Effectiveness of Husbands' Support Exclusive Breastfeeding Facebook Programme During the COVID-19 Pandemic.

Introduction: The exclusive breastfeeding rate for six months in the Northeast region of Thailand has recently significantly decreased, in contrast to all other regions in Thailand. Facebook is widely used worldwide to enhance knowledge, attitudes, and behaviours that support breastfeeding. This study aims to assess the effectiveness of a Facebook programme for husbands' support of exclusive breastfeeding during the COVID-19 pandemic. Methods: We employed a quasi-experimental study design conducted from September 2020 to November 2021. Data were collected from two tertiary hospitals in Thailand, involving a total of 72 participants-36 in the experimental group and 36 in the control group. These participants were husbands of postpartum women admitted to the postpartum wards. Four research instrument were the demographic questionnaire, the Husband's EBF Knowledge, Husband's EBF Attitude, and Husband's EBF Behavior Questionnaires. Demographic data were analysed using frequency distribution, percentages, and the Chi-square test. The mean difference in husbands' exclusive breastfeeding (EBF) knowledge scores was analysed using an independent samples t-test. Results: At baseline, there was no significant difference in husbands' exclusive breastfeeding (EBF) knowledge scores between the experimental and control groups (p = 0.82). By the 1st month, there was a significant difference in the mean scores of husbands' EBF knowledge between the two groups (p < 0.01). However, the mean score of attitude at 6-month (mean=108.03, SD=19.89) was higher than the mean score of behaviour at baseline (mean=101.81, SD=17.99), but it was not significant (p=0.40). In addition, the different score of behaviour among baseline (mean=65.86, SD=7.02) and 6-month (mean=68.58, SD=10.42) was not significant (p=0.24). Conclusion: The findings suggest that the Facebook programme is an effective platform for conveying exclusive breastfeeding (EBF) knowledge to husbands in Northeast Thailand during the COVID-19 pandemic.

Q-methodology identifies distinctive viewpoints of the facilitators and barriers to six-month exclusive breastfeeding in Northeast Thailand.

BACKGROUND: The six-month exclusive breastfeeding (EBF) rate almost halved between 2009 and 2013 in Northeast Thailand for no clear reason. Specific facilitators and barriers to six-month EBF have been identified for Thailand, but mothers' views on these factors to continuing EBF breastfeeding until six months have not been explored in this region. AIM: This study aimed to prioritize mothers' views on the identified facilitators and barriers of continuing six-month exclusive breastfeeding. Methods: Q-methodology was applied. This research was conducted at Well Baby Out-Patient Department of Khonkaen Hospital, Numphong Hospital and a private hospital. Thirty-four mothers, who had recently delivered infants aged between four and six months, were breastfeeding/had breastfed, were 20 to 40 years old, participated. Demographic data were analysed descriptively, and Q-method analysis was conducted using the PQ Method software 2.35. RESULTS: There was consensus that having knowledge about the advantages of EBF was the most important facilitator of six-month EBF, and 'not having any other responsibilities besides caring for her infant' was the least important facilitator of six-month EBF. Three viewpoints emerged identifying different groups/clusters of mothers, namely, (1) caring for self, (2) requiring support and (3) breastfeeding knowledge. Conclusions: Despite some consensus among participants, three distinct viewpoints emerged regarding which facilitators and barriers were important to mothers. It is clear that a programme to improve the six-month EBF rate in Northeast Thailand would need to incorporate interventions or activities that address the different viewpoints identified.

The Evaluation of Training for Health-Care Professionals and Community Leaders Regarding 6-Month Exclusive Breastfeeding in Northeast Thailand.

To address the reduction of the 6-month exclusive breastfeeding (EBF) rate in Northeast Thailand, a 3-year 6-month EBF intervention model was developed using concept mapping. A training for health-care professionals and community leaders was prioritized as the initial intervention. The aim was to assess the feasibility of the training intervention and its potential to improve 6-month EBF knowledge. A pre- and posttest, and an open question were conducted. Data were analyzed using t tests and thematic analysis. For the 17 health-care professionals and community leaders who participated, the mean 6-month EBF knowledge scores improved significantly from 5.28 to 10.21 (p value < .01). It is recommended that this workshop could be duplicated and scaled up in other regions across Thailand to standardize care.

