11 results
Search Results
2. Methodological development of an exploratory randomised controlled trial of an early years' nutrition intervention: the CHERRY programme ( Choosing Healthy Eating when Really Young).
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Watt, Richard Geddie, Draper, Alizon K., Ohly, Heather R., Rees, Gail, Pikhart, Hynek, Cooke, Lucy, Moore, Laurence, Crawley, Helen, Pettinger, Clare, McGlone, Pauline, and Hayter, Arabella K.M.
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CHILD development ,DIET ,FOOD habits ,FRUIT ,RESEARCH methodology ,METROPOLITAN areas ,NUTRITION ,PARENTS ,QUESTIONNAIRES ,RESEARCH ,RESEARCH funding ,RURAL conditions ,SURVEYS ,T-test (Statistics) ,TELEPHONES ,VEGETABLES ,LOGISTIC regression analysis ,SAMPLE size (Statistics) ,RANDOMIZED controlled trials ,HUMAN services programs ,EVALUATION of human services programs - Abstract
Good nutrition in the early years of life is vitally important for a child's development, growth and health. Children's diets in the United Kingdom are known to be poor, particularly among socially disadvantaged groups, and there is a need for timely and appropriate interventions that support parents to improve the diets of young children. The Medical Research Council has highlighted the importance of conducting developmental and exploratory research prior to undertaking full-scale trials to evaluate complex interventions, but have provided very limited detailed guidance on the conduct of these initial phases of research. This paper describes the initial developmental stage and the conduct of an exploratory randomised controlled trial undertaken to determine the feasibility and acceptability of a family-centred early years' nutrition intervention. Choosing Healthy Eating when Really Young ( CHERRY) is a programme for families with children aged 18 months to 5 years, delivered in children's centres in one urban ( Islington) and one rural ( Cornwall) location in the United Kingdom. In the development stage, a mixed-methods approach was used to investigate the nature of the problem and options for support. A detailed review of the evidence informed the theoretical basis of the study and the creation of a logic model. In the feasibility and pilot testing stage of the exploratory trial, 16 children's centres, with a sample of 394 families were recruited onto the study. We hope that the methodology, which we present in this paper, will inform and assist other researchers in conducting community-based, exploratory nutrition research in early years settings. [ABSTRACT FROM AUTHOR]
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- 2014
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3. Intrahousehold power inequalities and cooperation: Unpacking household responses to nutrition‐sensitive agriculture interventions in rural India.
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Harris‐Fry, Helen, Prost, Audrey, Beaumont, Emma, Fivian, Emily, Mohanty, Satyanarayan, Parida, Manoj, Pradhan, Ronali, Sahu, Satyapriya, Padhan, Shibanath, Mishra, Naba K., Rath, Shibanand, Rath, Suchitra, Koniz‐Booher, Peggy, Allen, Elizabeth, and Kadiyala, Suneetha
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PREVENTION of malnutrition ,CLUSTER sampling ,MOTHERS ,FOCUS groups ,AGRICULTURE ,RURAL conditions ,RESEARCH methodology ,CROSS-sectional method ,COOPERATIVENESS ,PREGNANT women ,DIET ,NUTRITION education ,RANDOMIZED controlled trials ,SELF-efficacy ,CHILD health services ,QUESTIONNAIRES ,DECISION making ,HEALTH behavior ,SOUND recordings ,DESCRIPTIVE statistics ,RESEARCH funding ,STATISTICAL sampling ,DATA analysis software ,POWER (Social sciences) ,EDUCATIONAL outcomes ,VIDEO recording ,HEALTH promotion - Abstract
Nutrition‐sensitive agriculture (NSA) interventions offer a means to improve the dietary quality of rural, undernourished populations. Their effectiveness could be further increased by understanding how household dynamics enable or inhibit the uptake of NSA behaviours. We used a convergent parallel mixed‐methods design to describe the links between household dynamics—specifically intrahousehold power inequalities and intrahousehold cooperation—and dietary quality and to explore whether household dynamics mediated or modified the effects of NSA interventions tested in a cluster‐randomized trial, Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN). We use quantitative data from cross‐sectional surveys in 148 village clusters at UPAVAN's baseline and 32 months afterwards (endline), and qualitative data from family case studies and focus group discussions with intervention participants and