Investigating Maternal Perspectives of Breastfeeding Support Targeted Towards Fathers in the Milk Man Mobile App Intervention.
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ABSTRACT: Background
The support of her infant's father is one of the most important factors influencing a mother's breastfeeding success, and an increasing number of interventions are targeted towards fathers. Engaging fathers as agents to influence a maternal behavior is potentially problematic, yet few studies report on maternal experiences.Objective
This study aims to explore mothers' perspectives of their partners' use of Milk Man, a father-focused breastfeeding smartphone app, and the acceptability of this approach.Materials and methods
New mothers (N = 459) whose partners had access to the app completed a questionnaire at six weeks postpartum. These data were used to determine knowledge, use and perspectives of the app. A sentiment analysis was conducted on responses to an open-ended question seeking maternal perspectives of the app.Results
Just over a quarter of mothers (28%) had been shown something from the app, and 37% had discussed something from Milk Man with their partner. There were 162 open-ended responses related to mothers' perspectives of the app. Relevant responses (n = 129) were coded to an overall sentiment node and then to a total of 23 child nodes (sub-nodes). Most comments were positive (94), with a smaller number either negative (25) or neutral (21). Negative comments related to the usability of the app and not its intent or content.Conclusion
Mothers found the father-focussed breastfeeding app to be acceptable. When designing interventions targeting one group to affect the behaviour of another, inclusion of measures to gain the perspectives of both should be seen as an imperative.
SUBMITTER: White BK
PROVIDER: S-EPMC10115714 | biostudies-literature | 2023 May
REPOSITORIES: biostudies-literature
Publications
Investigating Maternal Perspectives of Breastfeeding Support Targeted Towards Fathers in the Milk Man Mobile App Intervention.
White Becky K BK Giglia Roslyn C RC Burns Sharyn K SK Scott Jane A JA
Maternal and child health journal 20230315 5
<h4>Background</h4>The support of her infant's father is one of the most important factors influencing a mother's breastfeeding success, and an increasing number of interventions are targeted towards fathers. Engaging fathers as agents to influence a maternal behavior is potentially problematic, yet few studies report on maternal experiences.<h4>Objective</h4>This study aims to explore mothers' perspectives of their partners' use of Milk Man, a father-focused breastfeeding smartphone app, and th ...[more]
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Project description:BackgroundMobile technology offers unique opportunities to reach people with health promotion interventions. Breastfeeding is an important public health issue, and fathers are a key support. Milk Man is a father-focused breastfeeding app that sought to engage fathers with information and conversation about breastfeeding, with the goal to impact positively on breastfeeding duration.ObjectiveThe study aimed to describe the process evaluation of the Milk Man app that was trialed in the Parent Infant Feeding Initiative randomized controlled trial.MethodsThe app used an information library, gamification, push notifications, and social connectivity via a Web-based conversation forum, which included polls and conversation starters, to engage fathers with breastfeeding information. Fathers had access to the app from approximately 32 weeks of gestation to 6 months postpartum. Process evaluation data were collected from a self-completed questionnaire administered via a Web-based link sent to participants at 6 weeks postpartum, and app analytics data were collected directly from the app. Quantitative data from both sources and qualitative responses to open-ended questions were used to triangulate findings to investigate patterns of usage and the effectiveness of each app engagement strategy to motivate and engage users.ResultsA total of 80.3% (586/730) of participants, who were randomized to receive the app, downloaded Milk Man. Push notifications and interest in what other fathers had posted in the forum were the 2 main motivators to app use. Fathers used the app most while their partners were still pregnant and in the weeks immediately after the birth of their baby. Perspectives on the gamification strategy were varied. However, at 6 weeks postpartum, approximately one-third of fathers still using the app said that the gamification elements were encouraging the app use. The ease of use of the app and the design were important elements that were rated positively. The conversation forum emerged as the hub of app activity; all but 1 of the most accessed library articles and external organization links had been prompted as part of a conversation starter. Fathers posted comments in the conversation forum 1126 times (average of 2.21 per user) and voted in polls 3096 times (average of 6 per user).ConclusionsThese results demonstrate that the Milk Man app was an acceptable source of breastfeeding information and support that fathers and fathers-to-be are prepared to use throughout the perinatal period. The app showed encouraging results with facilitating conversation between partners. The conversation forum was clearly central to the success of the app, and fathers provided suggestions for improvement. Gamification results were varied, yet it was a key motivator for some users. These results provide valuable insight into the acceptability of the engagement strategies, including motivations for use and user perspectives on the app.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12614000605695; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?ACTRN=12614000605695.
