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Implementing evidence-based practice: evaluation of an opinion leader strategy to improve breast-feeding rates
Jane E Sisk1, Ann Lennarson Greer, Martha Wojtowycz
1Department of Health Policy, Mount Sinai School of Medicine, New York, NY, USA.
Objective:
The objective was to evaluate the effectiveness of opinion leaders in raising breast-feeding rates.
Study Design:
A randomized controlled trial of an opinion leader strategy in 18 hospitals in Central New York State compared mothers' intention to breast-feed during baseline and study years. Multivariate logistic regression with a mixed model analyzed the effects on breast-feeding exclusively and on breast- and formula-feeding combined.
Results:
Obstetric clinicians had a high degree of knowledge about breast-feeding benefits and of perceived responsibility to recommend breast-feeding. Obstetricians, family practitioners, and midwives agreed on the person identified as the opinion leader, in each case an obstetrician who was chief of obstetrics or obstetrics-gynecology. Breast-feeding rates in hospitals with the opinion leader intervention did not differ significantly from those in control-group hospitals during the study year.
Conclusion:
The opinion leader strategy in this case did not improve breast-feeding rates during the study year. Opinion leader strategies may make assumptions about clinician control that are not justified in situations such as breast-feeding.
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