facilitators. We found that households cooperated to grow and buy nutritious foods, and gendered power inequalities were associated with women's dietary quality, but cooperation and women's use of power was inhibited by several interlinked factors. UPAVAN interventions were more successful in more supportive, cooperative households, and in some cases, the interventions increased women's decision‐making power. However, women's decisions to enter into negotiations with family members depended on whether women deemed the practices promoted by UPAVAN interventions to be feasible, as well as women's confidence and previous cultivation success. We conclude that interventions may be more effective if they can elicit cooperation from the whole household. This will require a move towards more family‐centric intervention models that empower women while involving other family members and accounting for the varied ways that families cooperate and negotiate. Key messages: Household cooperation and intrahousehold power inequalities may influence children's and mothers' dietary diversity in rural OdishaThese factors partly determine the effects of nutrition‐sensitive agriculture (NSA) interventions tested in Upscaling Participatory Action and Videos for Agriculture and Nutrition, indicating that NSA interventions may be more effective if they include multiple family members.There is wide heterogeneity in household dynamics and the constraints that families face. Further research is needed to identify how interventions can respond to this heterogeneity so that NSA interventions are effective in an inclusive and empowering way. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Evaluation of mobile phone‐based Positive Deviance/Hearth child undernutrition program in Cambodia.
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Young, Melissa F., Baik, Diane, Reinsma, Kathryn, Gosdin, Lucas, Rogers, Hannah Paige, Oy, Sreymom, Invong, Wuddhika, Hen, Heang, Ouk, Sopheap, and Chhorvann, Chhea
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CLUSTER sampling ,STATISTICAL power analysis ,EVALUATION of human services programs ,COUNSELING ,CONFIDENCE intervals ,ANALYSIS of variance ,SOCIAL change ,RESEARCH methodology ,PUBLIC health ,QUANTITATIVE research ,REGRESSION analysis ,COMPARATIVE studies ,RANDOMIZED controlled trials ,DISEASE prevalence ,DESCRIPTIVE statistics ,QUESTIONNAIRES ,CHI-squared test ,RESEARCH funding ,TEXT messages ,STATISTICAL sampling ,DATA analysis software ,HEALTH promotion ,LONGITUDINAL method - Abstract
Child undernutrition in Cambodia is a persistent public health problem requiring low‐cost and scalable solutions. Rising cellphone use in low‐resource settings represents an opportunity to replace in‐person counselling visits with phone calls; however, questions remain on relative effectiveness. Our objective was to evaluate the impact of two options for delivering a World Vision infant and young child feeding (IYCF) counselling programme: (1) traditional Positive Deviance/Hearth (PDH) programme with in‐person visits or (2) PDH with Interactive Voice Calling (PDH‐IVC) which integrates phone calls to replace 62.5% of face‐to‐face interaction between caregivers and volunteers, compared to the standard of care (SOC). We conducted a longitudinal cluster‐randomised controlled trial in 361 children 6–23 months. We used an adjusted difference‐in‐difference approach using baseline, midline (3 months) and endline (12 months) surveys to evaluate the impact on child growth among the three groups. At baseline, nearly a third of children were underweight, and over half were food insecure. At midline the PDH group and the PDH‐IVC groups had improved weight‐for‐age z‐scores (0.13 DID, p = 0.011; 0.13 DID, p = 0.02, respectively) and weight‐for‐height z‐score (0.16 DID, p = 0.038; 0.24 DID, p = 0.002), relative to SOC. There were no differences in child height‐for‐age z‐scores. At endline, the impact was sustained only in the PDH‐IVC group for weight‐for‐age z‐score (0.14 DID, p = 0.049), and the prevalence of underweight declined by 12.8 percentage points (p = 0.036), relative to SOC. Integration of phone‐based IYCF counselling is a potentially promising solution to reduce the burden of in‐person visits; however, the modest improvements suggest the need to combine it with other strategies to improve child nutrition. [ABSTRACT FROM AUTHOR]
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- 2021
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5. A national research centre for the evaluation and implementation of person‐centred care: Content from the first interventional studies.
