Impact of counselling on exclusive breast-feeding practices in a poor urban setting in Kenya: a randomized controlled trial
Impact of counselling on exclusive breast-feeding practices in a poor urban setting in Kenya: a randomized controlled trial
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DOI：
10.1017/s1368980012004405
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发表时间：
2013-10-01
影响因子：
3.2
通讯作者：
Nduati, Ruth W.
中科院分区：
文献类型：
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作者：
Ochola, Sophie A.;Labadarios, Demetre;Nduati, Ruth W.
目的：探讨在肯尼亚资源匮乏的城市环境中，以设施为基础的半强化咨询和以家庭为基础的强化咨询对改善纯母乳喂养(EBF)的影响。设计：整群随机对照试验，9个村按1：1：1的比例通过计算机分配到2个干预组和1个对照组。家庭强化咨询小组(HBICG)在家中接受了7次由训练有素的同龄人提供的咨询，一次是产前，六次是产后。以设施为基础的半集中咨询小组(FBSICG)产前只接受了一次咨询。对照组(CG)没有接受研究小组的咨询。在分娩后6个月内每月收集有关婴儿喂养习惯的信息。数据收集团队对干预分配视而不见。调查结果为6个月时EBF患病率。地点：奈罗比基贝拉贫民窟。对象：从基贝拉一家产前诊所选择360名怀孕34-36周的HIV阴性妇女，每组120人。结果：在360名纳入研究的妇女中，265人完成了研究并进入分析(CG n 89；FBSICG n 87；HBICG n 89)。分析采用意向治疗。6个月时EBF患病率HBICG组为23.6%，FBSICG组为9.2%，CG组为5.6%。HBICG组母亲实施EBF的可能性是对照组的4倍(调整后相对危险度=4.01；95%可信区间分别为2.30、7.01；P=0.001)。两组EBF发生率差异无统计学意义(P>0.05)。结论：在社会经济条件较差的情况下，家庭强化辅导可以促进EBF的开展。一次以设施为基础的咨询不足以维持循证医学。
Objective: To determine the impact of facility-based semi-intensive and home-based intensive counselling in improving exclusive breast-feeding (EBF) in a low-resource urban setting in Kenya.Design: A cluster randomized controlled trial in which nine villages were assigned on a 1:1:1 ratio, by computer, to two intervention groups and a control group. The home-based intensive counselling group (HBICG) received seven counselling sessions at home by trained peers, one prenatally and six postnatally. The facility-based semi-intensive counselling group (FBSICG) received only one counselling session prenatally. The control group (CG) received no counselling from the research team. Information on infant feeding practices was collected monthly for 6 months after delivery. The data-gathering team was blinded to the intervention allocation. The outcome was EBF prevalence at 6 months.Setting: Kibera slum, Nairobi.Subjects: A total of 360 HIV-negative women, 34-36 weeks pregnant, were selected from an antenatal clinic in Kibera; 120 per study group.Results: Of the 360 women enrolled, 265 completed the study and were included in the analysis (CG n 89; FBSICG n 87; HBICG n 89). Analysis was by intention to treat. The prevalence of EBF at 6 months was 23.6% in HBICG, 9.2% in FBSICG and 5.6% in CG. HBICG mothers had four times increased likelihood to practise EBF compared with those in the CG (adjusted relative risk = 4.01; 95% CI 2.30, 7.01; P = 0.001). There was no significant difference between EBF rates in FBSICG and CG.Conclusions: EBF can be promoted in low socio-economic conditions using home-based intensive counselling. One session of facility-based counselling is not sufficient to sustain EBF.