Department of Obstetrics and Gynecology, Women and Infants Hospital, Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA.
Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.
Breastfeed Med. 2021 Aug;16(8):614-623. doi: 10.1089/bfm.2021.0012. Epub 2021 Apr 7.
Low-income women are less likely to breastfeed than high-income women. Technology-based interventions demonstrate promise in decreasing health disparities. We assessed whether increased use of breastfeeding smartphone applications (apps) impacts breastfeeding rates for low-income women. This is a secondary analysis of a randomized control trial (RCT), including nulliparous, low-income women. Women were randomized to one of two novel apps: control app containing digital breastfeeding handouts and BreastFeeding Friend (BFF), an interactive app containing on-demand breastfeeding educational and video content. App usage was securely tracked. The highest quartile of BFF and control app users were combined and compared to the lowest quartile of app users. The primary outcome was breastfeeding initiation. Secondary outcomes included breastfeeding outcomes and resource preferences through 6 months. In the RCT, BFF and control app median uses were 15 (interquartile range [IQR] 4-24) and 9 (IQR 5-19) ( = 0.1), respectively. Breastfeeding initiation did not differ with app usage (84.1% in highest quartile versus 78.2% for lowest quartile; = 0.5). Rates of sustained and exclusive breastfeeding through 6 months were similar between groups. Among both groups, smartphone apps were the most preferred breastfeeding resource at 6 weeks. Low quartile users also preferred alternative online breastfeeding resources: >50% of all users preferred technology-based breastfeeding resources. Increased usage of breastfeeding apps did not improve breastfeeding rates among low-income women. However, technology-based resources were the most preferred breastfeeding resource after hospital discharge, indicating ongoing development of technology-based interventions has potential to increase breastfeeding in this high-needs population. clinicaltrials.gov (NCT03167073).
低收入妇女母乳喂养的可能性低于高收入妇女。基于技术的干预措施在减少健康差距方面显示出前景。我们评估了增加使用母乳喂养智能手机应用程序是否会影响低收入妇女的母乳喂养率。这是一项随机对照试验（RCT）的二次分析，包括初产妇和低收入妇女。妇女被随机分配到两种新型应用程序之一：包含数字母乳喂养手册的对照应用程序和 BreastFeeding Friend（BFF），这是一个包含按需母乳喂养教育和视频内容的互动应用程序。应用程序使用情况被安全跟踪。将 BFF 和对照应用程序的最高四分位用户与最低四分位用户进行比较。主要结果是母乳喂养开始。次要结果包括通过 6 个月的母乳喂养结果和资源偏好。在 RCT 中，BFF 和对照应用程序的中位数使用量分别为 15（四分位间距 [IQR] 4-24）和 9（IQR 5-19）（=0.1）。母乳喂养开始率与应用程序使用量无关（最高四分位组为 84.1%，最低四分位组为 78.2%；=0.5）。6 个月时持续和纯母乳喂养的比例在两组之间相似。在两组中，智能手机应用程序是 6 周时最受欢迎的母乳喂养资源。低四分位组用户也更喜欢替代在线母乳喂养资源：超过 50%的所有用户更喜欢基于技术的母乳喂养资源。增加母乳喂养应用程序的使用并不能提高低收入妇女的母乳喂养率。然而，基于技术的资源是出院后最受欢迎的母乳喂养资源，这表明基于技术的干预措施的持续发展有可能增加这一高需求人群的母乳喂养率。clinicaltrials.gov（NCT03167073）。