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Gyllensten, Hanna, Björkman, Ida, Jakobsson Ung, Eva, Ekman, Inger, and Jakobsson, Sofie
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CONCEPTUAL structures ,RESEARCH methodology ,MEDICAL care research ,MEDICAL cooperation ,HEALTH outcome assessment ,QUESTIONNAIRES ,RESEARCH ,RESEARCH funding ,RANDOMIZED controlled trials ,HUMAN services programs ,CROSS-sectional method ,PATIENT-centered care ,EVALUATION of human services programs - Abstract
Background: Person‐centred care (PCC) has been suggested as a potential means to improve the care of patients with chronic and long‐term disorders. In this regard, a model for PCC was developed by the University of Gothenburg Centre for Person‐Centred Care (GPCC). Objective: The present study aimed to explore the theoretical frameworks, designs, contexts and intervention characteristics in the first 27 interventional studies conducted based on the ethics for person‐centredness provided by the GPCC. Design: Cross‐sectional study. Setting and participants: A questionnaire to the principal investigators of the 27 intervention studies financed by the GPCC and conducted between 2010 and 2016. Main outcome measures: Theoretical frameworks, contexts of studies, person‐centred ethic, and outcome measures. Results: Most of the interventions were based on the same ethical assumptions for person‐centredness but theories and models in applying the interventions differed. All studies were controlled; 12 randomized and 15 quasi‐experimental. Hospital in‐ and outpatient and primary care settings were represented and the outcome measures were related to the specific theories used. A complexity in designing, introducing and evaluating PCC interventions was evident. Conclusion: The frameworks, designs and interventions in the studies were in line with the established ethical basis of PCC, whereas outcome measures varied widely. Consensus discussions among researchers in the field are needed to make comparisons between studies feasible. Patient or public contributions: Patients or the public made no direct contributions, although most of the studied projects included such initiatives. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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6. A measurement scale to assess responsive feeding among Cambodian young children.
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Sall, Ndèye S., Bégin, France, Dupuis, Jérémie B., Bourque, Jimmy, Menasria, Lylia, Main, Barbara, Vong, Lenin, Hun, Vannary, Raminashvili, David, Chea, Chhorvann, Chiasson, Lucie, and Blaney, Sonia
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ENRICHED foods ,CAREGIVERS ,EXPERIMENTAL design ,FACTOR analysis ,INFANT nutrition ,INGESTION ,INTERPERSONAL relations ,RESEARCH methodology ,MOTHER-infant relationship ,NUTRITIONAL requirements ,NUTRITION education ,SCIENTIFIC observation ,PARENT-infant relationships ,QUESTIONNAIRES ,RESEARCH funding ,STATISTICAL sampling ,RANDOMIZED controlled trials ,PRE-tests & post-tests ,RESEARCH methodology evaluation ,DATA analysis software ,DESCRIPTIVE statistics ,CLUSTER sampling - Abstract
The caregiver–child interaction during mealtime, which refers to responsive feeding (RF), influences child's dietary intake. In Cambodia, given the level of malnutrition, getting better knowledge of RF among young children is essential, but to do so, using an appropriate assessment tool is necessary. We aim to develop and to validate a measurement tool to assess RF in two different situations (before and after an intervention) among children 6–23 months old. This research is part of a larger trial assessing the impact of nutrition education combined or not with the provision of complementary foods on child nutritional status. The "Opportunistic Observation Form" from the Process for the Promotion of Child Feeding package was used to collect data on RF through direct observations of child's meal episodes. Data were used to define an initial scale composed of four constructs and 15 indicators. Confirmatory factor analyses (CFA) and Hancock and Mueller's H reliability indices were computed to assess the validity and reliability of the scale. The final tool was applied to baseline and endline data. At baseline, the sample included 243 pairs and, at endline, 248 pairs. The final scale included two latent constructs (RF and active feeding) that comprise three indicators for active feeding and five for RF. Criteria for fit indices of CFA were met for both constructs though better at baseline. Reliability coefficients were above 0.80 for each construct at baseline and endline. This research proposes a scale that could be used to assess active feeding and RF. Further validation is warranted in different contexts. [ABSTRACT FROM AUTHOR]
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- 2020
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7. Effect of Comprehensive Behavioral and Exercise Intervention on Physical Function and Activity Participation After Total Knee Replacement: A Pilot Randomized Study.
