A Smartphone-Based Approach to Improved Breast-Feeding Rates And Self-Efficacy

Study Overview
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Brief Summary
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To provide patients with easily accessible information in the form of a smartphone application regarding medically appropriate information about breastfeeding and to assess the impact this information has on women's breastfeeding rates and perception of self-efficacy.

Detailed Description
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The benefits of breastfeeding for both mother and neonate have been well documented and extensively researched. Breastfeeding rates remain suboptimal despite known advantages including reduced lifetime risk of maternal ovarian cancer, more rapid return to pre-gestational weight, improvement in maternal/neonatal bonding, reduction in neonatal allergic/immunologic conditions. Both non-modifiable and modifiable factors affecting a mother's decision regarding breastfeeding have been identified. Modifiable factors include breastfeeding knowledge, self-efficacy, and confidence. Breastfeeding self-efficacy has been positively correlated with breastfeeding duration. There is a lack of local data on breastfeeding rates, duration, and self-efficacy in the Augusta University women's health population as well as a lack of documented improvement of these factors following educational programs. Our study aims to create a program that is easily accessible and available to our patient population in the form of a free application available on Apple devices capable of accessing the internet (e.g., i-phone, i-pad, etc.). This study will be a randomized control trial. The intervention group will have access to the application while the control group will not. Our hypothesis is that the application will improve breastfeeding rates, duration, and self-efficacy if offered to patients at 32 through 36 weeks gestation. This will be assessed by comparing initial self-efficacy survey results with survey results at six weeks and six months postpartum for the intervention versus control groups.

Official Title
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A Smartphone-Based Approach to Improved Breast-Feeding Rates And Self-Efficacy: A Randomized Controlled Clinical Trial

Conditions
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Breastfeeding

Intervention / Treatment
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* Other: Breastfeeding at AU Apple-Based Smartphone Application


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primiparous and multiparous females receiving prenatal care at Augusta University Obstetrics and Gynecology clinic at 32 through 36 weeks gestation. No documented anatomic differences in mother's chest anatomy. Access to the internet via an Apple® device (such as i-phone or i-pad). Delivery at Augusta University Medical Center Exclusion Criteria: Significant maternal intrapartum or postpartum complications (i.e., postpartum hemorrhage > 2000 mL, uterine inversion, retained products, ICU admission, postpartum psychosis). Infants admitted to neonatal intensive care unit >48 hours Pre-term deliveries prior to 37 weeks gestation Infants with cleft palate, or other palate/facial defects Patients without email access or internet access Patients without an Apple® device (i-phone, i-pad) Non-English speaker Mothers unable to breastfeed secondary to contraindicated communicable disease (i.e. HIV) Mothers unable to breastfeed secondary to contraindicated medications Mothers of infants up for adoption
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Control group will usual breastfeeding care (counseling by provider, access to lactation consultant, etc) Interventional group will receive usual care plus the breastfeeding application introduced between 32 to 36 weeks estimated gestational age.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental Arm<br>The participant will receive usual breastfeeding care such as counseling by her physician, access to lactation consults, nursing assistance in the hospital, access to our online resources. The participant will also receive the Apple breastfeeding application in the office once enrolled in the study between 32 to 36 weeks gestation. The participant will be taught how to use the application, and will have access to the study to continue use throughout the duration of follow-up. | Other: Breastfeeding at AU Apple-Based Smartphone Application<br>* This is a free Apple-Based Smartphone Application the participant can download. In the application, there is information and tips for breastfeeding success and continuation, as well as information on additional resources both online and in the community as a whole.<br>|
| No Intervention: Control Arm<br>The participant will receive usual breastfeeding care such as counseling by her physician, access to lactation consults, nursing assistance in the hospital, access to our online resources. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Breastfeeding Rates | We will assess the rates of both inclusive and exclusive breastfeeding rates | 6 weeks after delivery | 
| Breastfeeding Rates | We will assess the rates of both inclusive and exclusive breastfeeding rates | 6 months after delivery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Breastfeeding Self-Efficacy Rates | The breastfeeding self-efficacy short form is a validated, standardized form to assess participants' sense of breastfeeding self-efficacy. | 6 weeks postpartum | 
| Breastfeeding Self-Efficacy Rates | The breastfeeding self-efficacy short form is a validated, standardized form to assess participants' sense of breastfeeding self-efficacy. | 6 months postpartum. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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smartphone application, breastfeeding, breastfeeding self-efficacy