Breastfeeding Peer Support: Maternal and Volunteer Perceptions from a Randomized Controlled Trial

Dennis, Cindy‐Lee

doi:10.1046/j.1523-536x.2002.00184.x

Cited by 88 publications

(116 citation statements)

References 22 publications

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“…On the other hand, support from the father of the baby and the woman's mother, family and friends, peer counselor, or lactation consultant have been shown to increase breastfeeding behaviors (Arora et al, 2000;Dennis, 2002aDennis, , 2002bHumphreys, Thompson, & Miner, 1998;Lawrence, 1999;McKeever et al, 2002;Scott, Landers, Hughes, & Binns, 2001). In the current study, support from older women who had breastfed was seen as beneficial in promoting breastfeeding.…”

Section: Discussionmentioning

confidence: 99%

Assessing Infant Breastfeeding Beliefs Among Low-Income Mexican Americans

Gill

Reifsnider²,

Mann³

et al. 2004

jpe

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Focus groups were conducted with low-income, pregnant women and new mothers receiving services from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) along with their male partners and their mothers. All participants were Hispanics of Mexican American origin. The topics for the focus-group discussions were breastfeeding beliefs and perceptions. All participants were aware of the benefits of breastfeeding. Participants identified time, embarrassment, and pain as barriers to breastfeeding; discussed decision-making efforts regarding breastfeeding; identified cultural beliefs related to breastfeeding; and discussed the lack of care-provider support for breastfeeding.

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Section: Discussionmentioning

confidence: 99%

Assessing Infant Breastfeeding Beliefs Among Low-Income Mexican Americans

Gill

Reifsnider²,

Mann³

et al. 2004

jpe

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“…81 A randomised trial of peer support (mother to mother) provided by telephone was acceptable and associated with significant increases in breastfeeding rates at 3 months postpartum, compared with standard support provided in the main by hospital-based health-care professionals. 82 In a trial where doula support in a non-UK setting was restricted to labour only, increases in breastfeeding at 6 weeks were hypothesised to be due to increased empowerment by the doula during labour that increased women's sense of confidence and thus ability to breastfeed.…”

Section: Clinical and Public Health Outcomes For Women And Their Babiesmentioning

confidence: 99%

Multisite implementation of trained volunteer doula support for disadvantaged childbearing women: a mixed-methods evaluation

Spiby

Green

Darwin

et al. 2015

Health Services and Delivery Research

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Our study looked at five schemes in England which offer support to disadvantaged women having babies. The support starts in pregnancy and goes on for 6 weeks after the baby’s birth. It is provided by specially trained volunteers (called ‘doulas’). The idea started with one of the five schemes and was then taken up by the other four, with the help of funding from the Department of Health. The philosophy behind the original doula service was to provide women with the support needed for a positive birth experience and breastfeeding. We looked at impacts on the NHS, on the women and on the volunteers and at how services had started the schemes and kept them running.\ud Participation rates were lower than we had hoped among women and doulas; 167 women and 89 doulas completed questionnaires. However, from those who filled in questionnaires or took part in focus groups we heard that most women really appreciated the service. Where women were less pleased with the service, it was because they had not received as much support as they wanted.\ud There was some evidence that women who had doula support had fewer caesarean sections although the numbers were not sufficient to rule out the possibility that this difference was due to chance. Women supported by doulas were more likely to start and to be continuing breastfeeding when their baby was 6 weeks old.\ud Through questionnaires and telephone interviews we learned that most volunteers enjoyed their role and called it a privilege to support a woman at such an important time. They felt that they had learned a lot and gained confidence and some had gone on to further training.\ud Midwives who took part in focus groups and the heads of midwifery who were interviewed were generally positive about the scheme.\ud Starting the schemes and keeping them running: funding was a major issue that persisted for all the doula services; other challenges included ensuring a steady rate of women referred and available volunteers

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“…Volunteers often cite the availability of ongoing training whilst they are delivering an intervention as a motivation for adherence to a programme. 85,86,105,107 We have already commented on the lack of ongoing training to increase the confidence of volunteers and to maintain intervention adherence; this is a consequence of constrained costs and is a clear weakness of the intervention evaluated in our study (see Perspectives on the intervention from the group therapy intervention literature). When resources allow and volunteers are enthusiastic, volunteer befriending programmes should conduct training booster sessions, conduct in vivo observations or record and review sessions, conduct weekly supervision and hold periodic meetings with, or allow easy access for questions to, trainers for the sake of both intervention fidelity and volunteer retention.…”

