Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa ON, L1G 0C5, Canada.
Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa ON, L1G 0C5, Canada.
Midwifery. 2020 Nov;90:102812. doi: 10.1016/j.midw.2020.102812. Epub 2020 Jul 22.
Breastfeeding rates are suboptimal, putting mothers and their infants' health at risk. One modifiable risk factor amenable to intervention is partner support. Having women work as a team with their co-parents to meet their breastfeeding goals has been found to improve breastfeeding outcomes. eHealth resources have been found to be accessible and feasible ways to provide breastfeeding education yet, the best way to design breastfeeding interventions for mothers and their co-parents is not known.
To compare two study conditions to determine: (1) which way is more effective to provide breastfeeding education to women and their co-parents on increasing breastfeeding rates and associated secondary outcomes, such as breastfeeding knowledge, attitude, self-efficacy and overcoming challenges; (2) the difference in co-parenting and partner support between the study groups; (3) how parents in both groups preferred to access breastfeeding information; and (4) the groups' satisfaction with the eHealth resource that was provided.
This study used a randomized controlled trial design (Clinicaltrials.org #NCT03492411). Participants were randomly allocated to study groups with concealed opaque envelopes by a blinded research assistant. Participants in Study Condition #1 (SC1) accessed a previously created, online e-Health resource, in addition to other generally available resources they could access in the community; participants in Study Condition #2 (SC2) accessed only the generally available resources.
Participants were recruited in health care providers' offices and services for expectant parents in Ontario and via social media throughout Canada.
Expectant women (n = 113) and their co-parents (n = 104) were enrolled.
After eligibility was determined, consents obtained and baseline surveys completed, group allocation was conducted. SC1 had a virtual meeting with a research assistant to review the eHealth resource. Weekly emails were sent to all participants for 6 weeks as reminders. Follow-up data were electronically collected from mothers and co-parents at 2 weeks post enrollment and 4, 12, 26 and 52-weeks postpartum.
Breastfeeding rates were high in both groups (SC1 63% and SC2 57% 'exclusive' 6 months) and (SC1 71% and SC2 78% 'any' 12 months) and not statistically significantly different. High scores were found in both groups in secondary outcome measures. Generally available breastfeeding resources were used in both groups with websites being used often and rated as most helpful. SC1 rated the eHealth resource provided to them highly.
The findings suggest both mothers and their co-parents should be targeted in breastfeeding education and web-based resources designed to meet their needs.
母乳喂养率不理想，这使母亲及其婴儿的健康处于危险之中。一个可以通过干预来改变的风险因素是伴侣的支持。让女性与她们的共同父母合作来实现母乳喂养目标，这已被证明可以改善母乳喂养的结果。电子健康资源已被证明是提供母乳喂养教育的一种可及且可行的方式，但为母亲及其共同父母设计最佳的母乳喂养干预措施尚不清楚。
比较两种研究条件，以确定：（1）哪种方法更有效地向女性及其共同父母提供母乳喂养教育，以提高母乳喂养率和相关的次要结果，如母乳喂养知识、态度、自我效能感和克服挑战；（2）研究组之间在共同养育和伴侣支持方面的差异；（3）父母双方更喜欢通过哪种方式获取母乳喂养信息；以及（4）两组对提供的电子健康资源的满意度。
本研究采用随机对照试验设计（Clinicaltrials.org #NCT03492411）。参与者通过一名盲法研究助理使用密封不透明信封进行随机分组。研究条件 1（SC1）组的参与者除了可以在社区中获得的其他一般可用资源外，还可以访问之前创建的在线电子健康资源；研究条件 2（SC2）组的参与者仅可访问一般可用资源。
参与者是在安大略省的医疗保健提供者办公室和服务机构以及整个加拿大的社交媒体上招募的。
招募了 113 名孕妇及其共同父母（104 名）。
在确定了资格、获得了同意并完成了基线调查后，进行了分组。SC1 与一名研究助理进行了虚拟会议，以审查电子健康资源。在接下来的 6 周内，每周向所有参与者发送电子邮件提醒。在入组后 2 周、4 周、12 周、26 周和 52 周时，通过电子方式从母亲和共同父母处收集随访数据。
两组的母乳喂养率都很高（SC1 为 63%，SC2 为 57%，6 个月时为“纯母乳喂养”；SC1 为 71%，SC2 为 78%，12 个月时为“任何形式的母乳喂养”），且无统计学差异。两组在次要结局测量中均取得了较高的分数。一般可用的母乳喂养资源在两组中均有使用，网站使用频率较高，被评为最有帮助。SC1 对他们提供的电子健康资源评价很高。
研究结果表明，应针对母亲及其共同父母进行母乳喂养教育，设计满足他们需求的基于网络的资源。
