Process evaluation of a peer-led antenatal breastfeeding class for fathers: perceptions of facilitators and participants

Abstract

BackgroundThe Parent Infant Feeding Initiative (PIFI) was a factorial, randomised controlled trial that aimed to prolong exclusive breastfeeding by targeting expecting fathers. One of the intervention strategies evaluated was a father-focused breastfeeding class facilitated by a male peer facilitator. The aim of this mixed-methods descriptive study was to 1) evaluate the feedback provided from participants of the class and 2) explore the motivations and experiences of volunteer male peer facilitators trained to deliver the class.MethodsFather-focused breastfeeding antenatal (FFAB) classes were conducted in six Western Australian hospitals between August 2015 and December 2016. Following each peer facilitated FFAB class, expecting father participants completed an evaluation form to assess their satisfaction with the format, facilitation and content, in addition to whether their expectations and confidence to manage breastfeeding problems had changed. Feedback to open-ended questions was analysed using content analysis to identify learnings and suggestions for improvements. At the completion of PIFI, individual telephone interviews were undertaken with 14 peer facilitators to gain insight into their motivations for volunteering and experiences of conducting the classes. Transcripts from interviews were analysed using Braun and Clarke’s six phases for thematic analysis.ResultsParticipant evaluation forms were completed by 678 of the 697 father participants (98%). Overall satisfaction with class format, facilitation and content was high with 90% or more of fathers either strongly agreeing or agreeing with each positively-phrased evaluation item. Class participants enjoyed interacting with other fathers, appreciated validation of their role, were not always aware of the importance of breastfeeding or potential difficulties, valued the anticipatory guidance around what to expect in the early weeks of parenting and appreciated learning practical breastfeeding support strategies. Peer facilitators indicated they felt well prepared and supported to conduct FFAB classes. Analysis of interview transcripts revealed common experiences of the peer facilitators incorporating four themes: ‘Highlights of being a facilitator’, ‘Challenges’, ‘Mourning the project completion’ and ‘Satisfaction with training and support’.ConclusionFather-focused breastfeeding classes supported by volunteer male peer facilitators are a feasible and acceptable way of engaging fathers as breastfeeding supporters.Trial registrationACTRN12614000605695. Registered 6 June 2014.

Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial

“…To our knowledge, PIFI is the largest breastfeeding intervention targeting fathers. We have previously reported on the process evaluation of the interventions and demonstrated that each interventions in terms of intent, content, and delivery was feasible, useful, and acceptable to fathers [ 34 , 39 , 50 ]. We were, however, unable to demonstrate impact of a face-to-face or mHealth intervention, either individually or in combination, on infant feeding outcomes, maternal breastfeeding self-efficacy, or level of postpartum partner support.…”

“…Building on the feedback from participants and lessons learned in FIFI, we refined and updated the content of the FFABC, and 117 FFABCs with an average size of 4 to 6 participants were delivered by a team of 11 trained peer facilitators [ 39 ]. A short process evaluation survey was completed by 98% of class attendees, and overall satisfaction with class format, facilitation, and content was high.…”

“…Participants appreciated the validation of their role and valued the opportunity to interact with other fathers. Many fathers were not aware of the importance of or potential difficulties with breastfeeding and found the discussion around parenting and specific breastfeeding support strategies valuable [ 39 ].…”

“…The format and content of the FFABC was based on a “dads only” breastfeeding class trialed in the Fathers Infant Feeding Initiative (FIFI) [ 25 ]. Details of the FFABC and its process evaluation have been reported previously [ 39 ].…”

Relationship between Family Social Support and Exclusive Breastfeeding Behavior at Talise Health Center, Indonesia

“…Informational-social support is social support that the family provides to the mother to support exclusive breastfeeding success. A study that provides father-focused antenatal breastfeeding interventions to fathers shows that fathers who provide education to mothers are better prepared to support mothers in exclusive breastfeeding [21].…”