Literature DB >> 28173897

Exclusive breast-feeding promotion among HIV-infected women in South Africa: an Information-Motivation-Behavioural Skills model-based pilot intervention.

Emily L Tuthill1, Lisa M Butler2, Jennifer A Pellowski3, Jacqueline M McGrath4, Regina M Cusson4, Robert K Gable5, Jeffrey D Fisher2.   

Abstract

OBJECTIVE: Exclusive breast-feeding (EBF) provides optimal nutrition for infants and mothers. The practice of EBF while adhering to antiretroviral medication decreases the risk of mother-to-child transmission of HIV from approximately 25 % to less than 5 %. Thus the WHO recommends EBF for the first 6 months among HIV-infected women living in resource-limited settings; however, EBF rates remain low. In the present study our aim was to design and implement a pilot intervention promoting EBF among HIV-infected women.
DESIGN: The Information-Motivation-Behavioural Skills (IMB) model was applied in a brief motivational interviewing counselling session that was tested in a small randomized controlled trial.
SETTING: Pietermaritzburg, South Africa, at two comparable rural public health service clinics.
SUBJECTS: Sixty-eight HIV-infected women in their third trimester were enrolled and completed baseline interviews between June and August 2014. Those randomized to the intervention arm received the IMB-based pilot intervention directly following baseline interviews. Follow-up interviews occurred at 6 weeks postpartum.
RESULTS: While not significantly different between trial arms, high rates of intention and practice of EBF at 6-week follow-up were reported. Findings showed high levels of self-efficacy being significantly predictive of breast-feeding initiation and duration regardless of intervention arm.
CONCLUSIONS: Future research must account for breast-feeding self-efficacy on sustaining breast-feeding behaviour and leverage strategies to enhance self-efficacy in supportive interventions. Supporting breast-feeding behaviour through programmes that include both individual-level and multi-systems components targeting the role of health-care providers, family and community may create environments that value and support EBF behaviour.

Entities:  

Keywords:  Exclusive breast-feeding; HIV; Infant feeding; Information–Motivation–Behavioural Skills; Mother-to-child transmission of HIV; South Africa

Mesh:

Year:  2017        PMID: 28173897      PMCID: PMC6431238          DOI: 10.1017/S1368980016003657

Source DB:  PubMed          Journal:  Public Health Nutr        ISSN: 1368-9800            Impact factor:   4.022


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