Concept mapping to reach consensus on a 6-month exclusive breastfeeding strategy model to improve the rate in Northeast Thailand.

BACKGROUND: In implementation research, it is essential to involve all stakeholders in the development of complex interventions to ensure that the proposed intervention strategy is relevant and acceptable to the target area and group. The aim of this study was to involve stakeholders in conceptualising, developing, and prioritising a feasible intervention strategy to improve the 6-month exclusive breastfeeding rate in North-east Thailand. Concept mapping was used in a purposive sample including health care volunteers, health care professionals, and community leaders. During the first meeting, stakeholders (n = 22) expressed the generation of feasible interventions. During the second meeting, participants (n = 21) were asked to individually rate the feasibility of each intervention and to group them into relevant categories to enable multidimensional scaling and hierarchical cluster analysis. The outputs of analysis included the intervention list, cluster list, point map, point rating map, cluster map, and cluster rating map. All of these were shared with stakeholders (n = 17) during the third meeting to reach consensus on an intervention model. The final proposed intervention strategy included 15 feasible interventions in five clusters: health care services, community services, and education packages for parents, family members, and communities. These interventions were prioritised for implementation over a 3-year period. Once the feasibility of each intervention is established, the proposed model could be implemented and incorporated into local health policy. After assessing intervention effectiveness, each intervention could be scaled up to other middle-income countries to help improve overall maternal and child survival.

Perceptions of northeast Thai breastfeeding mothers regarding facilitators and barriers to six-month exclusive breastfeeding: focus group discussions.

BACKGROUND: The 6-month exclusive breastfeeding rate in the Northeast region of Thailand has recently significantly decreased in contrast to all other regions in Thailand. The factors that have influenced this decrease remain unknown. Hence, it is suggested that an investigation into factors that could improve or hinder EBF for 6 months in Northeast Thailand may be required to inform the development of relevant interventions to improve this situation. This study aimed to identify perceived facilitators and barriers to providing exclusive breastfeeding for 6 months in Northeast Thailand among breastfeeding mothers. METHODS: Six focus group discussions were conducted with a total of 30 mothers aged 20 to 40 years who had children aged between 4 and 6 months and were currently breastfeeding or had breastfeeding experience. Participants were recruited through self-selection sampling from Khonkaen hospital (urban), Numphong hospital (peri-urban) and private hospitals (urban) in Khonkaen, Thailand. Thematic analysis was employed to analyse the data. RESULTS: Five main themes, with 10 sub-themes, were identified as either facilitators (+) or barriers (-), or in some cases, as both (+/-). Breastfeeding knowledge, perceptions, maternal circumstances, support, and traditional food were the main identified themes. Mother's breastfeeding knowledge, intention to breastfeed, and social media were perceived as facilitators. Perceptions, employment, and formula milk promotion were perceived as barriers. Family, healthcare, and traditional food were perceived as both facilitators and barriers. The perception that social media was a way to access breastfeeding knowledge and support mothers in Northeast Thailand emerged as a new facilitating factor that had not previously been identified in Thai literature relating to facilitators and barriers to exclusive breastfeeding. Intention to breastfeed, family support, healthcare support and traditional food were mentioned by all groups, whereas mothers from urban areas specifically mentioned mother's breastfeeding knowledge, social media and employment sub-themes. Only mothers from the peri-urban area mentioned formula milk promotion and only mothers who had delivered in public hospitals mentioned the perceptions sub-theme. CONCLUSIONS: Knowledge about these facilitators and barriers may inform the design and development of specific and relevant interventions to improve the 6-month exclusive breastfeeding rate in the Northeast region of Thailand and be useful in other contexts. Social media emerged as a newly perceived facilitator in the Thai context and may be a useful inclusion in a 6-month exclusive breastfeeding intervention model.