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

Springer Science and Business Media LLC - Tập 20 Số 1 - 2020
Gill Thomson1, Jenny Ingram2, Joanne Clarke3, Debbie Johnson2, Heather Trickey4, Stephan U Dombrowski5, Pat Hoddinott6, Kirsty Darwent7, Kate Jolly3
1Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, Preston, UK
2Centre for Academic Child Health, University of Bristol, Bristol, UK
3Institute of Applied Health Research, Murray Learning Centre, University of Birmingham, Birmingham, B15 2TT, UK
4DECIPHER, Department of Social Medicine, Cardiff University, Cardiff, UK
5Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
6Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
7Faculty of Science and Sport, University of Stirling, Stirling, UK

Tóm tắt

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.

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Tài liệu tham khảo

Victora CG, Bahl R, Barr os AJ, França GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475–90.

McAndrew F, Thompson J, Fellows L, Large A, Speed M, Renfrew MJ. Infant feeding survey 2010. Leeds: Health and Social Care Information Centre; 2012.

Renfrew M, Ansell P, Macleod K. Formula feed preparation: helping reduce the risks; a systematic review. Arch Dis Child. 2003;88(10):855–8.

Dyson L, Green JM, Renfrew MJ, McMillan B, Woolridge M. Factors influencing the infant feeding decision for socioeconomically deprived pregnant teenagers: the moral dimension. Birth. 2010;37(2):141–9.

Forster DA, McLachlan HL, Lumley J. Factors associated with breastfeeding at six months postpartum in a group of Australian women. Int Breastfeed J. 2006;1(1):18.

Thomson G, Ebisch-Burton K, Flacking R. Shame if you do–shame if you don't: women's experiences of infant feeding. Matern Child Nutr. 2015;11(1):33–46.

McInnes RJ, Chambers JA. Supporting breastfeeding mothers: qualitative synthesis. J Adv Nurs. 2008;62(4):407–27.

Swanson V, Power KG. Initiation and continuation of breastfeeding: theory of planned behaviour. J Adv Nurs. 2005;50(3):272–82.

DiGirolamo A, Thompson N, Martorell R, Fein S, Grummer-Strawn L. Intention or experience? Predictors of continued breastfeeding. Health Educ Behav. 2005;32(2):208–26.

Susin LR, Giugliani ER, Kummer SC. Influence of grandmothers on breastfeeding practices. Rev Saude Publica. 2005;39(2):141–7.

Thomson G, Dykes F. Women's sense of coherence related to their infant feeding experiences. Matern Child Nutr. 2011;7(2):160–74.

McInnes RJ, Hoddinott P, Britten J, Darwent K, Craig LC. Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study. BMC Pregnancy Childbirth. 2013;13(1):114.

Hoddinott P, Craig LC, Britten J, McInnes RM. A serial qualitative interview study of infant feeding experiences: idealism meets realism. BMJ Open. 2012;2(2):e000504.

Schmied V, Sheehan A, Fenwick J, Dykes F. Embodied knowledge and emotional labour in family conversations about breastfeeding: a discourse analysis. Women Birth. 2013;26:S18.

Morgan A, Ziglio E. Revitalising the public health evidence base: An asset model. Springer: Health Assets in a Global Context; 2010. p. 3–16.

McLean J. Asset based approaches for health improvement: redressing the balance. Glasgow Centre for Population Health: UK; 2011.

Foot J, Hopkins T. A glass half-full: how an asset approach can improve community health and well-being: Great Britain improvement and development agency; 2010.

Friedli L. ‘What we’ve tried, hasn’t worked’: the politics of assets based public health. Crit Public Health. 2013;23(2):131–45.

McGoldrick M, Gerson R, Petry SS. Genograms: Assessment and intervention. London: Norton & Company; 2008.

Darwent K, McInnes R, Swanson V. The infant feeding genogram: a tool for exploring family infant feeding history and identifying support needs. BMC Pregnancy Childbirth. 2016;16(1):315.

Jolly K, Ingram J, Clarke J, Johnson D, Trickey H, Thomson G, et al. Protocol for a feasibility trial for improving breast feeding initiation and continuation: assets-based infant feeding help before and after birth (ABA). BMJ Open. 2018;8(1):e019142.

Clarke JL, Ingram J, Johnson D, Thomson G, Trickey H, Dombrowski SU, et al. The assets-based infant feeding help before and after birth (ABA) intervention for improving breastfeeding initiation and continuation: feasibility study results. Maternal Child Nutrition. 2019. https://doi.org/10.1111/mcn.12907.

Ingram J, Thomson G, Johnson D, Clarke JL, Trickey H, Hoddinott P, et al. Women's and peer supporters' experiences of an assets-based peer support intervention for increasing breastfeeding initiation and continuation: a qualitative study. Health Expect. 2020;23(3):622–31. https://doi.org/10.1111/hex.13042 Epub 2020 Mar 21.

Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46(1):81–95.

Michie S, Van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6(1):42.

Hoddinott P, Craig L, Maclennan G, Boyers D, Vale L. The FEeding Support Team (FEST) randomised, controlled feasibility trial of proactive and reactive telephone support for breastfeeding women living in disadvantaged areas. BMJ Open. 2012;2(2). https://doi.org/10.1136/bmjopen-2011-000652.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.

Rotegård AK, Moore SM, Fagermoen MS, Ruland CM. Health assets: a concept analysis. Int J Nurs Stud. 2010;47(4):513–25.

Aiken A, Thomson G. Professionalisation of a breast-feeding peer support service: issues and experiences of peer supporters. Midwifery. 2013;29(12):e145–e51.

Puskar K, Nerone M. Genogram: a useful tool for nurse practitioners. J Psychiatr Ment Health Nurs. 1996;3(1):55–60.

Weller B. Guidelines: incentives for health professionals. In: Global Health Workforce Alliance; 2008. https://www.who.int/workforcealliance/knowledge/publications/alliance/Incentives_ Guidelines%20ENG%20low.pdf?ua=1 [Accessed 11/07/2019].

National Maternity Review. Better Births: Improving outcomes of maternity services in England. https://wwwenglandnhsuk/wp-content/uploads/2016/02/national-maternity-review-reportpdf2016. [accessed 12/6/2019].

UNICEF UK. Evidence and rationale for the UNICEF UK baby friendly initiative: a resource for practitioners. London: UNICEF http://wwwuniceforguk/Documents/Baby_Friendly/Research/baby_friendly_evidence_rationalepdf [accessed 13/06/2019].

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