title: A Realistic Evaluation of Two Training Programs on Implementing Skin-to-Skin as a Standard of Care.
abstract: The authors used realistic evaluation to examine the real-world effectiveness of two 5-day training techniques on sustained optimal skin-to-skin practices that support Step 4 of the revised Baby-Friendly Hospital Initiative (BFHI). The authors found that education alone was insufficient to effect sustainable practice change. Exposure to the 5-day immersion model (Practice, Reflection, Education and training, Combined with Ethnography for Sustainable Success, or PRECESS) alone or combined with education was an effective strategy to change and sustain the standard of care for skin-to-skin practice (p < 0.00001). The intended outcome of sustained practice change toward implementation of skin-to-skin care through immersion or a combined approach shows promise and should be repeated in other localities.
authors.forename: Kajsa
authors.initials: K
authors.lastname: Brimdyr
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Widström
authors.forename: Karin
authors.initials: K
authors.lastname: Cadwell
authors.forename: Kristin
authors.initials: K
authors.lastname: Svensson
authors.forename: Cynthia
authors.initials: C
authors.lastname: Turner-Maffei
keywords: Baby-Friendly Hospital Initiative; breastfeeding; realistic evaluation; skin-to-skin