Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
Yale School of Public Health, 135 College Street, New Haven, CT, 06510, USA.
BMC Pregnancy Childbirth. 2024 Feb 9;24(1):120. doi: 10.1186/s12884-023-06213-0.
Person-centered breastfeeding counseling is a key but often overlooked aspect of high-quality services. We explored women's experiences of the Breastfeeding Heritage and Pride™ program, an evidence-based breastfeeding peer counseling program serving women with low incomes in the United States.
This study was conducted through an equitable community-clinical-academic partnership and guided by the World Health Organization (WHO) quality of care framework for maternal and newborn health, which highlights three domains of positive experiences of care: effective communication; respect and dignity; and emotional support. In-depth interviews were conducted with a purposive sample of women participating in the Breastfeeding Heritage and Pride™ program. Women were asked to describe their experiences with the program including examples of when good quality counseling was or was not provided. Each interview was conducted in English or Spanish, audio-recorded, and transcribed verbatim. Data were analyzed using reflexive thematic analysis. Once themes were generated, they were organized according to the three care experience domains in the WHO quality of care framework.
Twenty-eight in-depth interviews were conducted with a racially/ethnically and socio-economically diverse sample of women. Three themes described effective communication practices of peer counselors: tailoring communication to meet women's individual needs; offering comprehensive and honest information about infant feeding; and being timely, proactive, and responsive in all communications across the maternity care continuum. Two themes captured why women felt respected. First, peer counselors were respectful in their interactions with women; they were courteous, patient, and non-judgmental and respected women's infant feeding decisions. Second, peer counselors showed genuine interest in the well-being of women and their families, beyond breastfeeding. The key theme related to emotional support explored ways in which peer counselors offered encouragement to women, namely by affirming women's efforts to breastfeed and by providing reassurance that alleviated their worries about breastfeeding. These positive experiences of counseling were appreciated by women.
Women described having and valuing positive experiences in their interactions with peer counselors. Efforts to expand access to high-quality, person-centered breastfeeding counseling should, as part of quality assurance, include women's feedback on their experiences of these services.
以人为中心的母乳喂养咨询是高质量服务的一个关键但经常被忽视的方面。我们探讨了妇女对“母乳喂养传统与骄傲”计划的体验，这是一个基于证据的母乳喂养同伴咨询计划，为美国低收入妇女提供服务。
这项研究是通过公平的社区-临床-学术伙伴关系进行的，并遵循世界卫生组织（WHO）孕产妇和新生儿健康护理质量框架，该框架强调了护理体验的三个积极领域：有效沟通；尊重和尊严；情感支持。对参与“母乳喂养传统与骄傲”计划的妇女进行了有针对性的深入访谈。妇女被要求描述她们对该计划的体验，包括提供或未提供高质量咨询的例子。每次访谈均以英语或西班牙语进行，录音并逐字记录。使用反思性主题分析对数据进行分析。一旦生成主题，就根据 WHO 护理质量框架中的三个护理体验领域对其进行组织。
对种族/民族和社会经济多样化的妇女样本进行了 28 次深入访谈。三个主题描述了同伴顾问的有效沟通实践：根据妇女的个人需求调整沟通；提供全面、诚实的婴儿喂养信息；并在整个孕产护理连续体中所有沟通中及时、主动和响应。两个主题描述了为什么妇女感到受到尊重的原因。首先，同伴顾问在与妇女的互动中表现出尊重；他们彬彬有礼、有耐心、不评判，并尊重妇女的婴儿喂养决定。其次，同伴顾问对妇女及其家人的福祉表现出真正的兴趣，不仅仅是母乳喂养。与情感支持相关的关键主题探讨了同伴顾问向妇女提供鼓励的方式，即肯定妇女母乳喂养的努力，并提供缓解她们对母乳喂养担忧的保证。这些咨询的积极体验受到了妇女的赞赏。
妇女描述了与同伴顾问互动时的积极体验并重视这些体验。为扩大获得高质量、以人为中心的母乳喂养咨询的机会，应将妇女对这些服务的体验反馈纳入质量保证的一部分。
