A mixed methods evaluation of the memory aide for positioning: CHINS

A mixed methods evaluation of the breastfeeding memory aide CHINS Abstract
Introduction
Breastfeeding is a key public health priority, but rates remain persistently low in the United Kingdom despite wide scale roll out of UNICEF Baby Friendly Initiative training and accreditation in the United Kingdom. Here, memory aides such as CHINS – Close, Head free, In-line, Nose to Nipple and Sustainable, could help practitioners remember, recall and apply breastfeeding theory in their routine practice. This paper presents the first UK evaluation of CHINS.
Methods
A concurrent or convergent mixed methods approach was adopted using an overarching framework based on the four constructs of normalisation process theory. An online survey was developed targeted at breastfeeding practitioners from across the United Kingdom. A sub-set of survey respondents took part in qualitative focus groups.
Findings
In total 115 breastfeeding practitioners completed the survey and 16 of these took part in the focus group phase of the study. The findings show that CHINS has become a widely used feature of breastfeeding education and practice and this is largely because of its simplicity and ease of integration in everyday practice, as well as its sustained inclusion in UNICEF Baby Friendly Initiative training. CHINS has introduced a standardised approach to the principles of positioning for effective breastfeeding and in doing this has helped to address inconsistencies and poor practice in this area, as well as play a role in helping practitioners to build confidence in their breastfeeding practice.
Conclusion
There is a need to ensure the breastfeeding workforce develop and maintain skills in supporting breastfeeding practice and more work needs to be done to consider how best this can be achieved, including the role of memory aides such as CHINS in supporting this.
Key Words
Breastfeeding, positioning, CHINS, Normalisation Process Theory, mixed methods.