Highlights • This is the first review to identify and evaluate interventions aimed at increasing maternal influenza vaccine uptake. • There is little high-quality evidence from randomized controlled ...trials to guide public health recommendations on improving maternal influenza vaccination rates. • Based on the existing evidence, clinicians should provide influenza education pamphlets to pregnant women accompanied by a verbalized statement on the benefits of maternal vaccination to newborns. • High-quality RCTs are needed to further evaluate interventions to successfully improve maternal influenza vaccination rates.
Objective
Women frequently report breastfeeding problems in the early postpartum period. Women who have self-endorsed beliefs that breastfeeding benefits their babies and themselves are more likely ...to continue breastfeeding despite breastfeeding barriers. Maternal self-endorsed beliefs is a key component of maternal self-regulated motivation. The present study examined the association between maternal self-regulated motivation, breastfeeding duration and exclusivity in Chinese women.
Methods
This was a prospective cohort study, of which we recruited participants in postnatal maternity units of publicly funded hospitals in Hong Kong. Postpartum women were asked to fill in the validated breastfeeding self-regulation questionnaire (BSRQ) before hospital discharge and their breastfeeding status was assessed by telephone follow-ups at 6 and 12 weeks postpartum. Multiple logistic regression was used to study the relationship between breastfeeding self-regulated motivation and the duration of breastfeeding at follow-up.
Results
At 6 and 12 weeks postpartum, women who breastfed exclusively scored significantly higher in self-regulated motivation than those who formula-fed. The self-regulated motivation was associated with higher odds of exclusive breastfeeding at 6 weeks and any breastfeeding at 12 weeks postpartum.
Conclusions for Practice
The study found that self-regulated motivation was positively related to breastfeeding duration. Maternal self-regulated motivation toward breastfeeding could be enhanced by the availability of social support and breastfeeding-friendly facilities, resulting in longer breastfeeding duration.
Introduction
Numerous studies have shown that the constructs of the Theory of Reasoned Action (TRA), Theory of Planned Behavior (TPB) and Breastfeeding Self-Efficacy (BSE) Framework can effectively ...identify relationships between maternal psychosocial factors and breastfeeding initiation. However, the ability of these theories to predict breastfeeding duration has not been adequately analyzed. The aim of the review was to examine the utility of the constructs of TRA/TPB and BSE to predict breastfeeding duration.
Methods
We conducted a literature search using Pubmed (1980-May 2015), Medline (1966-May 2015), CINAHL (1980-May 2015), EMBASE (1980-May 2015) and PsycINFO (1980-May 2015). We selected studies that were observational studies without randomization or blinding, using TRA, TPB or BSE as the framework for analysis. Only studies reporting on breastfeeding duration were included.
Results
Thirty studies were selected, which include four using TRA, 10 using TPB, 15 using BSE and one using a combination of TPB and BSE. Maternal intention and breastfeeding self-efficacy were found to be important predictors of breastfeeding duration. Inconsistent findings were found in assessing the relationship between maternal attitudes, subjective norms, perceived behavior control and breastfeeding duration.
Discussion
The inadequacy of these constructs in explaining breastfeeding duration indicates a need to further explore the role of maternal self-determination in breastfeeding behavior.
To evaluate the psychometric properties of the traditional Chinese version of the Childbirth Experience Questionnaire (CEQ 2.0) and assess the childbirth experiences of Chinese women.
A ...cross-sectional survey was conducted in Hong Kong from July 2020 to February 2021. In total, 975 mothers, who could read traditional Chinese and gave birth in 2020 or 2021, were included in the analysis. Data were fitted into the model proposed by the original developers using the confirmatory factor analysis. The data were then randomly split into training and validation sets for exploratory and confirmatory factor analyses. Childbirth experiences were assessed. Factor structure, internal construct validity, internal consistency, and known-group validity were assessed.
