Becoming Breastfeeding Friendly (BBF) Scotland infographic

Breastfeeding rates in Scotland have improved in recent years, with an increase from 44% (2001/02) to 51% (2017/18) of babies reportedly receiving ‘any breastfeeding’ at first health visitor visit, and the proportion of babies being breastfed at 6-8 weeks rising from 36% of babies (born in 2001/02) to 42% (born in 2017/18). However, the figures remain relatively low and drop off rates high, with breastfeeding rates lower among women in areas of higher deprivation, exacerbating health inequalities. Supported by the University of Kent and facilitated by Scottish Government, a Scottish Committee of experts has worked since May 2018 to carry out the 5 step meeting process: a) To measure the current breastfeeding environment b) To develop a plan to implement recommendations to guide the scaling up of national breastfeeding protection, promotion and support efforts. This infographic presents the findings of the assessment of the Breastfeeding environment in Scotland and the committee's eight evidence-informed recommendation themes, based on the BBF Gear model

How can migrant communities and services collaborate to improve public health across diverse areas?

Purpose: In the UK, whilst data collection remains challenging, there is growing evidence of low uptake of preventative health services by migrant communities, with the knowledge and experience of accessing primary and community care particularly poor among Roma groups. Bhopal (2018) argues for political bravery in resourcing integrated strategies that advance migrant health in a wider social justice context and challenge negative narratives and persistent systemic inequities. Kent Community Health Foundation Trust (KCHFT) is implementing an innovative, asset-framed project over three years. They are testing new ways of working in recruitment, health visiting and school nursing; employing staff from migrant communities to strengthen and deliver preventative healthcare; and building collaborative partnerships and shared objectives with local community based organisations including Red Zebra's 'Roma in the Lead' project. CHSS is evaluating this approach to assess the effectiveness, feasibility and replicability

Becoming Breastfeeding Friendly in Wales: context, findings and recommendations

In Wales, whilst over 60% of women intend to breastfeed, the figure falls to 26% reporting any breastfeeding at 6 weeks. There is considerable variation among Health Boards and breastfeeding rates are lower among some groups, exacerbating health inequalities. Sustained intervention is required to both improve the experience of breastfeeding for women, babies and families, and advance towards the WHO’s 2025 global target of increasing exclusive breastfeeding in the first six months to at least 50%. Supported by the University of Kent and facilitated by Public Health Wales, a Welsh Committee of experts worked from April 2018 to February 2019 to deliver the 5 step Becoming Breastfeeding Friendly (BBF) process: a) to measure the current breastfeeding environment b) to develop a plan to implement recommendations to guide the scaling up of national breastfeeding protection, promotion and support efforts. This presentation documents the process, findings for Wales and the set of six evidence based recommendation themes. Combined action on these recommendations will strengthen and promote the breastfeeding environment for all mothers and babies in Wales

Expression of Interest Submission to the Signature Research Theme on Migration and Movement

Explanation of person research themes (childhood immunisations) and their relevance to the Signature Research Theme of Migration and Movement; current and possible national/international partnership; proposals for specialist and interdisciplinary workshops; and ideas for innovative practice in public engagement

Becoming breastfeeding friendly in Great Britain - Does implementation science work?

The Becoming Breastfeeding Friendly (BBF) in Great Britain study was conducted during 2017–2019 comprising three country studies: BBF England, Wales and Scotland. It was part of an international project being coordinated during the same period by the Yale School of Public Health across five world regions to inform countries and guide policies to improve the environment for the promotion, protection and support of breastfeeding. This paper reports on the application of the BBF process that is based on an implementation science approach, across the countries that constitute Great Britain (England, Wales and Scotland). The process involves assessing 54 benchmarks across eight interlocking gears that drive a country's ‘engine’ towards a sustainable policy approach to supporting, promoting and protecting breastfeeding. It takes a consensus-oriented approach to the evaluation of benchmarks and the development of recommendations. This paper provides a critical overview of how the process was conducted, the findings and recommendations that emerged and how these were managed. We draw on critical theory as a theoretical framework for explaining the different outcomes for each country and some considerations for future action

Print media coverage of breastfeeding in Great Britain: positive or negative?

Abstract Media can be a powerful communication tool to promote breastfeeding, influence mothers' breastfeeding behaviour, create positive social norms and generate support among stakeholders and policymakers for breastfeeding. However, negative stories could deter women from starting or continuing to breastfeed. This study aimed to describe the breadth and focus of the media coverage of breastfeeding and the message frames that are found in three of the most widely read national newspapers and three popular women's magazines in Great Britain over a 12-month period, as part of the Becoming Breastfeeding Friendly in Great Britain (BBF-GB) study. For this retrospective media analysis, 77 articles were identified and 42 were included in the study for coding and analysis. We conducted two content analyses to examine the articles' (1) message framing and (2) alignment with the eight components of an ‘enabling breastfeeding environment’ using the BBF Gear framework. Articles featuring breastfeeding appear in British newspapers and women's magazines all year round. Twenty-four per cent had a neutral tone, while 59% predominantly focused on the positive aspects or positive social support for breastfeeding, and 17% were predominantly focused on the negative aspects or negative social attitudes towards breastfeeding. The articles mainly focused on personal stories reflecting societal barriers and positive shifts (68%), with 12% presenting an analysis of breastfeeding evidence or barriers. There were fewer references to the legislation (5%) and availability of funding (2%) and support (9%). There was no coverage of national coordination and strategy, evaluation systems, or the political will to raise breastfeeding rates. KEY MESSAGES: - During the one-year study period, articles featuring breastfeeding appeared in the included British newspapers and women's magazines all year round rather than being focused on specific events, such as World Breastfeeding Week. - Articles mainly focused on personal stories and were initiated by social media posts or discussions on Television by mothers, often celebrity mothers. - While articles discussed the difficulties mothers face during breastfeeding, they also detailed positive support for breastfeeding, presenting a more balanced view. - The articles did not fully reflect BBF's Gear Model components for an enabling breastfeeding environment. Most were categorised as promotion articles with fewer advocacy pieces. There was little coverage of legislation, services and funding while political support, breastfeeding data and strategic oversight were not covered

