Creating exclusive breastfeeding knowledge translation tools with First Nations mothers in Northwest Territories, Canada
Bibliographic record
Abstract
BACKGROUND: Breastfeeding is an ideal method of infant feeding affecting lifelong health, and yet the uptake of breastfeeding in some Indigenous communities in Canada's north is low. OBJECTIVE: The aims of this project were to determine the rate and determinants of exclusive breastfeeding in a remote community in the Northwest Territories and to create knowledge translation tools to enhance breastfeeding locally. METHODS: The study methodology followed three steps. Firstly, a series of retrospective chart audits were conducted from hospital birth records of Tłı̨chǫ women (n=198) who gave birth during the period of 1 January 2010 to 31 December 2012. A second follow-up chart audit determined the rate of exclusive breastfeeding and was conducted in the local Community Health Centre. Chart audit data included the following factors related to breastfeeding: age of mother, parity, birthweight and Apgar scores. Secondly, semi-structured interviews with a purposive sample of Tłı̨chǫ mothers (n=8) and one Elder were conducted to identify breastfeeding practices, beliefs and the most appropriate medium to use to deliver health messages in Tłı̨chǫ. Third, based on the information obtained in Step 2, two knowledge translation tools were developed in collaboration with a local community Advisory Committee. RESULTS: The rate of exclusive breastfeeding initiation in the Tłı̨chǫ region is less than 30%. Physiological and demographic factors related to breastfeeding were identified. Thematic analysis revealed two overarching themes from the data, namely, "the pull to formula" (lifestyle preferences, drug and alcohol use, supplementation practices and limited role models) and "the pull to breast feeding" (traditional feeding method, spiritual practice and increased bonding with infant). CONCLUSION: There are a myriad of influences on breastfeeding for women living in remote locations. Ultimately, society informs the choice of infant feeding for the new mother, since mothers' feeding choices are based on contextual realities and circumstances in their lives that are out of their control. As health care providers, it is imperative that we recognize the realities of women's lives and the overlapping social determinants of health that may limit a mother's ability or choice to breastfeed. Further health promotion efforts, grounded in community-based research and a social determinants framework, are needed to improve prenatal and postnatal care of Indigenous women and children in Canada.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".