title: Perceptions of primary care-based breastfeeding promotion interventions: qualitative analysis of randomized controlled trial participant interviews.
abstract: OBJECTIVE
  This study examined women's perceptions and reported effects of routine, primary care-based interventions to increase breastfeeding.
  
  
  METHODS
  A subsample (n=67) of participants in randomized controlled trials (RCTs) completed semistructured exit interviews at 6 months postpartum. RCT arms included the following: (a) routine pre-/postnatal lactation consultant (LC) support (LC group); (b) electronic prompts (EP) guiding providers to discuss breastfeeding during prenatal care visits (EP group); (c) a combined intervention (LC+EP group); and (d) controls. Interview transcripts were coded and analyzed in MAX.qda.
  
  
  RESULTS
  Key findings included the following: (1) Brief, non-directive assessment of feeding via postpartum interviews focused attention upon feeding practices. When coupled with breastfeeding promotion interventions, interviews promoted breastfeeding. (2) The EP and LC interventions were complementary: EPs influenced initiation, while LCs helped overcome barriers and sustain breastfeeding. (3) Prenatal intent to feed both breastmilk and formula was associated with the greatest receptivity to study messages.
  
  
  CONCLUSIONS
  Findings underscore the need for interventions across the continuum of care. Trained LCs in prenatal/postpartum settings and prenatal care providers play important complementary roles that, when coupled with brief telephone feeding assessments, may improve breastfeeding rates.
authors.affiliation: Department of Anthropology, State University of New York at Albany, Albany, New York 1222, USA. eandaya@albany.edu
authors.forename: Elise
authors.initials: E
authors.lastname: Andaya
authors.forename: Karen
authors.initials: K
authors.lastname: Bonuck
authors.forename: Josephine
authors.initials: J
authors.lastname: Barnett
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lischewski-Goel
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D001942:Breast Feeding / Q000208:ethnology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D009519:New York City; D010353:Patient Education as Topic; D011247:Pregnancy; D011295:Prenatal Care; D036301:Qualitative Research; D016032:Randomized Controlled Trials as Topic