| S-EPMC6716479 | biostudies-literature
Project description:Background New mothers experience BF challenges but have limited evidence-based technology-enabled support. Objectives 1) Determine if using the Mother’s Milk Messaging™ app improved aspects of breastfeeding and breastfeeding rates and 2) Describe engagement as well as themes from the qualitative feedback on the app. Method Randomized Controlled Trial National sample of primiparous, singleton mothers recruited online and then randomized using stratification by language into three arms: 1) BF text messages plus app; 2) BF text messages, app and physician-moderated private Facebook (FB) group; 3) Attention control group who received injury prevention texts. Exclusive breastfeeding rates as primary outcome and knowledge/attitude, confidence, and social support as secondary outcomes. We determined engagement through analysis of app usage metrics. We conducted and content-coded interviews with participants to learn more about app usage and BF experience. Due to the nature of the intervention participants could not be blinded. Results There were a total of 346 participants in the trial, with 227 in the Intervention (n = 154 group 1 and n = 156 group 2) and 119 in the control group. Because of minimal Facebook activity, the two intervention groups 1 and 2 were combined. There were no differences in breastfeeding exclusivity and duration. (NS). Women in the intervention arm reported significantly higher confidence with breastfeeding and perceived social support to the control group (p < .05). Greater than 80% registered the app and those that engaged with the app had higher scores with time. Mothers appreciated receiving text messages and videos with reliable information. No harm was reported in this study. Conclusion MMM increased confidence with breastfeeding and with gathering social supports. Exclusively BF was high in all participants. Mothers perceived it as useful and dependable especially the texting. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04976-6.
| S-EPMC9400217 | biostudies-literature
Project description:BackgroundDespite the recognized health and economic benefits of exclusive breastfeeding, few Australian infants are exclusively breastfed beyond 5 months of age. Social support for breastfeeding, in particular the support of an infant's father, has been identified as a crucial element for successful breastfeeding.ObjectiveThe objective of this study was to determine the effectiveness of various father-focused breastfeeding interventions in terms of key infant feeding outcomes.MethodsThe study was a 4-arm, factorial, randomized controlled trial conducted in Perth, Australia. The trial arms included a control group and 3 interventions, consisting of a face-to-face father-focused antenatal breastfeeding class facilitated by a male peer facilitator; Milk Man, a breastfeeding smartphone app designed specifically for fathers; and a combination of both interventions. Expecting couples were recruited from hospital-based antenatal classes and block randomized to 1 of the 4 arms. Each partner completed surveys at recruitment and at 6 weeks and 26 weeks postpartum. Primary outcomes were duration of exclusive and any breastfeeding. Secondary outcomes included age of introduction of formula and complementary foods, maternal breastfeeding self-efficacy, and partner postpartum support.ResultsA total of 1426 couples were recruited from public (443/1426, 31.1%) and private (983/1426, 68.9%) hospitals. Of these, 76.6% (1092/1426) of fathers completed the baseline questionnaire, 58.6% (836/1426) completed the 6-week follow-up questionnaire, and 49.2% (702/1426) completed the 26-week follow-up questionnaire. The average age of fathers who completed the baseline questionnaire was 33.6 (SD 5.2) years; the majority were born in Australia (76.4%) and had attended university (61.8%). There were no significant differences between the control and any of the intervention groups in any of the infant feeding outcomes or level of breastfeeding self-efficacy and postpartum partner support reported by mothers.ConclusionsThis study did not demonstrate that any intervention was superior to another or that any intervention was inferior to the standard care delivered in routine antenatal classes. Further studies are needed to test the effectiveness of these interventions in more socioeconomically diverse populations that are likely to benefit most from additional partner supports.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12614000605695; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614000605695.International registered report identifier (irrid)RR2-10.1186/s12884-015-0601-5.
