Title: A novel peer-support intervention using Motivational Interviewing for breastfeeding maintenance: a UK feasibility study
Funder: Division for Social Care and Health Research (Wales)

Abstract: Design: (i) Rapid evidence review and qualitative research to inform development of a novel breastfeeding peer-support (BFPS) intervention that uses a motivational interviewing (MI) approach for breastfeeding (BF) maintenance and (ii) a non-randomised multi-site study to test the feasibility of delivering MI based BFPS to mothers living in areas with high levels of social deprivation.Setting: Community maternity services in three areas with high levels of social deprivation and low BF initiation rates in England and Wales. Evidence review strategy: Web-based survey of UK service providers and search of 14 databases to characterise the range of BFPS programmes in current practice identifying underpinning theoretical models implementation issues and economic evaluations.Target population: Pregnant women considering BF.Exclusions: Preterm birth (<37 weeks) BF not intitiated clinical reason that precludes BF continuation inability to consent.Intervention: MI based BFPS characterised by proactive daily one-to-one peer-supporter led contact for at least 2 weeks initiated within 48 hours of birth. Peer-supporters are women from a similar locality to the women they support who have breastfed completed accredited BFPS training and MI training. Content optimal timing and methods of contact training of peer-supporters and fit with existing services will be informed by focus groups with pregnant women mothers and peer-supporters and interviews with midwives health visitors and service managers.Measurement of costs and outcomes: Quantitative data will describe BFPS uptake completion of scheduled contacts with peer-supporters according to age-group and parity; recruitment and retention of peer-supporters; and intervention costs from the perspective of the UK NHS women and their families. We will assess the feasibility of different methods (structured telephone interviews with all mothers data collected by Health Visitors and routine NHS data from Child Health Systems Hospital Episode Statistics and General Practice) to collect outcome data (exclusive and partial BF at 10 days and 6-8 weeks maternal and child health well-being satisfaction and healthcare resource utilisation). Peer-supporter structured diaries audio recorded peer supporter-mother contacts (n=27) and qualitative interviews with mothers (n=30 at least half aged <20) peer-supporters (n=6-9) and health professionals (n=9) will be used to assess acceptability and intervention fidelity.Sample size: 6-9 peer-supporters (2-3 per site) will deliver BFPS to 90 mothers over a 6-month period.Project timetable including recruitment rate: 24 months. Month (M) 1–8: Rapid evidence review qualitative stakeholder research intervention development set up study sites. M 9–19: Peer-supporter recruitment training feasibility study recruitment intervention delivery and data collection. M 18-24: Analysis and write-up. There are approximately 400 term births per month in the 20% of most deprived areas in the 3 study areas combined. Assuming 55% of women intend to BF 50% of these consent and 90% go on to initiate BF the sample size will be achievable in four months.Expertise in team: Multidisciplinary team with expertise in developing and testing complex interventions across multiple sites in community settings MI BFPS programmes public health epidemiology qualitative research midwifery health visiting and health economics.


Research activity codes: 6.6 PSYCHOLOGICAL AND BEHAVIOURAL;5.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: REPRODUCTIVE HEALTH AND CHILDBIRTH