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The media plays a powerful role in shaping health‐related attitudes and behaviours. We investigated media reports about children's independent mobility (CIM) and associations with parental attitudes towards CIM. CIM‐related media reports (newspaper, online, television) during a 3‐month period were extracted from two databases. Concurrent parental attitudes were collected via telephone interview from 1779 parents of children aged 9–15 years. Media reports were overwhelmingly negative: 94% mentioned only risks and 6% mentioned benefits. There was no association between media reports and parental attitudes. Parental CIM attitudes are often complex and pervasive and may not be shifted by media coverage alone. [ABSTRACT FROM AUTHOR]

Place-based initiatives are frequently subject to "top-down" changes, despite having a "bottom-up" service delivery model. One example is the Australian Government's "Communities for Children" Facilitating Partner initiative (CfC), aimed at improving child, family and community outcomes in geographically disadvantaged areas. CfC introduced a policy requiring initially 30% then 50% of service delivery funding to be spent on evidence-based programs. This qualitative study explores the rarely examined views and experiences of government personnel tasked with implementing the policy. Seventeen government personnel across Australia were interviewed and asked about knowledge and attitudes toward evidence-based practice and the policy change, and perceptions of the factors that influenced policy implementation. Data were analyzed thematically and findings compared to existing frameworks and theoretical models. Six themes were identified. Participants cited workforce, contextual and cultural factors as influences on implementation. Most viewed the implementation as worthwhile, although some lingering skepticism remained. Findings were consistent with a theory of organizational readiness for change. Organizations that were "enthusiastic and confident" were more effective at implementation; those that were "pragmatic and confident" focussed on compliance rather than benefits to families; while those that were "resistant and unconfident" struggled with implementation. Findings were also consistent with a framework of factors that support sustained implementation in disadvantaged populations, with three additional factors identified. These findings highlight the importance for governing bodies to build supporting factors broadly, and to plan for the provision of additional supports to organizations with a low level of change readiness. Highlights: Place-based initiatives are increasingly required to use evidence-based programs to maximize benefits for families. Government personnel cite contextual, workforce, and cultural factors as influences on implementation. Considerable financial, logistical, and technical support is required to implement evidence-based programs. Enabling services to build evidence for home-grown programs ensures the right mix of programs for families. [ABSTRACT FROM AUTHOR]

The Diabetes and Antenatal Milk Expressing (DAME) randomised controlled trial (RCT) was conducted in 2011–2015, at six sites in Melbourne, Australia to explore the effect of advising women with diabetes in pregnancy to express breast milk from 36 weeks gestation. Infants whose mothers were randomised to express in pregnancy were more likely to be exclusively breast milk fed during their hospital stay, and there was no evidence of harm. This paper explores women's views and experiences of antenatal expressing. In this two‐arm RCT, 635 women with diabetes in pregnancy who were otherwise of low medical risk were randomised at 36–37 weeks gestation to usual care (not expressing, n = 316), or the intervention, where women were advised to hand express for 10 min twice daily until birth (n = 319). Semistructured face‐to‐face interviews were conducted with 10 women who expressed antenatally. They were asked about their experiences of antenatal expressing, including how they felt about the overall experience, the amount of breast milk they expressed, making time to express, and their experience of breastfeeding. Thematic analysis of the in‐depth interviews identified six themes: (1) learning and adapting expressing, (2) feelings and sensations associated with expressing, (3) support, (4) dis/empowerment, (5) health, and (6) the value of breast milk. Women had both positive and negative experiences of antenatal expressing. If health professionals are advising antenatal expressing to women, it is important they understand the range of outcomes and experiences. Key messages: Women's experiences of antenatal expressing were both positive and negative; it is important to understand the range of experiences.Women should be advised that some women express little or no breast milk antenatally and therefore be reassured if they are concerned.For women with diabetes in pregnancy, their diabetes management is a significant time burden, and should be considered when discussing antenatal expressing with women.Maternity care providers need to follow‐up with pregnant women advised to express, to provide education, reassurance, and reassess expressing techniques.Maternity care providers need to manage and prioritise the use of expressed breast milk. [ABSTRACT FROM AUTHOR]