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Table 2 Characteristics and outcomes of included studies

From: Education and training of healthcare staff in the knowledge, attitudes and skills needed to work effectively with breastfeeding women: a systematic review

Author and Year Study design Setting Participants Intervention Outcomes
Ekstrom 2005 [23] and Ekstrom 2015 [27] 2-arm cluster-randomised 10 municipalities in South-Western Sweden Midwives (n = 28) and postnatal nurses (n = 53). Process-orientated training programme. Consisted of seven sessions, including discussions on counselling skills and reflection on personal breastfeeding experiences. Participants were encouraged to develop a common breastfeeding policy between the antenatal clinic and the receiving child-health centres. N = 36. Breastfeeding attitudes at 1 year post training through 4 sub-scales: regulating, facilitating, disempowering and breastfeeding antipathy.
Usual approaches to training and care. No further detail provided. N = 45
Kronborg 2008 [24] 2-arm cluster-randomised 22 municipalities in Western Denmark Health visitors (n = 52) 18 h training ‘Breastfeeding Promotion and Support in a Baby-friendly Hospital’ course by the WHO. Included oral presentations, video presentations, exercises and role play. N = 52 Breastfeeding knowledge (including management of breastfeeding practices), indirect measures of attitudes (self-efficacy, subjective norms, behavioural intent and evaluation of importance) and BFHI stage 5 all measured immediately after programme.
Usual practice and then received the programme at the end of the study. N = 57.
Rea 1999 [25] 2-arm individual randomised trial Maternity hospital in a low income metropolitan area of Sao Paulo, Brazil. Healthcare professionals working in maternity services (n = 60) WHO/UNICEF 40 h breastfeeding counselling training course. Delivered as 33 sessions over 40 h and included theoretical and clinical aspects of breastfeeding and training on counselling skills. N = 20 Breastfeeding knowledge by a multiple choice testa immediately after the intervention. Observation of clinical and counsellinga skills specific to breastfeeding.
Usual training/care provision – no other details specified. N = 40
Westphal 1995 [26] and Taddei [28] 2-arm cluster-controlled trial 8 hospitals in a metropolitan area of wider Sao Paulo, Brazil. Healthcare professionals (obstetricians, paediatricians, nurses) in maternity hospitals (n = 12) 3 week programme delivered by Santos Lactation Centre based on the WellstartTM San Diego programme. Covered theoretical and practical aspects of breastfeeding. 66% of time was lectures and remainder was practical sessions. N = 4 (cluster level). Breastfeeding knowledge post-interventiona.
Compliance of the hospital with the BFHI ten steps measured by structured observations by a researcher and a questionnaire based on staff and mother’s reports in the institutional questionnairea
No detail provided on comparator. N = 4 (cluster level).
  1. aDoes not contribute data