Social Support for Breastfeeding in the Era of mHealth: A Content Analysis

Schindler‐Ruwisch, Jennifer; Roess, Amira; Robert, R; Napolitano, Melissa A.; Chiang, Shawn C.

doi:10.1177/0890334418773302

Cited by 33 publications

(28 citation statements)

References 36 publications

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“…Participants also suggested that during health visits, physicians, nurses, or health promoters can use the mHealth tool to explain standardized health information and provide access to the mHealth tool for caregivers to use beyond the encounter. Similar findings have been reflected in previous research in the development and assessment of mHealth interventions in other countries, including India and Germany [ 12 , 72 , 73 ].…”

Section: Discussionsupporting

confidence: 90%

“…To address this significant child health issue, breastfeeding promotion interventions emphasizing early initiation and EBF until 6 months of age are critical. These must be effectively designed and utilized in settings such as the Dominican Republic and other LMICs where challenges persist in providing high-quality, easily accessible EBF care and support [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Perceptions and Attitudes Toward Mobile Health in Development of an Exclusive Breastfeeding Tool: Focus Group Study With Caregivers and Health Promoters in the Dominican Republic

Casilang

Stonbraker²,

Japa³

et al. 2020

JMIR Pediatr Parent

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Background Despite growing interest in the use of technology to improve health outcomes in low- and middle-income countries (LMICs), local attitudes toward mobile health (mHealth) use in these settings are minimally understood. This is especially true in the Dominican Republic, where mHealth interventions are starting to emerge. This information is critical for developing effective mHealth interventions to address public health issues, such as low exclusive breastfeeding (EBF) rates, which can lead to poor outcomes. With an EBF rate of 5% in the first 6 months of life, the Dominican Republic has one of the lowest EBF rates worldwide. Objective This study aims to describe the current use of information and communication technology (ICT) and to analyze the attitudes and perceptions related to using mHealth interventions among caregivers of children aged ≤5 years and health promoters in the Dominican Republic. Findings can inform mHealth strategies aimed at improving EBF in this, and other, LMICs. Methods Participants were recruited from 3 outpatient sites: the Niños Primeros en Salud program at Centro de Salud Divina Providencia in Consuelo (rural setting) and Clínica de Familia La Romana and its program Módulo de Adolescentes Materno Infantil in La Romana (urban setting). Focus groups were conducted with caregivers and community health promoters to identify the use, attitudes, perceptions, and acceptability of mHealth as well as barriers to EBF. Discussions were conducted in Spanish, guided by semistructured interview guides. All sessions were audio-recorded and later transcribed. Thematic content analysis was conducted in Spanish by two bilingual researchers and was structured around a hybrid behavioral theory framework to identify salient themes. Results All participants (N=35) reported having a mobile phone, and 29 (83%) participants had a smartphone. Sources for obtaining health information included the internet, physicians and clinic, family and friends, health promoters, and television. Barriers to mHealth use included the cost of internet service, privacy concerns, and perceived credibility of information sources. Participants indicated the desire for, and willingness to use, an mHealth intervention to support breastfeeding. The desired features of a possible mHealth intervention included offering diverse methods of information delivery such as images and video content, text messages, and person-to-person interaction as well as notifications for appointments, vaccines, and feeding schedules. Other important considerations were internet-free access and content that included maternal and child health self-management topics beyond breastfeeding. Conclusions There is a high level of acceptance of ICT tools for breastfeeding promotion among caregivers in urban and rural areas of the Dominican Republic. As mHealth tools can contribute to increased breastfeeding self-efficacy, identifying desirable features of such a tool is necessary to create an effective intervention. Participants wanted to receive trusted and reliable information through various formats and were interested in information beyond breastfeeding.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Perceptions and Attitudes Toward Mobile Health in Development of an Exclusive Breastfeeding Tool: Focus Group Study With Caregivers and Health Promoters in the Dominican Republic

Casilang

Stonbraker²,

Japa³

et al. 2020

JMIR Pediatr Parent

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“…In line with the work of Schindler-Ruwisch et al, we found that for-profit companies and large businesses are more likely to create free breastfeeding apps [38]. Schindler-Ruwisch et al completed a content analysis of 53 breastfeeding apps in which they established that the majority of breastfeeding apps were free and developed by for-profit organizations [38]. Their review was limited in scope because the apps were not downloaded and explored; thus, features and educational content were not comprehensively assessed.…”

Section: Discussionsupporting

confidence: 87%

Features and Educational Content Related to Milk Production in Breastfeeding Apps: Content Analysis Informed by Social Cognitive Theory

