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- Member of: ASU Electronic Theses and Dissertations
Description
Late preterm infants (LPIs), born between 34 and 37 weeks gestation, are at risk for a myriad of health conditions related to neuro-muscular and physiologic immaturity. However, relative stability allow many of these infants to avoid care in specialty nurseries and discharge home with their mothers after birth. Due to underlying immaturity, feeding difficulty is the most common issue LPIs experience, resulting in early breastfeeding cessation, increased risk for secondary diagnoses, and hospital readmission. The purpose of this study was to assess early breastfeeding behavior of LPIs, including testing inter-rater reliability of an assessment tool and the feeding patterns of infants over time. An extensive review of breastfeeding assessment tools resulted in the selection of the Premature Infant Breastfeeding Behavior Scale (PIBBS) based on its reliability and validity in the preterm infant population. A convenience sample of LPI dyads was recruited and used to conduct inter-rater reliability testing of PIBBS. A longitudinal one-group non-experimental study was used for observational follow-up. A strong statistical agreement of PIBBS scores occurred between mothers and a healthcare professional (Cohen’s kappa values of items ranged from .776 to 1.000, p = <.001). Participants continued using the PIBBS tool after hospital discharge until their infants expected due dates (40 weeks adjusted age). T-test analyses were conducted to examine changes in scores over time indicating increase in item scores (p = .003 - .193). PIBBS appears to be a valid and reliable tool to assess breastfeeding among LPI dyads. Incorporation of PIBBS into a comprehensive plan of care could better support and protect breastfeeding among the LPI population.
ContributorsLober, Angela (Author) / Komnenich, Pauline (Thesis advisor) / Kelly, Lesly (Thesis advisor) / Dodgson, Joan (Committee member) / Arizona State University (Publisher)
Created2018
Description
Exclusivity and duration of breastfeeding and the provision of human milk in the United States is suboptimal. In the absence of adequate banked donor human milk for distribution to all infants in need, many families choose to engage in the practice of Private Arrangement Milk Sharing (PAMS), partially facilitated through social media, to procure human milk for their infants. Evidence regarding the participant and infant characteristics and risk abatement practices is incomplete. This dissertation describes and explores the characteristics of recipient participants and infants, family constellation, donor screening practices, and related risk abatement strategies. Data was collected via on-line survey as a sub-group of a larger data set including donor participants and international participants. Binary logistic regression modeling of factors that contribute to consistent screening and risk abatement practices and important antecedents to engaging in PAMS was conducted. Results are contextualized within a tailored socioecological framework of factors affecting infant feeding practices. Tailoring was accomplished via qualitative descriptive analysis of participant responses applied to an existing breastfeeding framework. Participants in this sample were predominantly white, married, with a mean age of 32.9 years, with at least some college education and above median income. Risk abatement and screening practices were influenced by support of a healthcare provider during decision-making, college education, infant age and health status, having lactation support, birth type and birth attendant, and the duration and sources sought for learning about milk sharing.
ContributorsBond, Angela Bowen (Author) / Reifsnider, Elizabeth G. (Thesis advisor) / Keller, Colleen (Committee member) / Todd, Michael (Committee member) / Arizona State University (Publisher)
Created2016
Description
Despite the widely recognized health benefits of breastfeeding and its endorsement by leading health organizations, as a preventative public health intervention, inadequate breastfeeding knowledge and lactation management skills among healthcare providers continues to be a major barrier for women who choose to initiate breastfeeding. Breastfeeding competencies are not standardized in healthcare education for any of the health professions. To address this gap, a few continuing education and professional development programs have been implemented, but paucity in research regarding the efficacy of these programs exists. The purpose of this study was to explore the changes in healthcare providers’ learning outcomes related to breastfeeding support and promotion.
A non-experimental pre-posttest self-report survey design was used to assess the feasibility and preliminary efficacy of an online breastfeeding educational intervention for healthcare providers. The Theory of Planned Behavior (TPB) provided the framework for exploring the participants’ psychological and behavioral outcomes. The research questions were: (1) What is the feasibility of an online breastfeeding course for healthcare providers? (2) What are healthcare providers’ psychological and behavioral changes occurring after completion of an online course? (3) How do the post-intervention psychological and behavioral outcomes of the online format compare with those of the previous format (hybrid) of this breastfeeding course?
