title: Outcome evaluation of an educational program for Japanese midwives to promote breast awareness for women.
abstract: OBJECTIVE
  The objective of this study was to evaluate educational approaches for midwives to promote breast awareness for postnatal women by measuring the knowledge, attitude and practice of midwives.
  
  
  METHODS
  A nonequivalent control design comparing two intervention groups and control group was used. Participants were Japanese midwives agreeing to this study. Midwives in the program group attended the program; those in the text group only read the textbook. Midwives in the control group neither attended the program nor learned by textbook. All measurements were administered at baseline, one-month post-program, and three-month post-program.
  
  
  RESULTS
  Among 215 participants, 168 midwives (45 program, 62 text, and 61 control) remained until three month follow-up. The knowledge test score was found to have significant mutual interactions between the three groups and time (F=14.2, df=4, p<0.001). However, the attitudes did not differ between the three groups. Implementation rates for midwifery practice incorporating breast awareness education for postpartum women were different at one month and three months between the three groups. Implementation of breast awareness education at three months revealed the following factors: program group (OR 5.4, 95%CI [1.3-21.8]; text group: OR 0.7, 95%CI [0.2-2.7]) and implementation of breast awareness education at the first time measurement (OR 18.6, 95%CI [4.6-73.9]).
  
  
  CONCLUSIONS
  The results of this study showed that the educational program increased midwives' knowledge and contributed to the continuation implementing breast awareness education for postpartum women about three months after testing.
authors.affiliation: St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan. Electronic address: yaeko-kataoka@slcn.ac.jp.
authors.forename: Yaeko
authors.initials: Y
authors.lastname: Kataoka
authors.affiliation: St. Luke's Birth Clinic, 1-24 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan. Electronic address: kyaoru@luke.or.jp.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ohbayashi
authors.affiliation: Osaka Medical College, 3-3 hacchonawate-cho, Takatsuki City, Osaka 569-0096, Japan. Electronic address: kumisuzuki@art.osaka-med.ac.jp.
authors.forename: Kumi
authors.initials: K
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D001364:Awareness; D001940:Breast; D004521:Educational Measurement; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D007564:Japan; D008875:Middle Aged; D008880:Midwifery / Q000193:education*; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods*; D049590:Postpartum Period; D011247:Pregnancy; D015397:Program Evaluation / Q000379:methods*
keywords: Breast awareness; Comparative study; Continuing education; Midwives; Postnatal