Section: Other Studies Involving Volunteer Provisionmentioning

confidence: 99%

“…Commitment is known to be positively related to the reception of sufficient support to ensure that volunteers are comfortable with their role and its procedures. 85,86,[104][105][106] A related factor that is known to be a key motivator in retaining volunteers is the availability of ongoing training. Volunteers often cite the availability of ongoing training whilst they are delivering an intervention as a motivation for adherence to a programme.…”

Section: Other Studies Involving Volunteer Provisionmentioning

confidence: 99%

Putting Life in Years (PLINY): a randomised controlled trial and mixed-methods process evaluation of a telephone friendship intervention to improve mental well-being in independently living older people

Hind

Mountain

Gossage-Worrall

et al. 2014

Public Health Research

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BackgroundSocial isolation in older adults is associated with morbidity. Evaluating interventions to promote social engagement is a research priority.MethodsA parallel-group randomised controlled trial was planned to evaluate whether telephone friendship (TF) improves the well-being of independently living older people. An internal pilot aimed to recruit 68 participants by 30 September 2012, with 80% retained at 6 months. Randomisation was web based and only analysts were blind to allocation. A service provider was contracted to train 10 volunteer facilitators by 1 April 2012 and 10 more by 1 September 2012. Participants were aged > 74 years with good cognitive function and living independently in an urban community. The intervention arm of the trial consisted of manualised TF with standardised training: (1) one-to-one befriending (10- to 20-minute calls once per week for up to 6 weeks made by volunteer facilitators) followed by (2) TF groups of six participants (1-hour teleconferences once per week for 12 weeks facilitated by the same volunteer). Friendship groups aimed to enhance social support and increase opportunities for social interaction to maintain well-being. This was compared with usual health and social care provision. The primary clinical outcome was the Short Form questionnaire-36 items (SF-36) mental health dimension score at 6 months post randomisation. Qualitative research assessing intervention acceptability (participants) and implementation issues (facilitators) and an intervention fidelity assessment were also carried out. Intervention implementation was documented through e-mails, meeting minutes and field notes. Acceptability was assessed through framework analysis of semistructured interviews. Two researchers coded audio recordings of telephone discussions for fidelity using a specially designed checklist.ResultsIn total, 157 people were randomised to the TF group (n = 78) or the control group (n = 79). Pilot recruitment and retention targets were met. Ten volunteers were trained by 1 September 2012; after volunteer attrition, three out of the 10 volunteers delivered the group intervention. In total, 50 out of the 78 TF participants did not receive the intervention and the trial was closed early. A total of 56 people contributed primary outcome data from the TF (n = 26) and control (n = 30) arms. The mean difference in SF-36 mental health score was 9.5 (95% confidence interval 4.5 to 14.5) after adjusting for age, sex and baseline score. Participants who were interviewed (n = 19) generally declared that the intervention was acceptable. Participant dissatisfaction with closure of the groups was reported (n = 4). Dissatisfaction focused on lack of face-to-face contact and shared interests or attitudes. Larger groups experienced better cohesion. Interviewed volunteers (n = 3) expressed a lack of clarity about procedures, anxieties about managing group dynamics and a lack of confidence in the training and in their management and found scheduling calls challenging. Training was 91–95% adherent with the checklist (39 items; three groups). Intervention fidelity ranged from 30.2% to 52.1% (28–41 items; three groups, three time points), indicating that groups were not facilitated in line with training, namely with regard to the setting of ground rules, the maintenance of confidentiality and facilitating contact between participants.ConclusionsAlthough the trial was unsuccessful for a range of logistical reasons, the experience gained is of value for the design and conduct of future trials. Participant recruitment and retention were feasible. Small voluntary sector organisations may be unable to recruit, train and retain adequate numbers of volunteers to implement new services at scale over a short time scale. Such risks might be mitigated by multicentre trials using multiple providers and specialists to recruit and manage volunteers.Trial registrationCurrent Controlled Trials ISRCTN28645428.FundingThis project was funded by the NIHR Public Health Research programme and will be published in full inPublic Health Research; Vol. 2, No. 7. See the NIHR Journals Library website for further project information.

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Breastfeeding Peer Support: Maternal and Volunteer Perceptions from a Randomized Controlled Trial

Cited by 88 publications

References 22 publications

Assessing Infant Breastfeeding Beliefs Among Low-Income Mexican Americans

Assessing Infant Breastfeeding Beliefs Among Low-Income Mexican Americans

Multisite implementation of trained volunteer doula support for disadvantaged childbearing women: a mixed-methods evaluation

Putting Life in Years (PLINY): a randomised controlled trial and mixed-methods process evaluation of a telephone friendship intervention to improve mental well-being in independently living older people

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