Although participants’ favorably assessed the feasibility (i.e., acceptability) of the 45-hour course, several factors contributed to participants’ satisfaction level: Previous online learning experience, connectedness with others, and the degree of structural support. Significant positive changes occurring in participants were increases in their knowledge and beliefs about breastfeeding; attitudes toward formula feeding; perceived behavioral control; perceptions about being able to perform breastfeeding supportive behaviors; and intentions to perform actions that are consistent with evidence-based breastfeeding supportive behaviors. Significant changes in the beliefs about formula feeding were not in the expected direction raising conceptual and pedagogical issues. Participants had negative perceptions about being able to implement what they learned in their workplaces or to affect policy. Findings support the use of online breastfeeding education programs for healthcare providers; changes at both individual and institutional levels are necessary to change provider practices.
A non-experimental pre-posttest self-report survey design was used to assess the feasibility and preliminary efficacy of an online breastfeeding educational intervention for healthcare providers. The Theory of Planned Behavior (TPB) provided the framework for exploring the participants’ psychological and behavioral outcomes. The research questions were: (1) What is the feasibility of an online breastfeeding course for healthcare providers? (2) What are healthcare providers’ psychological and behavioral changes occurring after completion of an online course? (3) How do the post-intervention psychological and behavioral outcomes of the online format compare with those of the previous format (hybrid) of this breastfeeding course?
Although participants’ favorably assessed the feasibility (i.e., acceptability) of the 45-hour course, several factors contributed to participants’ satisfaction level: Previous online learning experience, connectedness with others, and the degree of structural support. Significant positive changes occurring in participants were increases in their knowledge and beliefs about breastfeeding; attitudes toward formula feeding; perceived behavioral control; perceptions about being able to perform breastfeeding supportive behaviors; and intentions to perform actions that are consistent with evidence-based breastfeeding supportive behaviors. Significant changes in the beliefs about formula feeding were not in the expected direction raising conceptual and pedagogical issues. Participants had negative perceptions about being able to implement what they learned in their workplaces or to affect policy. Findings support the use of online breastfeeding education programs for healthcare providers; changes at both individual and institutional levels are necessary to change provider practices.
ContributorsWatkins, Amanda L (Author) / Dodgson, Joan E (Thesis advisor) / Reifsnider, Elizabeth G. (Committee member) / McClain, Darya (Committee member) / Arizona State University (Publisher)
Created2015
Description
Low income, pregnant adolescents have an increased risk of adverse pregnancy outcomes, such as preterm birth, delivery of low birth weight babies and excessive gestational weight gain that increases the risk of postpartum overweight and obesity. Inadequate dietary intake is a modifiable risk factor that may differentially impact maternal health and fetal outcomes for pregnant adults and adolescents. To evaluate the effectiveness of a social media intervention on improving prenatal health knowledge and dietary intake, 22 racially diverse pregnant women (59% Black and 36% White) were recruited and adolescent (n=10) outcomes compared to those of adults (n=12) across the intervention. Pre- and post-intervention nutrition knowledge questionnaires and diet recalls were completed to assess nutrition knowledge and dietary intake. When assessing dietary change across the intervention, significant decreases in fat (pre vs. post, 97.9 ± 0.2 g vs. 90.2 ± 0.2 g, P=0.047) and folate intake (pre vs. post, 537.6 ± 0.3 μg vs. 531.2 ± 0.2 μg, P=0.041) were observed while significant increases in carbohydrate (pre vs. post, 318.9 ± 0.2 g vs. 335.9 ± 0.2 g, P<0.001), calcium (pre vs. post, 851.3 ± 0.3 mg vs. 893.5 ± 0.2 mg, P<0.001) and magnesium intakes (pre vs. post, 212.9 ± 0.2 mg vs. 227.8 ± 0.2 mg, P<0.001) occurred. These time effects occurred independent of group (adolescents vs. adults) as time*group interactions were not significant (p>0.05) with the exception of sugar intake. Increases in sugar intake across the intervention were greater among the adolescent group (adolescent vs. adult, 7.9 ± 0.2 g vs. 6.0 ± 0.2 g, P=0.023). Overall nutrition knowledge was limited and confusion regarding MyPlate recommendations persisted. The inadequate dietary behaviors observed suggest that future interventions should focus education on specific dietary nutrients such as added sugars and fiber to improve dietary intakes. The best way to actively engage pregnant adolescents is unknown: however, social media has the potential to reach teens and low-income women with education that may be key in allowing interventions to change dietary habits and behaviors.
ContributorsEllis, Megan (Author) / Whisner, Corrie M (Thesis advisor) / Bruening, Meg (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2016