IMPROVING PHYSICIAN BREASTFEEDING COUNSELING AND SUPPORT

代表儿科医生、产科医生、 家庭医生都主张将母乳喂养作为首选 婴儿喂养方法因其对降低婴儿的影响而被证明 发病率。尽管《2000年健康人物》报告的目标是75%的母亲 将母乳喂养婴儿作为美国的目标，母乳喂养率 1984年开始在所有社会经济阶层下降，目前下降更少 超过55%的女性主动进行母乳喂养。尽管有几个因素 确定了有助于选择婴儿喂养方法的因素， 先前的研究已经证明，医生可以增加 通过给予适当的指导，母乳喂养的发生率和持续时间， 向潜在和现有的哺乳母亲提供支持和咨询。 然而，其他研究表明，大多数医生完成了 住院医师培训缺乏必要的知识和经验 有效的母乳喂养促进者和辅导员。 这项拟议研究的具体目的是：(1)进行一项全国性、 对3,000名儿科、产科和家庭的随机抽样邮寄调查 医学住院医师(每个专科1000名)和1800名 委员会认证的从业者(每个专业600人)，通过 特定专业的问卷，知识的现状， 关于母乳喂养的经验、态度和临床实践 这些专业；(2)分析回收的调查问卷，以确定 与教育和经验有关的具体缺陷 在住院医生和从业者中进行母乳喂养；(3)利用 将确定的不足之处作为指导制定 住院医师连续性中使用的专门教育干预措施 诊所；及。(4)进行试验测试及单一地点试验。 住院连续性诊所评估住院患者感知的干预措施 功效和有用性。驻地教育干预措施将是 基于成人学习的原则，并将利用书面 重点关注辅导技巧的材料、录像带和指导 积极的医生咨询、支持和解决问题的方法 潜在的和目前正在哺乳的母亲。反馈将用于 修改干预措施，为未来的随机试验做准备 确定它们的最终临床疗效。如果被证明是有效的 并在全国范围内实施，该计划将培养医生 成为更有效的母乳喂养推动者和辅导员，帮助 增加母乳喂养的发生率和持续时间。

The major specialty societies representing pediatricians, obstetricians, and family physicians have all advocated breastfeeding as the preferred method of infant feeding due to its demonstrated effect on lowering infant morbidity. Although the Healthy People 2000 report targets 75% of mothers breastfeeding their infants as a goal for the U.S., rates of breastfeeding began falling in 1984 across all socio-economic strata, and currently less than 55% of women initiate breastfeeding. Although several factors have been identified that contribute to choice of infant feeding method, previous research has demonstrated that physicians can increase the incidence and duration of breastfeeding by giving appropriate guidance, support, and counselling to potential and current breastfeeding mothers. However, other studies have suggested that most physicians complete residency training lacking the knowledge and experience necessary to be effective breastfeeding promoters and counsellors. The specific aims of this proposed study are to: (1) conduct a national, random sample mail survey of 3,000 pediatric, obstetric, and family medicine resident physicians (1,000 from each specialty) and 1,800 board-certified practitioners (600 from each specialty) to assess, through specialty-specific questionnaires, the current state of knowledge, experience, attitude, and clinical practice regarding breastfeeding among these specialties; (2) analyze the returned questionnaires to identify specific educational and experience-related deficiencies regarding breastfeeding among resident physicians and practitioners; (3) utilize the identified deficiencies as a "needs assessment" to guide the formulation of specialty-specific educational interventions for use in resident continuity clinics; and (4) perform a pilot test and single-site trial of the interventions in residency continuity clinics to assess resident-perceived efficacy and usefulness. The resident education interventions will be based on the principles of adult learning and will utilize written materials, videotapes, and instruction in counselling skills to focus on active methods of physician counselling, support, and problem-solving for potential and current breastfeeding mothers. Feedback will be used to modify the interventions in preparation for a future randomized trial to determine their ultimate clinical effectiveness. If proven to be effective and implemented on a national level, this program will prepare physicians to become more effective breastfeeding promoters and counsellors, helping to increase the incidence and duration of breastfeeding.