

PeerJ ◽

10.7717/peerj.5893 ◽

2018 ◽

Vol 6 ◽

pp. e5893 ◽

Cited By ~ 1

Author(s):

Einar B. Thorsteinsson ◽

Natasha M. Loi ◽

Kathryn Farr

Keyword(s):

Mental Health ◽

Postpartum Depression ◽

Help Seeking ◽

Intervention Group ◽

Parenting Intervention ◽

Control Group ◽

Video Documentary ◽

High Incidence ◽

Help Seeking Behaviour ◽

Seeking Help

Postpartum depression (PPD) is a prevalent mental illness affecting women, and less commonly, men in the weeks and months after giving birth. Despite the high incidence of PPD in Australia, rates for help-seeking remain low, with stigma and discrimination frequently cited as the most common deterrents to seeking help from a professional source. The present study sought to investigate PPD stigma in a sample of parents and to examine the effects of an intervention on stigma and help-seeking behaviour. A total of 212 parents aged 18–71 years (M = 36.88, 194 females) completed measures of personal and perceived PPD stigma and attitudes towards seeking mental health services and were randomly assigned to one of four groups: an intervention group (video documentary or factsheet related to PPD) or a control group (video documentary or factsheet not related to PPD). Results showed that there were no effects for type of intervention on either personal or perceived PPD stigma scores. No effect was found for help-seeking propensity. Males had higher personal PPD stigma than females and older age was associated with lower personal PPD stigma. Familiarity with PPD was associated with perceived PPD stigma in others but not personal PPD stigma. More work needs to be conducted to develop interventions to reduce PPD stigma in the community.

Download Full-text

Chinese Students’ Expectations Versus Reality When Studying on a UK-China Transnational Chemistry Degree Program

New Directions in the Teaching of Physical Sciences ◽

10.29311/ndtps.v0i14.3325 ◽

2019 ◽

Author(s):

Phillippa B Cranwell ◽

Michael G Edwards ◽

Katherine Jane Haxton ◽

Julie Hyde ◽

Elizabeth M Page ◽

...

Keyword(s):

Focus Groups ◽

Academic Staff ◽

Chinese Students ◽

Extensive Study ◽

Free Text ◽

Student Expectations ◽

Chemistry Students ◽

Before And After ◽

The Uk ◽

The Relationship

An extensive study has been conducted into the experiences of Chinese chemistry students studying on transnational education (TNE) programs at four UK institutions partnered with Chinese universities; in particular, student expectations regarding studying in the UK compared with reality were examined. Students were consulted by questionnaire both before and after arrival in the UK. Results from the questionnaires were statistically analysed, the free text responses coded and these data were used to inform further discussion in focus groups. The main differences between the UK and China fell into three key areas: the language barrier; study habits of TNE students in the UK compared to when in China; and the relationship between UK academic staff and the TNE students. These findings are discussed in more detail throughout this paper. We conclude by providing recommendations for other institutions establishing TNE courses.

Download Full-text