Sidhu¹,

Ma²,

Sadovnikova³

2019

JMIR Pediatr Parent

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Background Low milk production is one of the main reasons for premature breastfeeding cessation. Smartphone apps have the potential to assist mothers with promoting, interpreting, tracking, or learning about milk production. It is not known whether breastfeeding apps contain high-quality, engaging, and diverse content and features that could be used by mothers to increase their breastfeeding self-efficacy and answer their questions about milk production. Objective The overarching objective of this study was to identify and evaluate features and content within breastfeeding apps that could be used by mothers to increase breastfeeding self-efficacy and answer their questions about milk production. The secondary objectives were to quantify the diversity of representation of breastfeeding experiences within breastfeeding apps and to define the type of organization that is most likely to create free apps and/or apps with high-quality, engaging, and diverse features and content related to milk production. Methods Breastfeeding apps were identified in the Apple App Store. All features that assist mothers with tracking, promoting, or interpreting milk production in the first 0-6 months postpartum were noted. Every screen containing educational information about milk production was identified and saved for review. Images of mothers and caretakers within the selected screenshots were assessed. Three scoresheets informed by Social Cognitive Theory were created to evaluate all identified features, educational content, and images representing the breastfeeding experience. Results Forty-one breastfeeding apps were reviewed. Only seven apps contained both features and educational content related to milk production. Thirteen apps that contained educational content related to milk production received a mean combined content and cultural diversity score of 15.3 of 78. Of the 48 photos reviewed in screenshots that contained educational content on milk production, 87.5% (n=42) were of white women and their infants. For-profit companies and large organizations were most likely to create free apps and apps that received high scores on the combined content and diversity or features scoresheet, respectively. Conclusions Features and educational content related to milk production and breastfeeding imagery within breastfeeding apps were evaluated using three novel scoresheets informed by Social Cognitive Theory. Few apps contained both features that promote breastfeeding self-efficacy and high-quality, engaging, educational content with images of diverse caretakers. Thus, it is likely that parents, especially those from minority or low-income groups, have limited options when selecting a breastfeeding app. App developers could use the scoresheets and findings in this review to develop breastfeeding apps that assist mothers with interpreting, tracking, or learning about milk production through high-quality an...

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“…These results corroborate the study by Guijarro et al, 15 which used a similar strategy and obtained a higher percentage of breastfeeding (36% vs. 18.5%) after 6 months of age, level of evidence N4. A content analysis developed by Schindler-Ruwisch et al 37 identified that, just like mobile applications, text messaging is a potentially far-reaching resource in providing information about breastfeeding. 38 Austen et al 39 present the use of video with musical parody as an additional resource to sensitize young adults about the importance of breastfeeding.…”

Section: Alam Et Al (2017)mentioning

confidence: 99%

Telehealth and Breastfeeding: An Integrative Review

Santos

Borges

Azambuja

2020

Telemedicine and e-Health

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Background: This is an integrative review of scientific articles, published from 2000 to 2018, that address strategies for breastfeeding through telehealth. Telehealth is the safe and low cost use of information and communication technologies (ICTs) in health care. The objective is to identify the scientific production on the subject of telehealth as a support strategy for breastfeeding. Methods: A qualitative research study was carried out with emphasis on the integrative review of the Embase, Bireme, and PubMed databases, in Portuguese, English, and Spanish. The descriptors used were ''breastfeeding'' and ''telemedicine.'' Results: Twenty-three articles were identified and categorized as (1) synchronous support for telephone calls and/or videoconference; (2) asynchronous support for audio and text messaging, interactive websites, and mobile application; and (3) systematic review and meta-analysis. Experiences demonstrated viability to implementation, impact on exclusive breastfeeding time, and maintenance of breastfeeding, as well as positive user satisfaction. Conclusion: Viable telehealth strategies exist to support breastfeeding. With the existence of telehealth hubs, structured more than 10 years in Brazil, there seems to be potential in the development of projects in the area. There is room for innovation and for the expansion of telehealth services already offered.

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Social Support for Breastfeeding in the Era of mHealth: A Content Analysis

Abstract: Although freely available mobile applications and text-messaging programs exist, with potential for wide reach, the majority provide only informational support. These programs would benefit from additional study of their usefulness.

Cited by 33 publications

References 36 publications

Perceptions and Attitudes Toward Mobile Health in Development of an Exclusive Breastfeeding Tool: Focus Group Study With Caregivers and Health Promoters in the Dominican Republic

Perceptions and Attitudes Toward Mobile Health in Development of an Exclusive Breastfeeding Tool: Focus Group Study With Caregivers and Health Promoters in the Dominican Republic

Features and Educational Content Related to Milk Production in Breastfeeding Apps: Content Analysis Informed by Social Cognitive Theory

Telehealth and Breastfeeding: An Integrative Review

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