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）：这项K99-R00独立奖励奖的目的是将候选人的发展加速到具有与母乳喂养教育和支持有关的大规模行为干预和健康沟通方面的专业知识。在此5年奖励中，最初的两年（K99阶段）将致力于获得实现这些目标所必需的培训并开发在R00阶段使用的干预内容。在R00阶段（最后三年奖励）中，候选人将进行一项研究，该研究利用获得的培训技能来解决孕产妇感知不足的牛奶（PIM），这是最常见的原因过早的母乳喂养戒烟。该研究将涉及对K99开发的牛奶干预的试验随机试验 - 一个可移动的，半自动的基于文本消息的干预措施，以防止没有事先进行母乳喂养经验的母亲，以防止牛奶供应不足或不足的牛奶供应。牛奶通过将其转移到其他环境，可持续性和对IM预防的特定关注而不是事后治疗单个母乳喂养问题的特定关注的可能性来改善现有母乳喂养干预措施。牛奶基础的自动化文本将包括产前和产后教育以及针对预防PIM的支持。信息将对时间敏感（例如，特定于胎儿/婴儿的妊娠年龄，自分娩以来的时间），并基于在K99阶段进行的母乳喂养自我效能感（社会认知）理论和试验工作。牛奶干预将针对一个控制干预小组进行试用，该小组将通过国家文本Baby系统接受更普遍的围产期教育。从怀孕第25周到产后第8周，两组将收到每周3-5次的短信。感兴趣的测量结果将包括感知到的母乳供应，母乳喂养的信心，孕妇焦虑，母乳喂养的排他性和母乳喂养持续时间。数据将在基线（13-25胎周），34-36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个月的电话中通过电话重新评估母乳喂养的延续和排他性。在组和X组之间，结果度量的时间差异将以图形方式和线性混合建模进行研究。为了评估对牛奶进行修改的潜在需求，将与每个小组的一部分参与者进行电话访谈，以评估和比较使用干预，负担和挑战并建议进行更改。这项R00研究的结果预计将为更大的多站点干预试验提供信息。拟议的牛奶干预既及时又是重要的，因为它解决了母乳喂养持续时间和排他性的障碍，这些障碍已被2020年健康人和美国外科医生指定为国家健康的重点。这项研究还涉及Ninr的使命，该使命是为促进健康的个人和社区创建创新的交流干预措施，同时降低相关的医疗费用。