Why do interventions work in some places and not others: a breastfeeding support group trial.

In a cluster randomised controlled trial of a policy to provide community breastfeeding support groups in Scotland, breastfeeding rates declined in 3 of 7 intervention localities. From a preliminary study, we expected breastfeeding outcomes to vary and we prospectively used qualitative and quantitative methods to ask why. Ethnographic in-depth interviews, focus groups, observations and survey data were analysed to build seven embedded case studies.

Health professionals, implementation and outcomes: reflections on a complex intervention to improve breastfeeding rates in primary care.

Objectives: To understand why a complex breastfeeding coaching intervention, which offered health professional-facilitated breastfeeding groups for pregnant and breastfeeding mothers and personal peer coaches, was more effective at improving breastfeeding rates in some areas than others.

Methods: This controlled intervention study was designed, implemented and evaluated using principles from action research methodology. We theoretically sampled 14 health professionals with varying levels of involvement and 12 consented to be interviewed.

One-to-one or group-based peer support for breastfeeding? Women's perceptions of a breastfeeding peer coaching intervention.

Background: Studies reporting one-to-one peer support interventions have been successful in some countries with high breastfeeding initiation rates, but less so in Great Britain, where low uptake of peer support has occurred. We conducted a peer coaching intervention study in rural Scotland that improved breastfeeding initiation and duration. This study reports qualitative data about participants' perceptions of the coaching intervention.

Students' views of reflective learning techniques: an efficacy study at a UK medical school.

Objective: To describe the effects of a voluntary intervention using reflective learning techniques on students' learning.

Design: An interventional study with reflective learning techniques offered to medical students.

Setting: Year 3 of undergraduate medicine at Cardiff University where the curriculum is integrated with early clinical contact.

Effectiveness of a breastfeeding peer coaching intervention in rural Scotland.

Background: Breastfeeding initiation in Scotland in 2000 was 63 percent, compared with over 90 percent in Norway and Sweden. Although peer support is effective in improving exclusivity of breastfeeding in countries where over 80 percent of women initiate breastfeeding, the evidence for effectiveness in countries with lower initiation is uncertain. Our primary aim was to assess whether group-based and one-to-one peer breastfeeding coaching improves breastfeeding initiation and duration.

Stigma revisited, disclosure of emotional problems in primary care consultations in Wales.

The nature and effects of stigma have been widely discussed in the context of mental illness, and references to stigma are commonly used to explain a wide array of social processes. For example, it is often claimed that stigmatisation affects aspects of personal identity, that it underpins unjust and discriminatory behaviour, and that it is responsible for a reluctance among members of the lay public to disclose the presence of treatable psychiatric symptoms and problems to health professionals. A widespread reluctance to disclose symptoms of 'emotional problems' to health professionals is in fact well documented.

Working with Bangladeshi patients in Britain: perspectives from Primary Health Care.

Background: The difficulties of ethnic minority communities in accessing appropriate primary care are well documented, but little is known about the experiences of Primary Health Care Teams (PHCTs) serving these communities, or their strategies to help patients overcome these difficulties.

Objective: The purpose of the study was to explore the PHCT perspective of working with Bangladeshi patients.

Methods: Qualitative group discussions with PHCTs were set up by four health centres in the Grangetown area of Cardiff, where a large proportion of the Bangladeshi community lives.

Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care.

Interest in how qualitative health research might be used more widely to inform health policy and medical practice is growing. Synthesising findings from individual qualitative studies may be one method but application of conventional systematic review methodology to qualitative research presents significant philosophical and practical challenges. The aim here was to examine the feasibility of synthesising qualitative research using qualitative methodology including a formative evaluation of criteria for assessing the research to be synthesised.

Patients' opinions of the use of psychiatric case-finding questionnaires in general practice.

Background: The common mental disorders of depression and anxiety often remain undetected in general practice. Psychiatric screening instruments have been recommended to assist detection.

Aim: To assess patients' attitudes towards the use of psychiatric screening questionnaires for common mental disorders within general practice.

Using meta ethnography to synthesise qualitative research: a worked example.

Objectives: To demonstrate the benefits of applying meta ethnography to the synthesis of qualitative research, by means of a worked example.

Methods: Four papers about lay meanings of medicines were arbitrarily chosen. Noblit and Hare's seven-step process for conducting a meta ethnography was employed: getting started; deciding what is relevant to the initial interest; reading the studies; determining how the studies are related; translating the studies into one another; synthesising translations; and expressing the synthesis.

A qualitative study of women's views about how health professionals communicate about infant feeding.

OBJECTIVE: To look at how communication by health professionals about infant feeding is perceived by first time mothers. DESIGN: Qualitative semi-structured interviews early in pregnancy and 6-10 weeks after birth. SUBJECTS AND SETTING: Twenty-one white, low income women expecting their first baby were interviewed mostly at home, often with their partner or a relative.