Workshop to implement the baby-friendly office initiative - Effect on community physicians' offices

OBJECTIVE To assess the effect of a self-appraisal questionnaire and a work shop for office staff in promoting the baby-friendly office (BFO). DESIGN A two-times-three factorial design with a delayed workshop for one o f two groups: an early intervention group who attended a workshop for offic e staff in October 1997 (n = 23) and a late-intervention group who attended in April 1998 (n = 23). Self-appraisals were completed before the workshop s by ail participants in October 1997, by 37 offices in April 1998, and by 34 offices in October 1998. SETTING Offices of family physicians and primary care pediatricians in Hami lton-Wentworth, Ont. PARTICIPANTS Staff of 46 offices; 74% 34/46) completed all three assessment s. MAIN OUTCOME MEASURES Degree of change in implementing each of the "10 Step s to Baby-Friendly Office" and overall average BFO score received by each o ffice. RESULTS Of the 34 offices completing all assessments, none followed all 10 steps. initial mean score was 4.4 steps (standard deviation 1.4, n = 46). T he workshop intervention improved overall mean scores from 4.3 to 5.6 (P <. 001, n = 37). Although office staff completed the BFO self-appraisal tool, it alone had no effect on scores. Areas of improvement were noted in provid ing information to patients and displaying posters to promote breastfeeding . Key steps, such as not advertising breast milk substitutes and not distri buting free formula, did not change. CONCLUSION The workshop effected a modest but positive change in breastfeed ing promotion. The change was maintained at 6 and 12 months after the inter vention.