Mexico has shown a worrisome decrease in breastfeeding indicators, especially in the lowest socioeconomic level. Improving breastfeeding protection, promotion, and support services through workforce development is a key area of intervention. The objective of this study is to assess the influence on breastfeeding knowledge and abilities of a semi-virtual training for primary healthcare providers assisting beneficiaries of PROSPERA in Mexico, which is one of the largest conditional cash-transfer programs in the world. Two independent cross-sectional samples of healthcare providers were drawn at baseline and post-intervention in three states of Mexico. Baseline data were collected among primary physicians, registered nurses and nurse technicians (i.e. unit of analysis) on July 2016 (n = 529) and post-training between March and April 2017 (n = 211). A 19-item telephone questionnaire assessed providers’ general knowledge about breastfeeding, breastfeeding benefits and clinical aspects of breastfeeding, clinical ability to solve problems and abilities to overcome breastfeeding challenges. The effects of the training were assessed through a propensity score matching (PSM) stratified by types of providers (i.e. physicians, registered nurses, nurse technicians). The PSM analysis showed significant improvements among all providers in the general knowledge about breastfeeding (around 20 percentage points [pp]) and knowledge about breastfeeding benefits (approximately 50 pp). In addition, physicians improved their knowledge about clinical aspects of breastfeeding (7 pp), while registered nurses improved in their ability to solve breastfeeding problems (14 pp) and in helping mothers overcome breastfeeding challenges (12 pp). Promoting a breastfeeding enabling environment in Mexico to improve breastfeeding rates will require improving the knowledge and skills of healthcare providers. While a semi-virtual training showed large improvements in knowledge, developing skills among providers may require a more intensive approach.

中文翻译：

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墨西哥医疗保健提供者可以通过半虚拟培训了解多少有关母乳喂养的知识？倾向得分匹配分析。

墨西哥的母乳喂养指标下降令人担忧，尤其是在社会经济水平最低的地区。通过劳动力发展改善母乳喂养保护、促进和支持服务是干预的一个关键领域。本研究的目的是评估初级医疗保健提供者的半虚拟培训对帮助墨西哥 PROSPERA 受益人的母乳喂养知识和能力的影响，该培训是世界上最大的有条件现金转移计划之一。在墨西哥三个州的基线和干预后抽取了两个独立的医疗保健提供者横断面样本。基线数据是在 2016 年 7 月（n = 529）和 2017 年 3 月至 4 月的培训后（n = 211）的初级医师、注册护士和护士技师（即分析单位）中收集的。一份 19 项电话问卷评估了提供者对母乳喂养的一般知识、母乳喂养的好处和母乳喂养的临床方面、解决问题的临床能力以及克服母乳喂养挑战的能力。通过按提供者类型（即医生、注册护士、技术护士）分层的倾向评分匹配 (PSM) 评估培训效果。PSM 分析显示，所有提供者在母乳喂养的一般知识（约 20 个百分点 [pp]）和母乳喂养益处的知识（约 50 pp）方面都有显着改善。此外，医生提高了他们对母乳喂养临床方面的知识（7 页），而注册护士在解决母乳喂养问题（14 pp）和帮助母亲克服母乳喂养挑战（12 pp）方面的能力有所提高。在墨西哥促进母乳喂养有利环境以提高母乳喂养率需要提高医疗保健提供者的知识和技能。虽然半虚拟培训显示知识有了很大的提高，但在提供者之间发展技能可能需要更深入的方法。