Implementing evidence-based practice: evaluation of an opinion leader strategy to improve breast-feeding rates.
OBJECTIVE
The objective was to evaluate the effectiveness of opinion leaders in raising breast-feeding rates.


METHODS
A randomized controlled trial of an opinion leader strategy in 18 hospitals in Central New York State compared mothers' intention to breast-feed during baseline and study years. Multivariate logistic regression with a mixed model analyzed the effects on breast-feeding exclusively and on breast- and formula-feeding combined.


RESULTS
Obstetric clinicians had a high degree of knowledge about breast-feeding benefits and of perceived responsibility to recommend breast-feeding. Obstetricians, family practitioners, and midwives agreed on the person identified as the opinion leader, in each case an obstetrician who was chief of obstetrics or obstetrics-gynecology. Breast-feeding rates in hospitals with the opinion leader intervention did not differ significantly from those in control-group hospitals during the study year.


CONCLUSIONS
The opinion leader strategy in this case did not improve breast-feeding rates during the study year. Opinion leader strategies may make assumptions about clinician control that are not justified in situations such as breast-feeding.
Department of Health Policy, Mount Sinai School of Medicine, New York, NY, USA.
Jane E
JE
Sisk
Ann Lennarson
AL
Greer
Martha
M
Wojtowycz
Lani B
LB
Pincus
Richard H
RH
Aubry
D001291:Attitude of Health Personnel; D001942:Breast Feeding / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005194:Family Practice; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D009721:Nurse Midwives; D009774:Obstetrics; D009936:Organizational Innovation