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Piva, Sara R., Almeida, Gustavo J., Gil, Alexandra B., DiGioia, Anthony M., Helsel, Diane L., and Sowa, Gwendolyn A.
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KNEE surgery ,POSTOPERATIVE pain prevention ,BEHAVIOR therapy ,COMPARATIVE studies ,CONVALESCENCE ,EXERCISE therapy ,HEALTH attitudes ,HEALTH behavior ,HEALTH status indicators ,HEALTH surveys ,KINEMATICS ,KNEE ,RESEARCH methodology ,MEDICAL cooperation ,PATIENT education ,POSTOPERATIVE pain ,QUESTIONNAIRES ,RESEARCH ,RESEARCH funding ,TIME ,TOTAL knee replacement ,PILOT projects ,EVALUATION research ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,BLIND experiment - Abstract
Objective: To test the feasibility of a comprehensive behavioral intervention (CBI) program that combines intense exercises with an education program, to be implemented at a later stage (3 months) following total knee replacement (TKR), and to get a first impression of the effects of the CBI as compared to a standard of care exercise (SCE) program on the outcomes of physical function and physical activity.Methods: A total of 44 subjects participated in a 3-month program of either CBI or SCE, followed by 3 months of a home exercise program. Outcomes of physical function and physical activity were measured at baseline and at 6-month followup. Analysis of variance was used to compare statistical differences between groups, whereas responder analyses were used for clinically important differences.Results: The CBI was found to be safe and well tolerated. As compared to the SCE group, the CBI group had less pain (P = 0.035) and better physical function based on the Short Form 36 health survey (P = 0.017) and the single-leg stance test (P = 0.037). The other outcome measures did not demonstrate statistically significant differences between the 2 groups. Results from the responder analysis demonstrated that the CBI group had a 36% higher rate of responders in physical function as compared to the SCE group. Also, the CBI group had 23% more responders in the combined domains of physical function and physical activity.Conclusion: The CBI program is feasible and improves physical function and physical activity in patients several months after TKR. Larger pragmatic randomized trials are needed to confirm the results of this study. [ABSTRACT FROM AUTHOR]- Published
- 2017
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8. Feeding behaviors during home-based treatment of moderate acute malnutrition using corn-soy blends or lipid-based nutrient supplements.
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Iuel‐Brockdorf, Ann‐Sophie, Ouedraogo, Albertine, Ritz, Christian, Draebel, Tania Aase, Ashorn, Per, Filteau, Suzanne, and Michaelsen, Kim F.
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MALNUTRITION treatment ,ARTIFICIAL feeding ,CAREGIVERS ,CLINICAL trials ,CONFIDENCE intervals ,CONTENT analysis ,CORN ,DIETARY supplements ,ENTERAL feeding ,FOCUS groups ,HOME care services ,INFANTS ,INTERVIEWING ,LIPIDS ,LONGITUDINAL method ,RESEARCH methodology ,NUTRITIONAL requirements ,SCIENTIFIC observation ,PROBABILITY theory ,QUESTIONNAIRES ,RESEARCH funding ,STATISTICAL sampling ,SOYBEAN ,JUDGMENT sampling ,THEMATIC analysis ,RANDOMIZED controlled trials ,DESCRIPTIVE statistics ,ODDS ratio ,CHILDREN - Abstract
Feeding behaviors have an important impact on children's nutritional status and are essential to consider when implementing nutrition programs. The objective of this study was to explore and compare feeding behaviors related to supplementary feeding with corn-soy blends (CSB) and lipid-based nutrient supplements (LNS) based on best practice feeding behaviors. The study was conducted as part of a randomized controlled trial assessing the effectiveness of new formulations of CSB and LNS and comprised 1,546 children from 6 to 23 months. The study included a mixed methods approach using questionnaires, focus group discussions and home visits and interviews with a subsample of 20 caretakers of trial participants. We found that LNS, compared to CSB, were more likely to be mixed into other foods (OR [95% CI] 1.7 [1.3-2.2], p = <.001), served with a meal (OR [95% CI] 1.6 [1.1-2.3], p = <.018)or between meals (OR [95% CI] 1.5 [1.1-1.9], p = <.005), and fed using an encouraging feeding style (mean difference in percentage points [95% CI] 23% [6%:40%], p = .01). CSB were more likely to be fed using a forced feeding style (mean difference in percentage points [95% CI] 18% [3%:33%], p = .02) and were often observed to be served unprepared. The main differences in feeding behaviors between the two diet groups were linked to how and when supplements were served. Educational instructions should therefore be adapted according to the supplement provided; when providing CSB, efforts should be made to promote an encouraging feeding style, and emphasis should be made to ensure preparations are made according to recommendations. [ABSTRACT FROM AUTHOR]
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- 2017
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9. Early High-Intensity Versus Low-Intensity Rehabilitation After Total Knee Arthroplasty: A Randomized Controlled Trial.