| S-EPMC8076985 | biostudies-literature
Project description:BackgroundAdolescence can be a fertile time for relationship issues, with interpersonal conflict being a risk factor for poor mental health. Mobile app interventions may have a significant appeal to young people in assisting with relationship distress. However, currently available apps have not been formally evaluated. Youths' perspectives on engaging with mobile technology to assist with relationships are also unknown.ObjectiveThis study aimed to examine adolescents' attitudes toward the concept of a mobile phone app for relationship help and support, and whether they would be likely to use such an intervention.MethodsA cross-sectional Web survey consisting of 42 questions, including 13 free responses, was delivered. The proposed app, including character vignettes, was presented, and participants were asked to indicate whether they had experienced the same relationship issues, whether their peers would relate to the issues, and how helpful they found the proposed advice. Participants were also asked to provide their own suggestions for help, which were analyzed using thematic analyses.ResultsA total of 150 adolescents (aged 15 to 18) participated. Overall, 60.7% (91/150) were likely to use an app for relationship problems, and this was not associated with demographics or social support (all P values >.05). Likelihood of app usage was found to be influenced by perceived need for help, personal beliefs about app effectiveness, and whether the app is engaging and easy to use. Overall, adolescents were receptive of the proposed content with an average of 99.3% (149/150), rating the strategies provided as somewhat to very helpful.ConclusionsAdolescents were likely to use a mobile phone app for relationship support, and use was not influenced by gender, age, social support, or any other background characteristic. Instead, likely use was influenced by need, personal beliefs, usability, and the appropriateness of app content. App developers must address these factors if the app is to have a wide-scale uptake.
| S-EPMC5865001 | biostudies-literature
Project description:Breastfeeding provides benefits to the infant and mother; however, the rates of breastfeeding, particularly exclusive breastfeeding, remain below optimal levels in many Asian countries. The aim of this study is to review the benefits of breastfeeding to mothers and infants and current rates of breastfeeding in Vietnam, and to evaluate the effectiveness of a mobile application on exclusive breastfeeding among mothers in Vietnam. A two-arm, parallel triple-blinded randomised controlled trial will be conducted among 1000 mothers in Hanoi City, Vietnam, during 2020-2021. Eligible participants are pregnant women who will seek antenatal care from health facilities at 24-36 weeks of gestation and plan to deliver at two participating hospitals, own a smartphone, and carry a singleton foetus. Permuted-block randomisation method stratified by maternal age, education and parity will be used to ensure an equal number of participants in each group. A smartphone app will be developed to deliver breastfeeding and non-breastfeeding information to the intervention and control group, respectively. Data will be collected at baseline, before hospital discharge, and at 1, 4, and 6 months postpartum. This study envisages demonstrating whether a smartphone-based intervention can be effective at improving breastfeeding in Vietnam. Trials registration: ACTRN12619000531112.
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Project description:BackgroundBreastfeeding, acknowledged for its critical health benefits for both infants and mothers, remains markedly underutilized in Ireland, which reports the lowest breastfeeding rates in Europe. Recent data indicate that fewer than 60% of Irish mothers initiate breastfeeding at birth, with this rate precipitously declining in the subsequent weeks postpartum. Various sociocultural, psychological, and educational elements, such as prenatal breastfeeding education, influence this persistently low prevalence. This descriptive qualitative study explores the perspectives of mothers and healthcare professionals, specifically midwives and lactation consultants, on prenatal breastfeeding education classes in Ireland and how they influence mothers' breastfeeding decisions.MethodsA qualitative descriptive methodology was employed, utilizing online semi-structured interviews with midwives, lactation consultants (n = 10), and postnatal mothers (n = 20) from four tertiary hospitals in the Republic of Ireland. The data were subjected to reflexive thematic analysis, adhering to the six-step process of thematic analysis, to extrapolate and analyse the interview transcriptions. NVivo software was used to facilitate this analysis, given its robust capabilities in organizing, coding, and retrieving qualitative data efficiently. Four criteria for qualitative research were also used to enhance analytical rigor.ResultsPrenatal breastfeeding education in Ireland often presents breastfeeding in an idealized way, resulting in a gap between mothers' expectations and their actual experiences. Participants needed practical content that included realistic scenarios and breastfeeding benefits. Additionally, findings indicate a desire for a more interactive and personalized educational model to address expectant mothers' unique needs better. Limitations of the virtual class format were also highlighted, with participants noting the potential for technology to improve engagement and personalization. The data further underscore the need for consistency and accuracy in breastfeeding education, with participants identifying standardized approaches and awareness of socio-cultural dynamics, including partner involvement, as essential elements in effective prenatal breastfeeding education.ConclusionThis study underscores the necessity for a more realistic, interactive, and standardized approach to prenatal breastfeeding education in Ireland. Current classes often set idealized expectations that may leave mothers feeling unprepared for breastfeeding's real-life challenges. Addressing these gaps by integrating practical scenarios, enhancing technological tools for virtual classes, and incorporating socio-cultural considerations could improve breastfeeding education and maternal outcomes. This qualitative descriptive study highlights a disconnect between educational objectives and mothers' actual experiences, advocating for a holistic approach that includes personalized, culturally sensitive support and comprehensive training for healthcare providers.
