Grandmother and health care professional breastfeeding perspectives provide opportunities for health promotion in an American Indian community
Grandmother and health care professional breastfeeding perspectives provide opportunities for health promotion in an American Indian community
复制标题
DOI：
10.1016/j.socscimed.2018.05.017
复制
发表时间：
2018-07-01
影响因子：
5.4
通讯作者：
Rink, Elizabeth
中科院分区：
文献类型：
--
作者：
Houghtaling, Bailey;Shanks, Carmen Byker;Rink, Elizabeth
理由：虽然母乳喂养被公认为有益的，但美洲印第安妇女的母乳喂养率低于平均水平，导致健康不平等。文化的具体方法，母乳喂养的研究，要求在美洲印第安人社区的适当干预措施。具体而言，祖母在母乳喂养推广中的作用是非常重要的，特别是在美国印第安人（AI）群体中，尽管是一个未充分研究的主题迄今为止.Objective：本研究旨在填补一个突出的文献空白，通过利用扎根理论和社区为基础的研究方法，从祖母和医疗保健专业人员的声音告知母乳喂养的做法在美国农村Al社区。以社区为基础的方法指导了研究过程。便利和雪球抽样被用来招募半结构化和后续成员检查采访AI祖母（n = 27）和医疗保健专业人员（n = 7）。定性数据被转录，表征为意义单位，并由审查小组编码。数据之间的差异进行了协调审查，组织主题，并用于产生社区特定的母乳喂养construction.Results：三大主题出现，每个相关的子主题：（1）母乳喂养的重要性;（2）附件，债券，并传递知识;和（3）负担过重的医疗保健系统。多个子主题代表压力源和影响母乳喂养的知识，翻译和实践在这个社区，包括公式信念，历史创伤，社会压力，不信任，和药物滥用。旨在提高研究中心社区母乳喂养率的干预措施最好以部落资源为基础，并涉及一种协作方法，使更大的社区、祖母、医疗保健专业人员、和拥有不同技能的科学合作伙伴。需要更多的研究来确定压力源以及其他人工智能群体对婴儿喂养实践的任何潜在影响。将本文提出的研究方法应用于其他人工智能社区可能有助于理解母乳喂养实践的机遇和挑战。
Rationale: While breastfeeding is well recognized as beneficial, rates of breastfeeding among American Indian women are below average and contribute to health inequities. Culturally specific approaches to breastfeeding research are called for to inform appropriate interventions in American Indian communities. Specifically, a grandmother's role in breastfeeding promotion is of great import particularly in American Indian (AI) groups, although is an understudied topic to date.Objective: This research seeks to fill a prominent literature gap by utilizing a grounded theory and community based research approach to inform breastfeeding practices from the voices of grandmothers and health care professionals in a rural Al community in the United States.Methods: A community-based approach guided the research process. Convenience and snowball sampling was used to recruit for semi-structured and follow up member checking interviews with AI grandmothers (n = 27) and health care professionals (n = 7). Qualitative data were transcribed, characterized into meaning units, and coded by a review panel. Data were reconciled for discrepancies among reviewers, organized thematically, and used to generate community-specific breastfeeding constructs.Results: Three major themes emerged, each with relevant subthemes: (1) importance of breastfeeding; (2) attachment, bonding, and passing on knowledge; and (3) overburdened health care system. Multiple subthemes represent stressors and impact breastfeeding knowledge, translation, and practice within this community including formula beliefs, historical traumas, societal pressures, mistrust, and substance abuse.Conclusions: Interventions designed to raise breastfeeding rates in the study site community would ideally be grounded in tribal resources and involve a collaborative approach that engages the greater community, grandmothers, health care professionals, and scientific partners with varying skills. More research is needed to determine stressors and any potential impact on infant feeding practices among other AI groups. Application of the research approach presented here to other AI communities may be beneficial for understanding opportunities and challenges to breastfeeding practices.