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Bade, Michael J., Struessel, Tamara, Dayton, Michael, Foran, Jared, Kim, Raymond H., Miner, Todd, Wolfe, Pamela, Kohrt, Wendy M., Dennis, Douglas, and Stevens-Lapsley, Jennifer E.
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KNEE surgery ,COMPARATIVE studies ,CONVALESCENCE ,EXERCISE tests ,EXERCISE therapy ,RANGE of motion of joints ,KNEE ,KNEE diseases ,RESEARCH methodology ,MEDICAL cooperation ,MUSCLE strength ,OSTEOARTHRITIS ,QUESTIONNAIRES ,RESEARCH ,RESEARCH funding ,STATISTICAL sampling ,TOTAL knee replacement ,EVALUATION research ,QUADRICEPS muscle ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,WEIGHT-bearing (Orthopedics) ,REHABILITATION - Abstract
Objective: To examine the safety and efficacy of a high-intensity (HI) progressive rehabilitation protocol beginning 4 days after total knee arthroplasty (TKA) compared to a low-intensity (LI) rehabilitation protocol.Methods: A total of 162 participants (mean ± SD ages 63 ± 7 years; 89 women) were randomized to either the HI group or LI group after TKA. Key components of the HI intervention were the use of progressive resistance exercises and a rapid progression to weight-bearing exercises and activities. Both groups were treated in an outpatient setting 2 to 3 times per week for 11 weeks (26 total sessions). Outcomes included the stair climbing test (SCT; primary outcome), timed-up-and-go (TUG) test, 6-minute walk (6MW) test, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 12-item Short Form health survey (SF-12), knee range of motion (ROM), quadriceps and hamstring strength, and quadriceps activation. Outcomes were assessed preoperatively and at 1, 2, 3 (primary end point), 6, and 12 months postoperatively.Results: There were no significant differences between groups at 3 or 12 months in SCT, TUG, 6MW, WOMAC scores, knee ROM, quadriceps and hamstrings strength, quadriceps activation, or adverse event rates. By 12 months, outcomes on the 6MW, TUG, WOMAC, SF-12, quadriceps and hamstring strength, and quadriceps activation had improved beyond baseline performance in both groups.Conclusion: Both the HI and LI interventions were effective in improving strength and function after TKA. HI progressive rehabilitation is safe for individuals after TKA. However, its effectiveness may be limited by arthrogenic muscular inhibition in the early postoperative period. [ABSTRACT FROM AUTHOR]- Published
- 2017
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10. Motor skills of children with unilateral visual impairment in the Infant Aphakia Treatment Study.