| S-EPMC11654992 | biostudies-literature
Project description:BackgroundPrevious studies focusing on the association between gestational diabetes and breastfeeding duration have been inconclusive.ObjectivesWe aimed to determine whether maternal gestational hyperglycemia is associated with the duration of breastfeeding and the concentrations of markers linked to breastmilk production.MethodsData from the prospective, multiethnic Growing Up in Singapore Towards Healthy Outcomes study were used to assess the association of fasting plasma glucose (FPG) and 2-h postglucose challenge (2hPG) measured at 26-28 wk of gestation with duration of breastfeeding and concentrations of protein, lactose, citrate, sodium, potassium, and zinc in breastmilk 3 wk postpartum.ResultsOf the 1035 participants, 5.2% and 9.5% had elevated FPG and 2hPG, respectively, consistent with a diagnosis of gestational diabetes mellitus based on International Association of Diabetes and Pregnancy Study Groups criteria. FPG ≥5.1 mmol/L was associated with a crude reduction in median breastfeeding duration of 2.3 mo. In a model adjusted for maternal prepregnancy BMI and intention to breastfeed, FPG ≥5.1 mmol/L predicted earlier termination of any breastfeeding (adjusted HR: 1.47; 95% CI: 1.04, 2.08) but not full breastfeeding (adjusted HR: 1.08; 0.76, 1.55). 2hPG ≥8.5 mmol/L was not significantly associated with the durations of any (adjusted HR: 0.86; 95% CI: 0.62, 1.19) or full (adjusted HR: 0.85; 95% CI: 0.62, 1.18) breastfeeding. Maternal FPG was significantly and positively associated with breastmilk sodium (adjusted coefficient: 1.28; 95% CI: 1.08, 1.51) and sodium-to-potassium ratio (adjusted coefficient: 1.29; 95% CI: 1.08, 1.54) but not with other measured breastmilk components.ConclusionsWomen with FPG ≥5.1 mmol/L during pregnancy breastfeed for a shorter duration. Future work involving measurement of milk production is needed to determine whether low milk production predicts breastfeeding duration among women with elevated FPG. This trial was registered at www.clinicaltrials.gov as NCT01174875.
| S-EPMC7611668 | biostudies-literature
Project description:BackgroundMobile apps facilitate patients' access to portals and interaction with their healthcare providers. The COVID-19 pandemic accelerated this trend globally, but little evidence exists on patient portal usage in the Middle East, where internet access and digital literacy are limited. Our study aimed to explore how users utilize a patient portal through its related mobile app (MyChart by EPIC).MethodsWe conducted a cross-sectional survey of MyChart users, recruited from a tertiary care center in Lebanon. We collected MyChart usage patterns, perceived outcomes, and app quality, based on the Mobile Application Rating Scale (user version, uMARS), and sociodemographic factors. We examined associations between app usage, app quality, and sociodemographic factors using Pearson's correlations, Chi-square, ANOVA, and t-tests.Results428 users completed the survey; they were primarily female (63%), aged 41.3 ± 15.6 years, with a higher education level (87%) and a relatively high crowding index of 1.4 ± 0.6. Most of the sample was in good and very good health (78%) and had no chronic illnesses (67%), and accessed the portal through MyChart once a month or less (76%). The most frequently used features were accessing health records (98%), scheduling appointments (67%), and messaging physicians (56%). According to uMARS completers (n = 200), the objective quality score was 3.8 ± 0.5, and the subjective quality was 3.6 ± 0.7. No significant association was found between overall app usage and the mobile app quality measured via uMARS. Moreover, app use frequency was negatively associated with education, socioeconomic status, and perceived health status. On the other hand, app use was positively related to having chronic conditions, the number of physician visits and subjective app quality.ConclusionThe patient portal usage was not associated with app quality but with some of the participants' demographic factors. The app offers a user-friendly, good-quality interface to patient health records and physicians, appreciated chiefly by users with relatively low socioeconomic status and education. While this is encouraging, more research is needed to capture the usage patterns and perceptions of male patients and those with even lower education and socioeconomic status, to make patient portals more inclusive.
