Browsing by Author "Brockway, Meredith"
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- ItemOpen AccessAlberta Family Integrated Care (FICare) and Breastfeeding for Moderate to Late Preterm Infants: Cluster Randomized Controlled Trial 2 Month Follow-up(2023-01-02) Moe, Amanda; Benzies, Karen; McNeil, Deborah; Brockway, MeredithIntroduction: Human milk, specifically mothers’ own milk, is the optimal nutrition for infants and has significant protective effects, which are even greater for infants born prematurely. Compared to full-term infants, fewer preterm infants achieve exclusive breastfeeding to age 6 months. Aim: The purpose of this study was to examine the risks and protective factors associated with breastfeeding at age 2 months in moderate and late preterm infants who received Alberta Family Integrated Care (FICare) versus Standard Care while in the Neonatal Intensive Care Unit (NICU). Alberta FICare is a novel care model that empowers parents to build their knowledge, skill, and confidence in caring for their preterm infant. Methods: A longitudinal follow-up to the Alberta FICare cluster randomized controlled trial was conducted. Alberta FICare data for 455 infants (n = 204 Alberta FICare; n = 251 Standard Care) and their mothers were linked to feeding type data (exclusive human milk, non-exclusive human milk, or no human milk) collected at the infant’s 2-month public health immunization visit. Multinomial logistic regression was used to examine the factors associated with proportions of breastfeeding at age 2 months. Results: After controlling for covariates, there was a significant group difference favoring Standard Care versus Alberta FICare for non-exclusive breastfeeding compared to no breastfeeding at age 2 months. There were no significant group differences in model sub-analyses comparing exclusive breastfeeding versus non-exclusive breastfeeding and exclusive breastfeeding versus no breastfeeding. Mothers with singletons, higher education, higher parental NICU stress, higher breastfeeding self-efficacy, and feeding exclusively human milk at discharge were more likely to provide exclusive breastfeeding at age 2 months. Conclusion: Infants in the Standard Care group were more likely to receive non-exclusive breastfeeding at age 2 months compared to no breastfeeding. Group (Alberta FICare versus Standard Care) was not significant when comparing exclusive breastfeeding outcomes. Of the factors associated with exclusive breastfeeding in preterm infants, breastfeeding self-efficacy is a potentially modifiable one that could be targeted for interventions. Further research is required to examine the association between higher parental NICU stress and exclusive breastfeeding.
- ItemOpen AccessBreastfeeding self-efficacy and breastmilk feeding for moderate and late preterm infants in the Family Integrated Care trial: a mixed methods protocol(2018-07-06) Brockway, Meredith; Benzies, Karen M; Carr, Eloise; Aziz, KhalidAbstract Background Breastmilk is the ideal nutrition for preterm infants. Yet, breastmilk feeding rates among preterm infants are substantially lower than those of full-term infants. Barriers incurred through hospital care practices as well as the physical environment of the neonatal intensive care unit (NICU) can result in physical and emotional separation of infants from their parents, posing a substantial risk to establishing and maintaining breastfeeding. Additionally, current practitioner-focused care provision in the NICU can result in decreased breastfeeding self-efficacy (BSE), which is predictive of breastfeeding rates in mothers of preterm infants at 6 weeks postpartum. Methods Family Integrated Care (FICare) integrates and supports parents to actively participate in the care of their infant while in the NICU. Nested within the broader FICare trial, we will conduct an explanatory sequential mixed methods study to investigate if FICare improves maternal BSE and rates of breastmilk feeding in moderate and late preterm infants at discharge from the NICU. In phase 1, we will calculate the mean difference between admission and discharge BSE scores for the intervention group. Mothers who score in the top and bottom 20th percentile of change scores will be invited to participate in a semi-structured telephone interview exploring maternal experiences with infant feeding in the NICU. We will conduct inductive thematic analysis to identify and describe the facilitators and barriers of FICare on maternal feeding experiences. Once data saturation is achieved and themes have been established, phase 2 will revisit the quantitative data to determine whether FICare was impactful on BSE and breastmilk feeding rates. Findings from the qualitative and quantitative phases will be integrated to determine how infant feeding experiences on FICare units work to improve or detract from maternal BSE and rates of breastmilk feeding. Discussion FICare may help to improve maternal BSE and rates of breastmilk feeding in moderate and late preterm infants. Improved breastmilk feeding outcomes can have a substantial impact on overall infant health, developmental outcomes, and maternal-infant bonding and will help to improve long-term health outcomes for moderate and late preterm infants. Trial registration ( NCT02879799 ). Registered May 27, 2016 protocol version June 9, 2016 Version 2.
- ItemEmbargoInvestigating the Interprofessional Socialization of Healthcare Educators Following an Interprofessional Simulation Facilitator Training Program: A Mixed Methods Study(2024-06-05) Dolan, Sara; Nowell, Lorelli; Moules, Nancy; Brockway, MeredithBackground: Patient safety incidents due to poor interprofessional collaboration have devastating impacts on patients and their families. Interprofessional socialization can lead to interprofessional collaboration. Interprofessional education is one method used to promote interprofessional socialization. Healthcare educators in the practice setting are tasked with delivering interprofessional education; however, they require specialized skills and interprofessional connections to effectively facilitate interprofessional learning. Although there is literature discussing the interprofessional socialization of students and frontline staff, there is a gap in the literature regarding the interprofessional socialization of healthcare educators in the practice setting. Purpose: The purpose of this research was to examine the experiences and perceptions of healthcare educators in the practice setting regarding interprofessional socialization following an interprofessional simulation facilitator training (SimSkills). Methods: I completed an explanatory sequential mixed methods study, including secondary data from program evaluation surveys (n = 87) and follow-up semi-structured interviews (n= 17), to examine participants perceptions and experiences of interprofessional socialization. In the first (quantitative) phase of the study, data were collected from the provincial simulation program, eSIM, in Alberta as part of an ongoing program evaluation. Attendees of the SimSkills program were invited to complete a retrospective pre-post program evaluation survey to evaluate their attitudes toward interprofessional socialization. In the second (qualitative) phase of the study, semi-structured interviews were conducted to explore the secondary data findings in greater depth. Descriptive and inferential statistics were used to analyze the quantitative data and qualitative data were analyzed using interpretive description. Integration occurred when quantitative data were used to inform the interview guide and qualitative data were used to explain quantitative results. Results: There was a statistically significant increase in the attitude toward interprofessional socialization following the training. Qualitative findings revealed five themes regarding interprofessional socialization: (a) benefits gained through interprofessional socialization, (b) interprofessional, uniprofessional, or both (dual identity), (c) facilitators to interprofessional socialization, (d) barriers to interprofessional socialization, and (f) opportunities to strengthen interprofessional socialization. Conclusion: Healthcare educators have positive views of interprofessional socialization; however, interprofessional socialization behaviors are inconsistent with interprofessional socialization behaviors across settings. Interprofessional learning opportunities may enhance interprofessional socialization among healthcare educators.