Providing Peer Mother Support Through Cell Phone and Group Meetings to Increase Exclusive Breastfeeding in Kenya

Effectiveness of a Baby-friendly Hospital Based Mothers' Support Group, and a Cell-phone Based Peer Support Program in Supporting Exclusive Breastfeeding in an Urban Kenyan Community.

This behavioural support intervention trial will investigate the potential to increase exclusive breastfeeding rates in an urban Kenyan community through peer mother support delivered either by cell phone or through group meetings. It will follow a cohort of more than 800 women attending antenatal care at a large public hospital, and compare indicators of breastfeeding and infant and maternal health between groups receiving one or other type of peer mother support. The main part of the study will test the primary hypothesis that peer group and cell phone based support can both increase rates of EBF at 3 months by 20% relative to a control group.

Study Overview

• Status: Completed
• Conditions: Breastfeeding
• Intervention / Treatment: Behavioral: Peer mother support for continued exclusive breastfeeding

Detailed Description

The general objective was to assess whether participation from late pregnancy through to 3 months postpartum in bi-weekly cell phone based peer support (CPS) or monthly peer-led support groups (PSG) can increase adoption and duration of EBF amongst low-income women in Kenya served by a nationalized BFHI certified hospital above benchmarks achieved with current approaches and standard of care by existing facility-based support (SOC).

The study aimed to reach the following specific objectives related to message delivery on EBF:

assess the feasibility of two innovative approaches (CPS and PSG) to deliver extended postnatal peer support for EBF by women in an urban, low-income country setting; compare the effectiveness of these two innovative approaches to existing facility-based support; and compare the relative effectiveness of each type of peer support intervention.

• Study Type: Interventional
• Enrollment (Actual): 823
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Kenya
  • Rift Valley
    • Nakuru, Rift Valley, Kenya
      • Nakuru Provincial General Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 45 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria for mothers:

1. attending antenatal care services at the target facility;
2. confirmed pregnant by a health care worker;
3. 24-32 weeks gestation at enrollment;
4. competency in KiSwahili or English (or both)
5. current resident of Nakuru municipality and expecting to reside there for the next 6 months;
6. intend to breastfeed their newborn;
7. self-report of any condition preventing the subject from breastfeeding (excluding HIV infection)
8. no history of mental illness
9. either HIV-negative on test result OR referred bto PMTCT services following verified positive HIV-test results
10. willing to participate in study described in IC forms
11. 18-45 years of age

Study Plan

How is the study designed?

Design Details

• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: CPS, cell phone based peer support; Cell phone base peer mother support for continued exclusive breastfeeding	Behavioral: Peer mother support for continued exclusive breastfeeding; Peer counselling on breastfeeding beginning in third trimester and continuing until 3 months postpartum
Active Comparator: PSG, group meeting based peer support; Group based peer Cell phone base peer mother support for continued exclusive breastfeeding	Behavioral: Peer mother support for continued exclusive breastfeeding; Peer counselling on breastfeeding beginning in third trimester and continuing until 3 months postpartum
No Intervention: Control; Current standard of care and support (national health system)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
exclusive breastfeeding	3 months post partum

Collaborators and Investigators

• Sponsor: University of Toronto
• Collaborators: Emory University; University of California, Davis; Global Alliance for Improved Nutrition; Egerton University
• Investigators: Study Director: Daniel Sellen, PhD, University of Toronto; Principal Investigator: Elizabeth Kamau-Mbuthia, PhD, Egerton University; Principal Investigator: Samwel Mbugua, MSc, Egerton University; Principal Investigator: Aimee Webb Girard, Emory University

Study record dates

Study Major Dates

• Study Start: June 1, 2011
• Primary Completion (Actual): October 1, 2012
• Study Completion (Actual): January 1, 2013

Study Registration Dates

• First Submitted: June 28, 2011
• First Submitted That Met QC Criteria: June 29, 2011
• First Posted (Estimate): June 30, 2011

Study Record Updates

• Last Update Posted (Estimate): October 25, 2013
• Last Update Submitted That Met QC Criteria: October 24, 2013
• Last Verified: October 1, 2013

More Information

Terms related to this study

• Keywords: breastfeeding exclusively
• Other Study ID Numbers: 26370