Use of Videoconferencing for Lactation Consultation: An Online Cross-Sectional Survey of Mothers' Acceptance in the United States.

BACKGROUND: Suboptimal breastfeeding duration and exclusivity rates are a public health concern. Therefore, there is a need for identifying effective tools for use in interventions targeting specific barriers to optimal breastfeeding outcomes. Research aim: This study aimed to assess the relationship between acceptance of remote lactation consultation using videoconferencing and (a) maternal demographic factors, (b) technology acceptance subscales, (c) maternal learning style preferences, and (d) other potentially explanatory maternal factors. METHODS: This was a cross-sectional, online study. English-speaking mothers of at least 18 years of age, with an infant age 4 months or younger, and who reported initiating breastfeeding were eligible to participate. Mothers were recruited from 27 randomly selected states. One hundred one mothers completed the survey, resulting in a response rate of 71%. The main outcome was acceptance of videoconferencing use for lactation consultation. RESULTS: No significant differences were found in acceptance by maternal demographic factors or learning style preferences. Acceptance was significantly related to perceived ease of use ( r = .680, p < .001), perceived usefulness/extrinsic motivation ( r = .774, p < .001), intrinsic motivation ( r = .689, p < .001), desire for control of privacy ( r = -.293, p < .01), and mother's perception of the infant father's/maternal partner's acceptance of videoconferencing for lactation consultation ( r = .432, p < .001). Only perceived usefulness/extrinsic motivation and maternal age remained in the final regression model ( R2 = .616, p < .001). Although perceived usefulness/extrinsic motivation was positively associated with acceptance, maternal age was inversely related. CONCLUSION: This sample of mothers indicated general acceptance of videoconferencing for lactation consultation, with younger mothers and those perceiving it to be more useful demonstrating greater acceptance.

Breastfeeding knowledge, attitudes, prior exposure, and intent among undergraduate students.

BACKGROUND: Understanding breastfeeding knowledge, attitudes, and exposures among nonpregnant youth who are likely to be future parents may provide significant pathways to successfully increasing breastfeeding as the normal, accepted way of feeding infants. However, based on a recent review of the literature, only 3 studies have assessed these factors in nonpregnant, young adults in the United States in the past 10 years. OBJECTIVE: The objective of this study was to gather more recent data regarding breastfeeding knowledge, attitudes, and prior exposure among undergraduate university students. METHODS: This was a cross-sectional survey, conducted in November 2010. A convenience sample, consisting of undergraduates in attendance in 2 sections of an introductory nutrition class at a large research university, was used for this project (N = 248). RESULTS: Breastfeeding knowledge was relatively good. However, overall breastfeeding attitudes were more neutral, which appeared to be explained by the belief that breastfeeding is painful, restrictive, and inconvenient, both in general and specifically for the working mother. Though support for breastfeeding in public was low, men were significantly less likely than women to believe it to be embarrassing or unacceptable. In addition, breastfeeding attitudes were more positive among older students and those who were breastfed as infants. Those who were breastfed as infants were also significantly more likely to intend to breastfeed future children. CONCLUSIONS: Though this sample indicates good breastfeeding knowledge, attitudes were more neutral, and support for breastfeeding in public appears low. This finding is contradictory and warrants further exploration.

Remote lactation consultation: a qualitative study of maternal response to experience and recommendations for survey development.

BACKGROUND: Use of videoconferencing technology for healthcare intervention and support is an area of tremendous potential, especially in regard to application in rural or underserved communities. Potential for cost-savings, time-savings, and increased access to care are the ultimate driving force behind use of this technology, for both providers and recipients of healthcare services. Recently, the Federal Government has initiated rulings to support the increased use of computer technology in underserved areas. Therefore, exploring novel applications of the technology of videoconferencing is timely. Remote lactation consultation may be one such novel application. OBJECTIVES: The primary objective of this pilot study was to describe the maternal experience of lactation consultation by means of videoconferencing, compared with standard face-to-face care, using grounded theory for model development. METHODS: Twelve mothers participated in both a videoconferencing and a face-to-face consultation during one visit to the study site. Using grounded theory methods, responses to an in-depth phone interview occurring 3 days post-consultation were analyzed for major themes and a theoretical model proposed. RESULTS: Three major themes emerged including maternal characteristics and interaction with technology, accuracy and trust determines acceptability for consultation type and, conditional acceptance of remote consultation use. CONCLUSIONS: Emergent themes were grounded in existing literature, and potential scales were identified to assist with development of a future tool to test the theoretical model. Responses to the videoconferencing experience were positive, but preferred use of the technology was situational.