Wilhelm Susan L, Aguirre Trina M, Koehler Ann E, Rodehorst T Kim
University of Nebraska Medical Center, College of Nursing-West Nebraska Division , Scottsbluff, Nebraska , USA.
Issues Compr Pediatr Nurs. 2015 Mar;38(1):7-21. doi: 10.3109/01460862.2014.971977. Epub 2014 Nov 6.
Although most Hispanic/Latino-American mothers initiate breastfeeding, duration and exclusivity of breastfeeding remain low. We explored whether a motivational interviewing (MI) intervention could help rural Mexican-American mothers continue breastfeeding. We used a two-group (MI intervention n = 26, attention control [AC] n = 27) repeated measures experimental design. Assessments and interventions occurred at 3 days, 2 weeks, and 6 weeks postpartum (time points when mothers are particularly vulnerable to discontinuing breastfeeding), with a final phone assessment at 6 months postpartum. We collected demographic data and measured intent to breastfeed for 6 months (intent question), self-efficacy (Breastfeeding Self-Efficacy Scale-Short Form), and collected breastfeeding information (breastfeeding assessment questionnaire). Independent t-tests and Mann Whitney U non-parametric tests were used to evaluate group differences (α = 0.05). High levels of attrition by week 6 impaired our ability to evaluate the potential of our MI intervention. No significant differences were found between groups for any of the outcome variables (intent to breastfeed for 6 months, breastfeeding self-efficacy, and duration of breastfeeding). Though the mothers intended to breastfeed for 6 months and were confident in their ability to do so, most did not breastfeed for 6 months. At 6 months, mothers receiving the MI intervention had breastfed an average of 90 days compared to 82 days for those receiving the AC sessions and 22% of the mothers in each group were still breastfeeding at some level. Because of the impact of attrition during this study, we discuss factors that contributed to attrition and approaches to lessen this problem in future studies. Such efforts may require a greater investment of time and resources and should be budgeted accordingly. Culturally appropriate interventions are needed to help rural Mexican-American mothers meet their breastfeeding goals, thus providing an opportunity to reduce their children's risk of multiple diseases and obesity. Only when we address these considerations will we have an opportunity to decrease health disparities, promote healthy behaviors, and be trusted health care partners.
尽管大多数西班牙裔/拉丁裔美国母亲开始进行母乳喂养，但母乳喂养的持续时间和纯母乳喂养率仍然较低。我们探讨了动机性访谈（MI）干预是否有助于墨西哥裔美国农村母亲持续进行母乳喂养。我们采用了两组（MI干预组n = 26，注意力控制[AC]组n = 27）重复测量实验设计。评估和干预在产后3天、2周和6周（母亲特别容易停止母乳喂养的时间点）进行，产后6个月进行最后一次电话评估。我们收集了人口统计学数据，并测量了6个月母乳喂养的意愿（意愿问题）、自我效能感（母乳喂养自我效能量表简版），并收集了母乳喂养信息（母乳喂养评估问卷）。使用独立t检验和曼-惠特尼U非参数检验来评估组间差异（α = 0.05）。到第6周时的高失访率削弱了我们评估MI干预潜力的能力。在任何结果变量（6个月母乳喂养意愿、母乳喂养自我效能感和母乳喂养持续时间）上，两组之间均未发现显著差异。尽管母亲们打算母乳喂养6个月并且对自己这样做的能力有信心，但大多数母亲并没有母乳喂养6个月。在6个月时，接受MI干预的母亲平均母乳喂养了90天，而接受AC课程的母亲为82天，每组中22%的母亲仍在某种程度上进行母乳喂养。由于本研究中失访的影响，我们讨论了导致失访的因素以及在未来研究中减轻这一问题的方法。此类努力可能需要投入更多的时间和资源，应相应地进行预算。需要采取符合文化背景的干预措施，以帮助墨西哥裔美国农村母亲实现她们的母乳喂养目标，从而为降低其子女患多种疾病和肥胖症的风险提供机会。只有当我们解决这些问题时，我们才有机会减少健康差距、促进健康行为并成为值得信赖的医疗保健伙伴。