The originally proposed CEQ2.0 model showed a poor fit. An exploratory factor analysis identified a revised four-factor model (CEQ2.0-R) on a randomly split sample, which showed a satisfactory fit (CFI=0.912; TLI=0.884; SRMR=.053; RMSEA=0.072) on the other split sample. The revised scale comprised 13 items and four domains: (1)"Own capacity" (6 items), (2) "General support" (3 items), (3) "Perceived safety" (2 items), and (4) "Professional support" (2 items). CEQ2.0-R showed high internal construct validity and reliability. It can differentiate between participants with different characteristics, including parity, oxytocin augmentation, and companionship during labour. The childbirth experiences of the participants were merely positive, and participants reported that more support from midwives is needed.
CEQ2.0-R can adequately describe the childbirth experiences of women in Hong Kong. The questionnaire is easy to be administer and can be used to assess several domains of the childbirth experiences. It may be useful to evaluate the aspects of support needed during childbirth.
With mobile technologies becoming more advanced and accessible, mobile health (mHealth) has been incorporated in delivering timely and convenient breastfeeding support. However, its feasibility and ...potential efficacy remain to be examined. Therefore, the primary objective of this study is to assess the feasibility and acceptability of an online instant messaging peer support group for breastfeeding. The secondary objective is to evaluate the effect of the intervention on breastfeeding outcomes.
A pilot randomized controlled trial was conducted. A total of 33 primiparous women were recruited in the antenatal clinic at a public hospital in Hong Kong between March and April 2021. They were randomized to receive either standard care (n = 18) or standard care and receive peer-group support in an online instant messaging app (n = 15). Participants received telephone follow-up for up to six months postpartum or until they stopped breastfeeding. After completing the study, six participants in the intervention group were interviewed to understand their perceptions of the intervention.
This pilot study shows that online messaging peer support group is feasible and acceptable to women. In total, 54.4% of the eligible women agreed to participate, and 97.0% completed the follow-up. Participants perceived that providing peer support through instant messaging app is appropriate. It serves as a channel for the participants to ask questions and obtain information. Furthermore, meetings of the peer supporters and group members can be held to enhance the effectiveness of the intervention. In addition, no significant differences were found in any and exclusive breastfeeding rates, breastfeeding attitude, and breastfeeding self-efficacy between the two groups.
This study shows that online messaging peer support group is feasible and acceptable. A full-scale study should be conducted to understand the effect of the online instant messaging peer support group on breastfeeding outcomes.
The study protocol is registered on Clinicaltrial.gov (NCT04826796) on 1 April 2021.
Purpose: There is a rising prevalence in undetected perinatal depression in many countries, more effort in screening and early identification of perinatal depression is needed. While the Whooley ...questionnaire is the recommended case-finding strategy for perinatal depression, there is no validated Chinese version. The aim was to evaluate the diagnostic accuracy and stability of the translated Chinese Whooley questionnaire against gold standard measurement during and early after pregnancy.
Materials and Methods: This observational study recruited 131 pregnant women from an antenatal clinic in Hong Kong from September 2019 to May 2020. We translated the Whooley questionnaire in Chinese and evaluated self-reported responses against an interviewer-assessed diagnostic standard (DSM-IV criteria) in 107 women at 26-28 gestational weeks. We calculated sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio, with DSM-IV diagnosis as the gold standard.
Results: The Chinese Whooley questions had a sensitivity of 79% (95% CI 54.4-93.9), a specificity of 97% (95% CI 90.4-99.3), a positive likelihood ratio of 23.2 (95% CI 7.4-72.1) and a negative likelihood ratio of 0.2 (95% CI 0.1-0.5) in identifying perinatal depression.
Conclusion: The translated Chinese Whooley questionnaire has an acceptable diagnostic accuracy in identifying perinatal depression. It can be implemented in health services among Cantonesespeaking Chinese population.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Both breastfeeding intentions and exposure to baby-friendly hospital practices were found to be associated with a longer duration of breastfeeding. This study aims to examine the effect of exposure ...to baby-friendly hospital practices on mothers' achievement of their planned duration of breastfeeding.