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Celano, Marianne, Hartmann, E Eugenie, DuBois, Lindreth G, and Drews‐Botsch, Carolyn
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MOTOR ability ,VISION disorders ,APHAKIA ,INFANTS ,MONOCULARS ,CHILD development ,COMPARATIVE studies ,DEPTH perception ,RESEARCH methodology ,MEDICAL cooperation ,QUESTIONNAIRES ,RESEARCH ,RESEARCH funding ,VISION ,VISUAL acuity ,EVALUATION research ,RANDOMIZED controlled trials ,DISEASE complications - Abstract
Aim: To assess motor functioning in children aged 4 years 6 months enrolled in the Infant Aphakia Treatment Study, and to determine contributions of visual acuity and stereopsis to measured motor skills.Method: One hundred and four children (53% female) with unilateral aphakia randomized to intraocular lens or contact lens treatment were evaluated at 4 years 6 months (age range 4y 6mo-4y 11mo) for monocular recognition visual acuity, motor skills, and stereopsis by a traveling examiner masked to treatment condition. Motor skills were assessed with the Movement Assessment Battery for Children--Second Edition (MABC-2). Visual acuity was operationalized as log10 of the minimum angle of resolution (logMAR) value for treated eye, best logMAR value for either eye, and intraocular logMAR difference.Results: Student's t-tests showed no significant differences in MABC-2 scores between the intraocular lens and contact lens groups. The mean total score was low (6.43; 18th centile) compared with the normative reference group. Motor functioning was not related to visual acuity in the treated eye or to intraocular logMAR difference, but was predicted in a regression model by the better visual acuity of either eye (usually the fellow eye), even after accounting for the influence of age at surgery, examiner, orthotropic ocular alignment, and stereopsis.Interpretation: Children with unilateral congenital cataract may have delayed motor functioning at 4 years 6 months, which may adversely affect their social and academic functioning. [ABSTRACT FROM AUTHOR]- Published
- 2016
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11. Promoting positive attitudes to breastfeeding: the development and evaluation of a theory-based intervention with school children involving a cluster randomised controlled trial.
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Giles, Melanie, Millar, Samantha, Armour, Cherie, McClenahan, Carol, Mallett, John, and Stewart‐Knox, Barbara
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ANALYSIS of variance ,ATTITUDE (Psychology) ,BEHAVIOR modification ,BREASTFEEDING ,BREASTFEEDING promotion ,FOCUS groups ,INTENTION ,INTERVIEWING ,LONGITUDINAL method ,RESEARCH methodology ,QUESTIONNAIRES ,REGRESSION analysis ,RESEARCH funding ,SCHOOLS ,SURVEYS ,SAMPLE size (Statistics) ,SOCIAL support ,RANDOMIZED controlled trials ,HUMAN services programs ,PRE-tests & post-tests ,PLANNED behavior theory ,EVALUATION of human services programs ,DATA analysis software - Abstract
The objective of this study was to design, implement and evaluate an intervention based on the theory of planned behaviour (TPB) to enhance young peoples' motivations to breastfeed/support a partner to breastfeed. Six semi‐structured focus groups were first conducted with 48 13–14‐year‐olds from two schools in Northern Ireland. The salient beliefs elicited were subsequently used to design a TPB‐based questionnaire that was then administered to 2021 13–14‐year‐old pupils (852 males; 1169 females) from 36 post‐primary schools to identify the most important determinants of breastfeeding. The results were used to inform the design and implementation of an intervention package that was subsequently evaluated using a cluster randomised controlled trial involving 44 randomly selected schools across Northern Ireland. Questionnaires were administered to 18 intervention and 26 control schools at baseline and again at 1 and 6 months post‐intervention to evaluate its effectiveness. Multi‐level modelling was employed to analyse the data. The results revealed significant effects on women's intention to breastfeed, β = 0.208, t(1275) = 2.715, P = 0.007; attitudes, β = 0.223, t(1275) = 4.655, P < 0.001; moral attitudes, β = 0.231, t(1275) = 4.211, P < 0.001; subjective norm, β = 0.118, t(1275) = 2.521, P = 0.012; and knowledge, β = 0.109, d.f. (1275) = 7.843, P < 0.001. However, for men, the results revealed significant effects on only the construct of knowledge, β = 0.104, t(541) = 4.345, P < 0.001.The research has provided evidence to support the need for breastfeeding education in schools and has shown how a theoretical framework may be used to inform the design and evaluation of a health behaviour intervention. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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