TY - JOUR
T1 - A clinic-based breastfeeding peer counselor intervention in an urban, low-income population
T2 - Interaction with breastfeeding attitude
AU - Srinivas, Ganga L.
AU - Benson, Mary
AU - Worley, Sarah
AU - Schulte, Elaine
N1 - Publisher Copyright:
© The Author(s) 2014.
PY - 2015/2/17
Y1 - 2015/2/17
N2 - Background: Whereas breastfeeding initiation rates have risen in all groups throughout the country, rates of breastfeeding duration have changed more slowly. Peer counseling has had some success in sustaining breastfeeding, but with intensive programs and variable effects. Objectives: We aimed to improve rates of any and exclusive breastfeeding at 1 and 6 months using a low-intensity peer counseling intervention beginning prenatally. We also planned to study the interaction of breastfeeding attitude and selfefficacy with the intervention. Methods: One hundred twenty prenatal women underwent stratified randomization based on breastfeeding attitude, measured by the Iowa Infant Feeding Attitude Scale (IIFAS). The peer counselor contacted the intervention group by telephone or in clinic up to 4 months postdelivery. Study groups were compared on breastfeeding outcomes, adjusting for IIFAS strata, and on interactions with self-efficacy. Results: One hundred three women were followed to at least 1 month. Women with positive attitudes had significantly higher rates of initiation (93% vs 61%) and breastfeeding at 1 and 6 months (79% vs 25% and 12% vs 0%, respectively) than those with negative attitudes, regardless of intervention. After adjusting for self-efficacy, women who received peer counseling had significantly higher breastfeeding rates at 1 month (odds ratio = 3.2; 95% confidence interval, 1.02-9.8). The intervention group was marginally more likely to achieve their breastfeeding goal (43% vs 22%, P = .073). Conclusion: Breastfeeding rates in all women improved during the study period. Breastfeeding attitude was more strongly associated with breastfeeding behavior than peer support. Peer counseling supported women with low self-efficacy and helped women achieve their breastfeeding goals.
AB - Background: Whereas breastfeeding initiation rates have risen in all groups throughout the country, rates of breastfeeding duration have changed more slowly. Peer counseling has had some success in sustaining breastfeeding, but with intensive programs and variable effects. Objectives: We aimed to improve rates of any and exclusive breastfeeding at 1 and 6 months using a low-intensity peer counseling intervention beginning prenatally. We also planned to study the interaction of breastfeeding attitude and selfefficacy with the intervention. Methods: One hundred twenty prenatal women underwent stratified randomization based on breastfeeding attitude, measured by the Iowa Infant Feeding Attitude Scale (IIFAS). The peer counselor contacted the intervention group by telephone or in clinic up to 4 months postdelivery. Study groups were compared on breastfeeding outcomes, adjusting for IIFAS strata, and on interactions with self-efficacy. Results: One hundred three women were followed to at least 1 month. Women with positive attitudes had significantly higher rates of initiation (93% vs 61%) and breastfeeding at 1 and 6 months (79% vs 25% and 12% vs 0%, respectively) than those with negative attitudes, regardless of intervention. After adjusting for self-efficacy, women who received peer counseling had significantly higher breastfeeding rates at 1 month (odds ratio = 3.2; 95% confidence interval, 1.02-9.8). The intervention group was marginally more likely to achieve their breastfeeding goal (43% vs 22%, P = .073). Conclusion: Breastfeeding rates in all women improved during the study period. Breastfeeding attitude was more strongly associated with breastfeeding behavior than peer support. Peer counseling supported women with low self-efficacy and helped women achieve their breastfeeding goals.
KW - attitude
KW - breastfeeding
KW - intervention
KW - peer counselor
KW - randomized clinical trial
KW - self-efficacy
UR - http://www.scopus.com/inward/record.url?scp=84920993144&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84920993144&partnerID=8YFLogxK
U2 - 10.1177/0890334414548860
DO - 10.1177/0890334414548860
M3 - Article
C2 - 25193602
AN - SCOPUS:84920993144
SN - 0890-3344
VL - 31
SP - 120
EP - 128
JO - Journal of Human Lactation
JF - Journal of Human Lactation
IS - 1
ER -