Assessing the influence of health professionals attitudes on

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					Assessing the influence of health
professionals attitudes on breast-
          feeding rates.
    D Marks, R O'Connor, T Carney
               A Clarke
      Health Psychology Training

“In what way do professionals attitudes
 contribute to breast feeding promotion
     Background – Project Details
• Focus groups:
  Health Visitors
  Community Midwives
  Care Assistants
  School Nurses
  Health Promotion Staff

Total = 57
                 Focus Groups
• What are your views on why Breastfeeding rates amongst
  teenage mothers and those in socially deprived areas are
                         so low?

    • What are the key influences on your thoughts on

 • Do you think the Breast is Best campaign has taken the
       right tone, or do you think it has gone to far?

• What was your experience of being supported like when
  you were making your own feeding decisions i.e. for your
                     own children?
   Results – What things are important in
          breast feeding initiation?
• Importance of early intervention:
   “This is not so much for a problem for us as health visitors,
           because we get them from the 10th/11th day”

 “Of course, by the time they get to us (midwives) it’s too late.
                  The decision’s already made”

Family Role – Grandmothers (direct and indirect):
   “They get pregnant, the guy’s off and running, and they just
      think ‘Well I’ll hand this baby over to my mum’. And the
   granny’s quite happy to take them because that’s the kind of
               way they’ve been brought up as well.
• Sexualisation of the breast:

  “Sometimes also the partner’s views that the breasts are
  his and not this baby who’s coming along. That’s another
  issue for women is that partner’s don’t want them to do

• The role of the media:

      “I think as well, the media has got a lot to blame,
  particularly in teenage mums. Right from a very early age
     they’re looking at their figures and their role models.
   And they’re thinking of their breasts as something that’s
    to be shown off and looked at as a sexual thing rather
                     than a practical thing.”
   Concern Regarding the ‘Breast is Best’
• “It’s so in your face sometimes you can always get, ‘Oh for
  goodness sake … that’s enough.’ I think you can feel maybe
    sometimes overwhelmed by the messages I don’t know
                whether that’s going in the right.”

 • “I was in Glasgow the other day and honestly there was
  Tannoys going on about breast is best and I thought … ‘This
       is becoming so negative’. Breast is best but it’s not
   explained to people actually why … they just keep shouting
  ‘Breast is Best’. I think people get to the stage … they switch
     off to it. Honestly, see in Glasgow when it was getting
      Tannoyed in Argyll Street – if I’d a towel I would have
   thrown it over the Tannoy. I thought ‘Please just give us a
Feelings Towards Breastfeeding Promotion

“The vast majority (of mothers), before they’ve
 even conceived have made up their minds how
            they are going to feed.”

    “There’s no way you can increase the
  breastfeeding rates when you are going into
  somebody who’s baby is 14 days old because
      the has been made about feeding”
      Breast Feeding Promotion
“That’s entirely up to them. I always say you’re a
         good mother whatever you do.”

   “Breast is best and that’s what we need to
    promote, but we mustn’t make the mother
  feel guilty, and they can feel forced into a line
        where they just don’t want to go.”
• Research
     “Well the 3 biggest killers of women is breast cancer,
  ovarian cancer and complications of and it reduces it by 4%
                  every year you breast feed”

• Training
  “You accept that breast is best, we’ve all done the training,
             we encourage as much as possible.”

• Own experiences
“I am slightly influenced by my own experience, because I tried
     to breastfeed and it wasn’t successful … she (a midwife)
      gave me the bottle, and it was like a whole weight had
                       been lifted off of me”
• 2 Stages

• 1) Online

• 2) Group Based Intervention

• 2 foundation stones:
  Motivational Interviewing (MI)
  Cognitive Behavioural Therapy (CBT)
Theory of Planned Behaviour
• MI – reflective, method of engaging intrinsic
  motivation to change behaviour

• CBT – a psychotherapeutic approach that aim
  to influence emotions, behaviours, and
  cognitions through a goal-orientated,
  systematic approach
• Problem Based Learning

• 2 expectant mothers – outline of their
  attitudes/interview with midwife

• Short Q + A session on attitudes
              Individual Task
• List 6 things which influence whether a
  mother will choose to breast feed or not
                      • Partners
• Society/Culture
                      • Money
• Grandmothers
                      • Health Professionals
• Media
                Group Task
• In groups of 3-4, discuss the following
  What Sort of Things Effect Health
  Professionals Views of Any Health Behaviour?
  1) Smoking?

  2) Breast Feeding?
Health Professionals Views

 What Effects Health Professionals Views?

• Influences on Health Professionals’ beliefs:
• The seriousness of the consequences of
  carrying out/not carrying out the desired
  health behaviour.
• Personal knowledge of the patient, health
  professional’s stereotypes, own experiences,
  In what ways do these effect us?
• Discuss – groups

• Specifics related to focus groups

• Cognitive Challenging tasks – self-reflective
  and example based.

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