Go Golborne Action Learning Event: Partner survey and interviews

The causes of obesity are complex; tackling the problem requires evidence-led action at every level, from the individual to society, and across all sectors. As part of their whole system strategy to halt and reverse the rising trend in childhood obesity, the London Bi-borough Public Health team are delivering Go Golborne, an innovative 3 year community-based pilot (2015-2018), in a highly diverse and deprived ward in the Royal Borough of Kensington and Chelsea (RBKC), with elevated levels of childhood obesity. CHSS is conducting a 4 year theory-led evaluation of the pilot to assess the effectiveness, feasibility and replicability of this ‘whole place’ multi-stakeholder approach. This presentation details the early findings of an online survey distributed to project partners and interview findings with project partners

Becoming Breastfeeding Friendly Scotland: report

Background: Breastfeeding and the provision of human milk is the most accessible and cost-effective activity available to public health, which is known to prevent a range of infectious and non-communicable diseases (NCDs), specifically gastro-enteritis, childhood obesity, diabetes type 2 and maternal breast cancer[1],[2]. However, global efforts to further improve exclusive breastfeeding rates have had limited success, in part because effective scaling‐up frameworks and roadmaps have not been developed[3]. Breastfeeding rates in Scotland have improved in recent years, with an increase from 44% (2001/2002) to 51% (2017/2018) of babies reportedly receiving 'any breastfeeding' at first health visitor visit at 10-14 days, and the proportion of babies being breastfed at 6-8 weeks rising from 36% of babies (born in 2001/02) to 42% of babies (born in 2017/18)[4] However, the figures remain relatively low and drop off rates high when compared to other countries and recommended targets, with breastfeeding rates lower among women in areas of higher deprivation, exacerbating health inequalities. BBF: The Becoming Breastfeeding Friendly (BBF) toolkit was developed through highly structured technical and academic collaboration, led by Yale University and has been piloted in Mexico and Ghana. In the short term, it provides an evidence-based tool to guide countries in assessing their breastfeeding status and their readiness to scale up. In the long term, it supports countries to identify the concrete measures they can take to sustainably increase breastfeeding rates, based on data-driven recommendations. The BBF Gear Model is made up of eight simultaneous conditions which sustain breastfeeding: the gears. This conceptual model illustrates how each gear must be sufficiently mobilised to turn the next, whilst the central Coordination gear gathers and delivers timely feedback. Using the BBF framework, the BBF Scotland committee has prioritised a set of eight recommendation themes to take forward in order to scale up the protection, promotion and support of breastfeeding in Scotland

Becoming Breastfeeding Friendly in Britain Scaling up Breastfeeding in Wales, Scotland and England

The UK has one of the lowest breastfeeding rates in the world; 80% of babies are breastfed at birth, only 1% are exclusively breastfed by 6 months. Breastfeeding rates are lower among women in areas of higher deprivation, exacerbating health inequalities. The Becoming Breastfeeding Friendly toolkit was developed through highly structured technical and academic collaboration, led by Yale University. It has been piloted in Mexico and Ghana. In the short term, it provides an evidence-based tool to guide countries in assessing their breastfeeding status, and their readiness to scale up; and in the long term, it supports countries to identify the concrete measures they can take to sustainably increase breastfeeding rates, based on data-driven recommendations. Launching BBF GB, breastfeeding experts from Scotland, Wales and England attended the first GB Engagement Committee in December 2017, agreeing to deliver BBF separately in each country to reflect structural and cultural variation. The CHSS team is now supporting three locally developed Country Committees of experts in Scotland, Wales and England to carry out the 5 step meeting process

The implications of the COVID-19 pandemic for the construction of the family affluence scale: findings from 16 countries

The Family Affluence Scale (FAS) is a widely used and validated instrument to measure adolescents’ socioeconomic status (SES). It is plausible that the COVID-19 pandemic and resulting social and economic changes have affected the capacity of the six-item FAS-III to measure adolescent SES, particularly the holiday and computer items. Using data from 247,503 adolescents from 16 European countries participating in the Health Behaviour in School-aged Children (HBSC) study before (2013/14 and 2017/18) and during (2021/22) the pandemic, the present study aims to fill this gap. Findings showed that although the internal consistency of the scale decreased during the pandemic, related to the functioning of the computer and especially the holiday item, it was still acceptable in all countries. Furthermore, measurement invariance analysis showed that during the pandemic the item thresholds of the computer and particularly the holiday item deviated from the thresholds of these items before the pandemic. However, all item factor loadings were comparable to the factor loadings before the pandemic. In addition, during the pandemic the computer and holiday item and their correlations with health-related outcomes were mostly still in the expected direction. Removing these items from the scale yielded comparable or decreased scale criterion validity as compared to the original FAS-III scale in most countries. These findings inform future research that although mean differences in family affluence levels before and during the pandemic should be interpreted with caution, it is a suitable tool to study (changes in) socioeconomic health inequalities among adolescents during the pandemic