Division of General Academic Pediatric and Adolescent Medicine, Department of Pediatrics, Rainbow Babies and Children’s Hospital,Cleveland, Ohio 44106, USA.
Breastfeed Med. 2013 Feb;8(1):58-67. doi: 10.1089/bfm.2012.0012. Epub 2012 Jul 23.
This study identified barriers to breastfeeding among high-risk inner-city African-American mothers.
We used audiotaped focus groups moderated by an experienced International Board Certified Lactation Consultant, with recruitment supported by the community partner MomsFirst™ (Cleveland Department of Public Health, Cleveland, OH). Institutional Review Board approval and written informed consent were obtained. Notes-based analysis was conducted with use of a prior analytic structure called Factors Influencing Beliefs (FIBs), redefined with inclusion/exclusion criteria to address breastfeeding issues.
Three focus groups included 20 high-risk inner-city expectant and delivered mothers. Relevant FIBs domains were as follows: Risk Appraisal, Self Perception, Relationship Issues/Social Support, and Structural/Environmental Factors. Risk Appraisal themes included awareness of benefits, fear of pain, misconceptions, and lack of information. Self Perception themes included low self-efficacy with fear of social isolation and limited expression of positive self-esteem. Relationship Issues/Social Support themes included formula as a cultural norm, worries about breastfeeding in public, and challenging family relationships. Structural/Environmental Factors themes included negative postpartum hospital experiences and lack of support after going home.
Several findings have been previously reported, such as fear of pain with breastfeeding, but we identified new themes, including self-esteem and self-efficacy, and new concerns, for example, that large breasts would suffocate a breastfeeding infant. The FIBs analytic framework, as modified for breastfeeding issues, creates a context for future analysis and comparison of related studies and may be a useful tool to improve understanding of barriers to breastfeeding among high-risk inner-city women.
本研究旨在确定高危城市内非裔美国母亲母乳喂养的障碍。
我们使用由经验丰富的国际认证哺乳顾问主持的录音焦点小组，在社区合作伙伴 MomsFirst™（克利夫兰公共卫生部，克利夫兰，OH）的支持下进行招募。获得了机构审查委员会的批准和书面知情同意。使用先前称为影响信念因素（FIBs）的分析结构进行基于注释的分析，该结构经过重新定义，纳入/排除标准以解决母乳喂养问题。
三个焦点小组包括 20 名高危城市的孕妇和产妇。相关的 FIB 领域如下：风险评估、自我认知、关系问题/社会支持和结构/环境因素。风险评估主题包括对益处的认识、对疼痛的恐惧、误解和缺乏信息。自我认知主题包括低自我效能感、对社会孤立的恐惧和对积极自尊的表达有限。关系问题/社会支持主题包括配方作为一种文化规范、担心在公共场合母乳喂养以及与家庭关系紧张。结构/环境因素主题包括产后医院体验不佳和回家后缺乏支持。
我们已经发现了一些以前报道过的发现，例如母乳喂养时的疼痛恐惧，但我们确定了新的主题，包括自尊和自我效能感，以及新的关注点，例如大乳房会使母乳喂养的婴儿窒息。针对母乳喂养问题进行修改的 FIBs 分析框架为未来分析和比较相关研究创造了一个背景，并且可能是一种有用的工具，可以帮助更好地理解高危城市妇女母乳喂养的障碍。
