Background Breastfeeding peer support is advocated in national and international guidelines, but the evidence base is mixed. In the UK, breastfeeding peer support was found to be ineffective in randomised controlled trials, while women report positive impacts on breastfeeding experiences in qualitative studies. A key criticism levied against breastfeeding peer support is the lack of theory underpinning intervention design. Here we use the Behaviour Change Wheel to structure the analysis of evaluation data from an infant feeding peer support service in one area in North West England. We aimed to provide theoretically informed insights into how peer support can be operationalised to influence women's breastfeeding experiences. Methods A 2 year mixed-methods evaluation (2014-2016) comprised surveys and interviews (individual or group) with peer supporters, health and community professionals, project leads and women, and routinely collected infant feeding data. We used the three layers (policies, intervention functions and behaviour-related components) of the Behaviour Change Wheel to structure and interpret the data. Results Overall data comprised 23 interviews (n = 14 - individual; n = 9 - group) and 409 completed surveys. The findings are presented in three sections. First, the 'policies' (outer) layer of the Behaviour Change Wheel provides insights into the existing context, infrastructure and resources that underpinned peer support delivery. Then the second (intervention functions) and inner (behaviour components) layers of the Behaviour Change Wheel are used to present three themes, 'developing capabilities for infant feeding', 'motivating guidance and support' and 'opportunities for support'. These findings highlight that a peer support service delivered in a context of effective interdisciplinary partnerships, Baby Friendly Initiative accreditation, and flexible service planning, with peer support provided via different types of instrumental, social, practical and emotional support was perceived to be highly beneficial on women's breastfeeding experiences. In the final section key challenges faced by the service are outlined. Conclusion While gaps and areas for development were highlighted, the service enhanced women's capabilities, motivations and opportunities for breastfeeding. These theoretically informed insights into an organic and responsive peer support service help build the evidence base for breastfeeding peer support and to identify positive delivery features for future testing.

中文翻译：

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使用行为改变轮来探索婴儿喂养同伴的支持；来自英国西北部评估的见解。

背景技术在国家和国际准则中都提倡母乳喂养同伴的支持，但是证据基础参差不齐。在英国，在随机对照试验中发现母乳喂养的同伴支持无效，而妇女在定性研究中报告了对母乳喂养经历的积极影响。反对母乳喂养同伴支持的主要批评是缺乏干预设计的理论基础。在这里，我们使用行为改变轮来构建英格兰西北部一个地区的婴儿喂养同伴支持服务的评估数据分析。我们旨在提供理论上的见解，以了解如何发挥同伴支持以影响女性的母乳喂养经历。方法进行为期2年的混合方法评估（2014-2016年），包括对同龄支持者，卫生和社区专业人员，项目负责人和妇女的调查和访谈（个人或小组），并定期收集婴儿喂养数据。我们使用了“行为改变轮”的三个层（策略，干预功能和与行为相关的组件）来构造和解释数据。结果总体数据包括23项访谈（n = 14-个人； n = 9-小组）和409个完成的调查。研究结果分为三个部分。首先，“行为改变轮”的“政策”（外部）层提供了对支持对等支持交付的现有上下文，基础架构和资源的见解。然后，行为改变轮的第二层（干预功能）和内部层（行为组件）用于呈现三个主题，“发展婴儿喂养的能力”，“激励指导和支持”以及“支持机会”。这些发现强调，在有效的跨学科合作伙伴关系，婴儿友好计划认证和灵活的服务计划的背景下提供的同伴支持服务，通过不同类型的工具，社会，实践和情感支持提供的同伴支持被认为对妇女的母乳喂养经历。在最后一节中，概述了服务所面临的主要挑战。结论虽然强调了差距和发展领域，但该服务增强了妇女的能力，母乳喂养的动机和机会。这些从理论上获得的对有机且响应迅速的同伴支持服务的见解，有助于为母乳喂养同伴支持建立证据基础，并为以后的测试确定积极的交付功能。