title: Workshop to implement the baby-friendly office initiative. Effect on community physicians' offices.
abstract: OBJECTIVE
  To assess the effect of a self-appraisal questionnaire and a workshop for office staff in promoting the baby-friendly office (BFO).
  
  
  METHODS
  A two-times-three factorial design with a delayed workshop for one of two groups: an early intervention group who attended a workshop for office staff in October 1997 (n = 23) and a late-intervention group who attended in April 1998 (n = 23). Self-appraisals were completed before the workshops by all participants in October 1997, by 37 offices in April 1998, and by 34 offices in October 1998.
  
  
  METHODS
  Offices of family physicians and primary care pediatricians in Hamilton-Wentworth, Ont.
  
  
  METHODS
  Staff of 46 offices; 74% (34/46) completed all three assessments.
  
  
  METHODS
  Degree of change in implementing each of the "10 Steps to Baby-Friendly Office" and overall average BFO score received by each office.
  
  
  RESULTS
  Of the 34 offices completing all assessments, none followed all 10 steps. Initial mean score was 4.4 steps (standard deviation 1.4, n = 46). The workshop intervention improved overall mean scores from 4.3 to 5.6 (P < .001, n = 37). Although office staff completed the BFO self-appraisal tool, it alone had no effect on scores. Areas of improvement were noted in providing information to patients and displaying posters to promote breastfeeding. Key steps, such as not advertising breast milk substitutes and not distributing free formula, did not change.
  
  
  CONCLUSIONS
  The workshop effected a modest but positive change in breastfeeding promotion. The change was maintained at 6 and 12 months after the intervention.
authors.affiliation: Department of Family Medicine, McMaster University, Hamilton.
authors.forename: F
authors.initials: F
authors.lastname: Shariff
authors.forename: C
authors.initials: C
authors.lastname: Levitt
authors.forename: J
authors.initials: J
authors.lastname: Kaczorowski
authors.forename: J
authors.initials: J
authors.lastname: Wakefield
authors.forename: H
authors.initials: H
authors.lastname: Dawson
authors.forename: D
authors.initials: D
authors.lastname: Sheehan
authors.forename: J
authors.initials: J
authors.lastname: Sellors
mesh_terms: D000328:Adult; D000329:Advertising; D001942:Breast Feeding; D005260:Female; D019983:Guideline Adherence; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics; D011247:Pregnancy; D011320:Primary Health Care