Khoury Amal J, Moazzem S Wakerul, Jarjoura Chad M, Carothers Cathy, Hinton Agnes
Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida, USA.
Womens Health Issues. 2005 Mar-Apr;15(2):64-72. doi: 10.1016/j.whi.2004.09.003.
Despite the documented health and emotional benefits of breast-feeding to women and children, breast-feeding rates are low among subgroups of women. In this study, we examine factors associated with breast-feeding initiation in low-income women, including Theory of Planned Behavior measures of attitude, support, and perceived control, as well as sociodemographic characteristics. A mail survey, with telephone follow-up, of 733 postpartum Medicaid beneficiaries in Mississippi was conducted in 2000. The breast-feeding initiation rate in this population was 38%. Women who were older, white, non-Hispanic, college-educated, married, not certified for the Supplemental Nutrition Program for Women, Infants, and Children, and not working full-time were more likely to breast-feed than formula-feed at hospital discharge. Attitudes regarding benefits and barriers to breast-feeding, as well as health care system and social support, were associated with breast-feeding initiation at the multivariate level. Adding the health care system support variables to the regression model, and specifically support from lactation specialists and hospital nurses, explained the association between breast-feeding initiation and women's perceived control over the time and social constraints barriers to breast-feeding. The findings support the need for health care system interventions, family interventions, and public health education campaigns to promote breast-feeding in low-income women.
尽管有记录表明母乳喂养对妇女和儿童的健康及情感有益，但某些女性亚群体的母乳喂养率较低。在本研究中，我们调查了与低收入女性开始母乳喂养相关的因素，包括计划行为理论中态度、支持和感知控制方面的指标，以及社会人口学特征。2000年，我们对密西西比州733名产后医疗补助受益女性进行了邮件调查，并进行电话随访。该人群的母乳喂养启动率为38%。年龄较大、白人、非西班牙裔、受过大学教育、已婚、未获得妇女、婴儿和儿童补充营养计划认证且未全职工作的女性，在出院时更有可能选择母乳喂养而非配方奶喂养。在多变量层面，对母乳喂养的益处和障碍的态度，以及医疗保健系统和社会支持，都与母乳喂养的开始有关。将医疗保健系统支持变量添加到回归模型中，特别是来自哺乳专家和医院护士的支持，解释了母乳喂养开始与女性对母乳喂养时间的感知控制以及社会限制障碍之间的关联。研究结果支持需要医疗保健系统干预、家庭干预和公共卫生教育活动，以促进低收入女性的母乳喂养。
