Subjective Environmental Experiences and Women's Breastfeeding Journeys: A Survival Analysis Using an Online Survey of UK Mothers.
Subjective Environmental Experiences and Women's Breastfeeding Journeys: A Survival Analysis Using an Online Survey of UK Mothers.
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DOI：
10.3390/ijerph17217903
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发表时间：
2020-10-28
影响因子：
--
通讯作者：
Emmott EH
中科院分区：
文献类型：
--
作者：
Brown LJ;Myers S;Page AE;Emmott EH
当地的自然和社会环境因素是人类健康和行为的重要驱动因素。环境感知与生殖和育儿都有联系，但主观环境体验和母乳喂养之间的联系仍不清楚。COX-Aalen生存模型使用对0-24个月大孩子的英国母亲的在线调查的回顾数据，检验负面的主观环境经历是否与任何和纯母乳喂养负相关(最大n=473)。与预测相匹配，在五项环境措施中，停止母乳喂养的危险增加，尽管不显著(HR：1.05-1.26)，但停止纯母乳喂养的危险(HR：0.65-0.87)(不显著)减少。评分过程没有发现显著的时变效应。然而，估计的累积系数图显示，产后最初几周最容易受到环境影响，与我们的预测相反，主观环境经验较差的母亲在这个时候停止母乳喂养的可能性较小。此外，对于那些认为乱扔垃圾是个问题的母亲来说，停止纯母乳喂养的风险随着时间的推移而下降。预测的停止母乳喂养增加的危险只在母乳喂养的后期才明显，而且只有报告说乱扔垃圾是一个问题的母亲或人们往往不认识彼此的母亲才明显。人们认为，更恶劣的身体和社会环境条件会阻止女性进行母乳喂养，但情况并不总是如此。妇女停止母乳喂养的危险会随着时间的推移而变化，在她们的母乳喂养过程中，可能会有特定的时间点，主观环境经验发挥了作用。
Local physical and social environmental factors are important drivers of human health and behaviour. Environmental perception has been linked with both reproduction and parenting, but links between subjective environmental experiences and breastfeeding remain unclear. Using retrospective data from an online survey of UK mothers of children aged 0–24 months, Cox-Aalen survival models test whether negative subjective environmental experiences negatively correlated with any and exclusive breastfeeding (max n = 473). Matching predictions, hazards of stopping any breastfeeding were increased, albeit non-significantly, across the five environmental measures (HR: 1.05–1.26) Hazards for stopping exclusive breastfeeding were however (non-significantly) reduced (HR: 0.65–0.87). Score processes found no significant time-varying effects. However, estimated cumulative coefficient graphs showed that the first few weeks postpartum were most susceptible to environmental influences and that contrary to our predictions, mothers with worse subjective environmental experiences were less likely to stop breastfeeding at this time. In addition, the hazard of stopping exclusive breastfeeding declined over time for mothers who thought that littering was a problem. The predicted increased hazards of stopping breastfeeding were only evident in the later stages of any breastfeeding and only for mothers who reported littering as a problem or that people tended not to know each other. Perceived harsher physical and social environmental conditions are assumed to deter women from breastfeeding, but this may not always be the case. Women’s hazards of stopping breastfeeding change over time and there may be particular timepoints in their breastfeeding journeys where subjective environmental experiences play a role.
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DOI：
10.1093/emph/eox011
发表时间：
2017
期刊：
Evolution, medicine, and public health
影响因子：
--
作者：
Brown LJ;Sear R
通讯作者：
Sear R
影响因子：
2.7
作者：
Brown, Amy
通讯作者：
Brown, Amy
影响因子：
6.3
作者：
Agyemang, C.;Vrijkotte, T. G. M.;Stronks, K.
通讯作者：
Stronks, K.
影响因子：
4.4
作者：
Brown, Amy E.;Raynor, Peter;Lee, Michelle D.
通讯作者：
Lee, Michelle D.
影响因子：
3.4
作者：
Brown, Laura J.;Sear, Rebecca
通讯作者：
Sear, Rebecca