Feasibility and acceptability of a motivational interviewing breastfeeding peer support intervention
Feasibility and acceptability of a motivational interviewing breastfeeding peer support intervention
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DOI：
10.1111/mcn.12703
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发表时间：
2019-04-01
影响因子：
3.4
通讯作者：
Paranjothy, Shantini
中科院分区：
文献类型：
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作者：
Copeland, Lauren;Merrett, Laura;Paranjothy, Shantini
在三个英国进行了一项非对照研究和工艺评价。社区产科站点，以确定提供一种新的母乳喂养同伴支持干预的可行性和可接受性，通过动机访谈（MI; Mam-Kind）。同伴支持者接受了培训，以提供“母亲亲切”干预措施，提供密集的一对一同伴支持，包括（a）产前接触，（B）出生后48小时内的面对面接触，（c）出生后2周的主动（同伴支持者领导的）隔日接触，以及（d）母亲领导的接触，再持续6周。同伴支持者完成了结构化的日记和录音与母亲面对面的会议。半结构化的采访进行了有目的的样本的母亲，卫生专业人员，和所有同行的支持者。访谈数据进行了专题分析，以评估干预的可接受性。使用MITI 4.2工具评估了音频记录的同行支持会议的干预保真度和MI技术的使用。八名同伴支持者在三个国家卫生服务局的孕产服务中向70名母亲提供了Mam-Kind干预措施。定性访谈的母亲（n = 28），同行的支持者（n = 8），和卫生专业人员（n = 12）表示，干预是可以接受的，卫生专业人员认为它可以与现有的服务。干预内容的保真度很高; 93%的干预目标在会议期间得到了满足。然而，同行的支持者报告说，在适应从专家的经验的作用，以合作的作用的困难。我们已经确定了使用MI知情方法提供母乳喂养同伴支持的可行性和可接受性。需要完善干预措施，以进一步发展同伴支持者提供以母亲为中心的支持的技能。应该在随机对照试验中测试改进的干预措施的有效性。
An uncontrolled study with process evaluation was conducted in three U.K. community maternity sites to establish the feasibility and acceptability of delivering a novel breastfeeding peer-support intervention informed by motivational interviewing (MI; Mam-Kind). Peer-supporters were trained to deliver the Mam-Kind intervention that provided intensive one-to-one peer-support, including (a) antenatal contact, (b) face-to-face contact within 48 hr of birth, (c) proactive (peer-supporter led) alternate day contact for 2 weeks after birth, and (d) mother-led contact for a further 6 weeks. Peer-supporters completed structured diaries and audio-recorded face-to-face sessions with mothers. Semistructured interviews were conducted with a purposive sample of mothers, health professionals, and all peer-supporters. Interview data were analysed thematically to assess intervention acceptability. Audio-recorded peer-support sessions were assessed for intervention fidelity and the use of MI techniques, using the MITI 4.2 tool. Eight peer-supporters delivered the Mam-Kind intervention to 70 mothers in three National Health Service maternity services. Qualitative interviews with mothers (n = 28), peer-supporters (n = 8), and health professionals (n = 12) indicated that the intervention was acceptable, and health professionals felt it could be integrated with existing services. There was high fidelity to intervention content; 93% of intervention objectives were met during sessions. However, peer-supporters reported difficulties in adapting from an expert-by-experience role to a collaborative role. We have established the feasibility and acceptability of providing breastfeeding peer-support using a MI-informed approach. Refinement of the intervention is needed to further develop peer-supporters' skills in providing mother-centred support. The refined intervention should be tested for effectiveness in a randomised controlled trial.