Effectiveness of a group educational intervention - prolact - in primary care to promote exclusive breastfeeding: a cluster randomized clinical trial

被引:5
作者
Jesus Santamaria-Martin, Maria [1 ]
Martin-Iglesias, Susana [2 ]
Schwarz, Christine [3 ]
Rico-Blazquez, Milagros [4 ,5 ,6 ,7 ]
Alexander Portocarrero-Nunez, Julian [3 ]
Diez-Izquierdo, Laura [8 ]
Llamosas-Falcon, Laura [9 ]
Rodriguez-Barrientos, Ricardo [4 ,5 ,7 ]
del-Cura-Gonzalez, Isabel [4 ,5 ,7 ,10 ]
机构
[1] Ctr Salud Lucero, Serv Madrileno Salud, Gerencia Asistencial Atenc Primaria, Madrid, Spain
[2] Serv Madrileno Salud, Direcc Asistencial Gerencia Asistencial Atenc Pri, Madrid, Spain
[3] Inst Salud Carlos III, Escuela Nacl Sanidad, Madrid, Spain
[4] Gerencia Asistencial Atenc Primaria, Res Unit, Serv Madrilen Salud, Calle San Martin Porres 6, Madrid 28035, Spain
[5] RICORS RICAPPS Inst Salud Carlos III, Hlth Serv Res Chron Patients Network REDISSEC, Madrid, Spain
[6] Univ Complutense Madrid, Fac Nursing Physiotherapy & Podiatry, Nursing Dept, Madrid, Spain
[7] Inst Invest Sanitaria Gregorio Maranon IISGM, Madrid, Spain
[8] Hosp Infanta Sofia, Prevent Med, Madrid, Spain
[9] Hosp Univ, Prevent Med & Publ Hlth, Madrid, Spain
[10] Univ Rey Juan Carlos, Dept Med Specialties & Publ Hlth, Madrid, Spain
关键词
Breast-feeding; Primary healthcare; Health education; Clinical trial; Health promotion;
D O I
10.1186/s12884-022-04394-8
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Background: The rates of exclusive breastfeeding at 6 months in Spain are far from recommended by the World Health Organization, which is 50% by 2025. Evidence of the effectiveness of group interventions in late postpartum is limited. The objective of this study was to evaluate the effectiveness of the PROLACT group educational intervention for increasing the proportion of mother-child dyads with exclusive breastfeeding at 6 months compared to the usual practice in primary care. Method: Multicentre cluster randomized clinical trial. A total of 434 mother-child dyads who breastfed exclusively in the first 4 weeks of the children's life and agreed to participate were included. The main outcome was exclusive breastfeeding at 6 months. Secondary variables were type of breastfeeding, reasons for abandonment, degree of adherence and satisfaction with the intervention. To study the effectiveness, the difference in the proportions of dyads with exclusive breastfeeding at 6 months was calculated, and the relative risk (RR) and number needed to treat (NNT) were calculated with their 95% CIs. To study the factors associated with the maintenance of exclusive breastfeeding at 6 months, a multilevel logistic regression model was fitted. All analyses were performed to intention to treat. Results: The percentage of dyads with exclusive breastfeeding at 6 months was 22.4% in the intervention group and 8.8% in the control group. PROLACT intervention obtained an RR =2.53 (95% CI: 1.54-4.15) and an NNT= 7 (95%CI: 5-14). The factors associated with exclusive breastfeeding at 6 months were the PROLACT intervention, OR= 3.51 (95%CI: 1.55-7.93); age > 39 years, OR = 2.79 (95%CI: 1.02-7.6); previous breastfeeding experience, OR= 2.61 (95%CI: 1.29-5.29); income between 500 and 833.33 (sic), OR = 3.52 (95%CI 1.47-8.47).); planning to start work before the infant was 6 months old, OR= 0.35 (0.19-0.63) . Conclusions: The PROLACT intervention in primary care is more effective than the usual practice for maintaining exclusive breastfeeding at 6 months, and can therefore be considered evidence-based practice for implementation in standard practice.
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页数:12
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共 34 条
  • [1] Patterns of intra-cluster correlation from primary care research to inform study design and analysis
    Adams, G
    Gulliford, MC
    Ukoumunne, OC
    Eldridge, S
    Chinn, S
    Campbell, MJ
    [J]. JOURNAL OF CLINICAL EPIDEMIOLOGY, 2004, 57 (08) : 785 - 794
  • [2] [Anonymous], 2012, INF EST SAL POBL COM
  • [3] [Anonymous], 2017, GUIA PRACT CLIN LACT
  • [4] [Anonymous], International Code of Marketing of Breast-milk Substitutes
  • [5] Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs
    Bartick, Melissa C.
    Schwarz, Eleanor Bimla
    Green, Brittany D.
    Jegier, Briana J.
    Reinhold, Arnold G.
    Colaizy, Tarah T.
    Bogen, Debra L.
    Schaefer, Andrew J.
    Stuebe, Alison M.
    [J]. MATERNAL AND CHILD NUTRITION, 2017, 13 (01)
  • [6] BOE, 2021, BOL OF EST
  • [7] Buchner H., 2007, HLTH GAIN EC EVALUAT
  • [8] Consort 2010 statement: extension to cluster randomised trials
    Campbell, Marion K.
    Piaggio, Gilda
    Elbourne, Diana R.
    Altman, Douglas G.
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 2012, 345
  • [9] Diaz-Gomez Marta, 2016, Rev Esp Salud Publica, V90, pe1
  • [10] Effect of Prenatal Counseling on Breastfeeding Rates in Mothers of Twins
    Ferreira Mikami, Fernanda Cristina
    Brizot, Maria de Lourdes
    Tase, Terezinha Hideco
    Saccuman, Elizabeth
    Vieira Francisco, Rossana Pulcineli
    Zugaib, Marcelo
    [J]. JOGNN-JOURNAL OF OBSTETRIC GYNECOLOGIC AND NEONATAL NURSING, 2017, 46 (02): : 229 - 237