Preventing Perceived Insufficient Milk: Development of a Text Message-Based Inter

防止乳汁不足：开发基于短信的交互

基本信息

批准号：
9343055
负责人：
Jill Radtke Demirci
金额：
$ 24.13万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-05 至 2019-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9343055
关键词：
Achievement Address Anxiety Award Behavior Behavior Therapy Behavioral Breast Feeding Breastfed infant Characteristics Child Communication Communication Barriers Communities Cost Analysis Data Development Education Effectiveness Elements Exclusive Breastfeeding Fetus Formula supplementation Frequencies Gestational Age Goals Growth Health Health Care Costs Health Communication Health Priorities Health Promotion Healthcare Healthy People 2010 Healthy People 2020 Human Milk Incidence Individual Infant Internet Intervention Intervention Studies Intervention Trial Interview Lead Maternal and Child Health Milk Mission Modeling Modification Mothers Outcome Measure Participant Pathway interactions Patient Self-Report Pattern Perception Perinatal Phase Plant Roots Population Postpartum Period Postpartum Women Pregnancy Pregnant Women Prevention Randomized Research Research Infrastructure Research Personnel Research Proposals Self Efficacy Societies Support System Surgeon System Telephone Telephone Interviews Testing Text Time Training Weaning Woman Work base behavioral health experience falls feeding group intervention health economics health of the mother improved infant death innovation interest maternal anxiety milk production milk supply milk volume pilot trial premature prenatal prevent programs psychologic public health relevance randomized trial self diagnosis skills training social cognitive theory theories

项目摘要

DESCRIPTION (provided by applicant): This purpose of this K99-R00 Pathway to Independence Award is to expedite the candidate's development into an independent investigator with expertise in the conduct of large-scale behavioral interventions and health communication related to breastfeeding education and support. Within this 5 year award, the first two years (K99 phase) will be dedicated to obtaining the training necessary to accomplish these goals and developing the intervention content to be used in the R00 phase. In the R00 phase (final 3 years of award), the candidate will conduct a study that utilizes the acquired training skills to address maternal perceived insufficient milk (PIM), the most frequent reason for premature breastfeeding cessation. The study will involve a pilot randomized trial of the K99-developed MILK intervention-a mobile, semi-automated text message-based intervention to prevent perceived low or insufficient milk supply, in a population of mothers without prior breastfeeding experience. MILK improves upon existing breastfeeding support interventions through its potential for transferability to other settings, sustainability, and specific focus on IM prevention, rather than post-hoc treatment of individual breastfeeding problems. Automated texts, which comprise the basis of MILK, will include both prenatal and postpartum education and support geared toward prevention of PIM. Messages will be time-sensitive (e.g., specific to gestational age of fetus/infant, time since delivery) and based on the Breastfeeding Self-Efficacy (Social Cognitive) Theory and pilot work undertaken in the K99 phase. The MILK intervention will be trialed against a control intervention group, who will receive more general perinatal education through the national Text4Baby system. Both groups will receive text messages 3-5 times per week from week 25 of pregnancy through week 8 postpartum. Measured outcomes of interest will include perceived breast milk supply, breastfeeding confidence, maternal anxiety, breastfeeding exclusivity, and breastfeeding duration. Data will be collected at baseline (13-25 gestational weeks), 34-36 gestational weeks, and at 1, 2, 4, and 8 weeks postpartum. To assess the potential longer-term impact of the intervention, breastfeeding continuation and exclusivity will be reassessed via telephone at 6 months postpartum. Between group and group x time differences in outcome measures will be examined graphically and via linear mixed modeling. To assess the potential need for modifications to MILK, telephone interviews will be conducted with a subset of participants in each group to assess and compare intervention use, burdens and challenges, and suggested alterations. The results from this R00 study are expected to inform a larger, multisite intervention trial. The proposed MILK intervention is both timely and significant, as it addresses barriers to breastfeeding duration and exclusivity which have been designated national health priorities by Healthy People 2020 and the U.S. Surgeon General. This study also addresses NINR's mission to create innovative communication interventions for individuals and communities that promote health while reducing associated healthcare costs.

描述（由申请人提供）：K99-R00 独立之路奖的目的是加快候选人发展成为一名独立调查员，在进行与母乳喂养教育和支持相关的大规模行为干预和健康沟通方面拥有专业知识。在这个为期 5 年的奖项中，前两年（K99 阶段）将致力于获得实现这些目标所需的培训，并开发用于 R00 阶段的干预内容。在 R00 阶段（奖励的最后 3 年），候选人将进行一项研究，利用所获得的培训技能来解决母亲认为乳汁不足 (PIM) 的问题，这是产妇乳汁不足的最常见原因。过早停止母乳喂养。该研究将涉及 K99 开发的 MILK 干预措施的试点随机试验，这是一种基于移动、半自动短信的干预措施，旨在防止没有母乳喂养经验的母亲群体出现母乳供应不足或不足的情况。 MILK 改进了现有的母乳喂养支持干预措施，因为它具有可转移到其他环境、可持续性的潜力，并且特别关注 IM 预防，而不是对个别母乳喂养问题进行事后治疗。构成 MILK 基础的自动化文本将包括产前和产后教育以及旨在预防 PIM 的支持。信息将具有时间敏感性（例如，特定于胎儿/婴儿的胎龄、自分娩以来的时间），并基于母乳喂养自我效能（社会认知）理论和 K99 阶段进行的试点工作。 MILK 干预措施将针对控制干预组进行试验，该组将通过国家 Text4Baby 系统接受更全面的围产期教育。从怀孕第 25 周到产后第 8 周，两组患者每周都会收到 3-5 次短信。感兴趣的测量结果将包括感知母乳供应、母乳喂养信心、母亲焦虑、纯母乳喂养和母乳喂养持续时间。将在基线（13-25 孕周）、34-36 孕周以及产后 1、2、4 和 8 周收集数据。为了评估干预措施的潜在长期影响，将在产后 6 个月通过电话重新评估是否继续母乳喂养和纯母乳喂养。组与 x 组之间结果测量的时间差异将以图形方式并通过线性混合模型进行检查。为了评估对 MILK 进行修改的潜在需要，将对每组中的一部分参与者进行电话访谈，以评估和比较干预措施的使用、负担和挑战以及建议的改变。这项 R00 研究的结果预计将为更大规模的多中心干预试验提供信息。拟议的 MILK 干预措施既及时又重要，因为它解决了母乳喂养持续时间和纯母乳喂养的障碍，这些障碍已被“健康人民 2020”和美国外科医生指定为国家卫生优先事项。这项研究还阐述了 NINR 的使命，即为个人和社区创建创新的沟通干预措施，促进健康，同时降低相关的医疗费用。