A total of 1011 mother-newborn pairs from the postnatal units of four public hospitals in Hong Kong were recruited. Sociodemographic data and breastfeeding intention data were collected via self-report questionnaires during the postnatal hospitalization and exposure to Baby-Friendly hospital practices were assessed through hospital records and maternal self-report. Breastfeeding status after hospital discharge was assessed through telephone follow-up for up to 12 months postnatal, or until participants were no longer breastfeeding.
Only 55% (n = 552) of study participants achieved their intended duration of breastfeeding. Participants with higher socioeconomic status, previous breastfeeding experience, and those who had lived in Hong Kong for less than 5 years, were more likely to achieve their planned duration of breastfeeding. Among baby-friendly hospital practices, feeding only breast milk during the hospitalization and providing information about breastfeeding support on discharge were associated with participants' achieving their individual breastfeeding intentions. After adjustment, when compared with women who experienced onebaby-friendly practice, participants who experienced six baby-friendly hospital practices were significantly more likely to achieve their planned duration of breastfeeding (adjusted odds ratio = 8.45, 95% confidence interval 3.03-23.6).
Nearly half of participants did not achieve their planned breastfeeding duration. Exposure to baby-friendly hospital practices, especially in-hospital exclusive breastfeeding and providing breastfeeding support information upon hospital discharge may help more mothers to achieve their individual breastfeeding goals.
This study's objective was to assess the diagnostic properties of the Whooley questions in identifying depression among perinatal women according to previously published studies. We conducted a ...systematic review and meta-analysis of studies investigating the diagnostic accuracy of the Whooley questions in perinatal women.
Nine databases were searched in October 2021. All primary studies evaluated the diagnostic properties of the Whooley questions compared with a diagnostic gold standard in women during the perinatal period or, if not identified as being in the perinatal stage within the study, women between 20 weeks' gestation to 4 weeks post-delivery. A bivariate mixed-effects meta-analysis was performed to estimate pooled diagnostic properties and measure heterogeneity. Meta-regression was conducted to evaluate factors contributing to heterogeneity.
Six studies were included in the review; five were used in the meta-analysis. The pooled sensitivity (95 % confidence interval) was 0.95 (0.81–0.99), pooled specificity was 0.60 (0.44–0.74), pooled positive likelihood ratio was 2.4 (1.6–3.4), pooled negative likelihood ratio was 0.09 (0.02–0.32), and pooled diagnostic odds ratio was 27 (7–106); heterogeneity was substantial (I2 = 0.90, 0.81–1.00). Participant age and setting (community vs. hospital) significantly contributed to heterogeneity.
The Whooley questions have high sensitivity but moderate specificity for perinatal women. The Whooley questions are a short and acceptable tool for identifying depression in perinatal women. However, a potential risk exists of incorrectly identifying a high proportion of women as positive. Using the Whooley questions followed by a secondary case-finding tool could reduce the misdiagnosis risk.
•Detecting perinatal depression is important for preventing poorer future outcomes.•The Whooley questions accurately identify negative cases of perinatal depression•However, there is a risk to a potential risk of identifying false positives.•A second tool alongside the Whooley questions can reduce risk of false positives.
To test the individual effect of artificial food colorings (AFCs) and a preservative on the behavior of the general Chinese population.
One hundred thirty children (70 boys and 60 girls) in Hong Kong ...with a mean age of 8.64 years were enlisted to the study with a within-subject crossover between AFCs, a preservative (sodium benzoate), and a placebo capsule. Two behavior scores were used including the strengths and weaknesses of attention deficit hyperactivity disorder and normal behavior rating scale and the child behavior checklist-teacher report form.
Capsule A containing AFCs and Capsule B containing sodium benzoate had no significant adverse effect compared with placebo in both behavior scores. This result persisted when analysis was restricted to children with 85% consumption of capsule (per protocol analysis).
There seem to be no significant associations between AFCs and a preservative on Chinese children's behavior at the age of 8 to 9 years. Future directions and implications of this research are discussed.
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