| S-EPMC10481578 | biostudies-literature
Project description:BackgroundEvolving societal trends are resulting in fathers having an increasing influence on the health-related behaviors that children develop. Research shows that most fathers are committed to their role and when equipped with knowledge, can have a positive impact on their child's health. However, parenting resources typically target mothers, with fathers being excluded. While evolving mobile phone technology provides an efficient means for delivering parenting resources, many fathers find that mobile health (mHealth) technology does not provide material they can engage with.ObjectiveThis study aimed to explore how to make parenting apps more engaging and useful for fathers using an existing parenting mHealth resource, the My Baby Now app, as a case study.MethodsA total of 14 purposefully selected, Australian fathers of 7 months to 5-year-old children took part in a qualitative study, comprising either focus groups or interviews. Recorded focus groups and interviews were transcribed verbatim, then coded using a combination of deductive and inductive methods. Reflexive thematic analysis was undertaken to identify patterns and themes.ResultsCurrent parenting apps provide parenting information that can be unappealing for fathers. To improve paternal engagement with mHealth resources, fathers highlighted the need for father specific information, with an increase in positive imagery and positive descriptions of fathers in their parenting role. There should be father-exclusive domains such as forums, and also push notifications to provide positive reinforcement and encouragement for fathers.ConclusionsmHealth has the capacity to deliver information to fathers when needed. This reduces the risk of paternal frustration and disengagement from parenting. Further benefit will be gained by research to understand possible differences in mHealth app usage by fathers of differing socioeconomic position, cultural backgrounds, and family status, such as single fathers and same-sex couples.
| S-EPMC11890138 | biostudies-literature
Project description:BackgroundBreastfeeding provides multiple maternal and child benefits, but breastfeeding rates are suboptimal. Parental leave access and use have been associated with higher breastfeeding rates, however, there have been a lack of studies examining fathers' use of parental leave. The objective of this study was to measure the associations between fathers' work leave and infant breastfeeding among a representative sample of fathers from Georgia, United States.MethodsThis cross-sectional study used data from a novel public health surveillance pilot study, the Pregnancy Risk Assessment Monitoring System (PRAMS) for Dads. We tested the association between leave (paid leave [yes/no] and leave length [≥ 2 weeks or < 2 weeks] with 1) breastfeeding initiation and 2) breastfeeding at 8 weeks using multivariable logistic regression adjusting for paternal, maternal, and infant characteristics.ResultsAmong the 240 (92.3%) employed fathers, 172 (73.4%) reported taking leave (paid or unpaid) after their infant's birth. Among fathers who took leave, median leave length was 2 weeks. White fathers had a higher percentage of paid leave use compared to other racial and ethnic groups (p <.001). Fathers who took paid leave were more likely to report taking leave ≥ 2 weeks (p <.001). In adjusted models, fathers who took ≥ 2 weeks of leave reported higher rates of infant breastfeeding at 8 weeks (79.3% vs. 60.5%; aPR [adjusted prevalence ratio] = 1.31; 95% CI, 1.09-1.57) compared with those who took < 2 weeks of leave. There was no association detected between breastfeeding at 8 weeks and paid leave (aPR = 1.06; 95% CI, 0.85-1.33).ConclusionsThis study adds to the growing evidence linking fathers' work leave with family benefits, namely improved breastfeeding duration, which has important workplace and health policy considerations for the use and availability of parental leave for fathers.
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