@article{singletary_farooqi_2024, title={Beliefs, Experiences, and Practices of Lady Health Workers in Facilitating Breastfeeding in Rural Communities in Pakistan}, ISSN={["1552-7557"]}, DOI={10.1177/10497323241242640}, abstractNote={Pakistan has extremely poor breastfeeding indicators: fewer than half of infants under 6 months are exclusively breastfed, only 20% of infants are breastfed within the first hour of life, and nearly half are never fed colostrum. The country’s high infant morbidity and mortality is in part due to this suboptimal infant feeding. A network of lady health workers (LHWs) employed by the government facilitate maternal and child health programs, including breastfeeding support in their communities. This study describes LHWs’ perspectives and experiences regarding breastfeeding. We conducted semi-structured interviews with 14 LHWs and used thematic qualitative analysis to code and analyze the data. Our research revealed that LHWs use their role as members of the community and involve influential members of the family to build trust. Frequent home visits beginning prenatally help them address misconceptions about infant feeding. While they have strong knowledge about the benefits of breastfeeding and the importance of colostrum, they demonstrate gaps in their knowledge regarding breast conditions, the safe preparation of human milk substitutes, the physiology of milk production, and supporting mothers who are separated from their baby. Future training should address these areas where LHWs lack knowledge to help mothers facilitate early and exclusive breastfeeding. With adequate training, LHWs are uniquely positioned to use their role as trusted members of the community to effectively counsel families on the importance of breastfeeding and support the clinical needs of women during the perinatal time.}, journal={QUALITATIVE HEALTH RESEARCH}, author={Singletary, Nicola and Farooqi, Zoha Waqar}, year={2024}, month={Jun} }
 @article{singletary_sanchez_spencer_fogleman_chetwynd_2023, title={Immersive Videos Improve Student Self-Efficacy in Clinical Lactation}, volume={32}, ISSN={["1548-8519"]}, DOI={10.1891/JPE-2022-0013}, abstractNote={The current study examined the use of immersive technology as a way to improve access to high-quality interpersonal breastfeeding interactions in an undergraduate clinical lactation course. In particular, we investigated the impact of immersive consultation videos and related activities on student self-efficacy, motivational beliefs, and perceived skill level. Results indicate that usability was high, with participants rating videos, interactives, and activities positively. Students did report a significant increase in self-efficacy and their perceived ability to meet the course learning objectives; no significant changes in the level of interest or perceived skill were found. Our results demonstrate that high-quality immersive videos can be an important learning tool for teaching clinical skills when access to direct patient care is limited or absent.}, number={3}, journal={JOURNAL OF PERINATAL EDUCATION}, author={Singletary, Nicola and Sanchez, Rebecca and Spencer, Dan and Fogleman, April Danielle and Chetwynd, Ellen}, year={2023}, pages={162–174} }
 @article{singletary_bruce_goodell_fogleman_2022, title={A qualitative study exploring teachers' beliefs regarding breastfeeding education in family and consumer sciences classrooms}, volume={17}, ISSN={["1746-4358"]}, DOI={10.1186/s13006-022-00510-8}, abstractNote={AbstractBackgroundResearch shows that elementary and secondary school children have considered infant feeding choices for when they become parents and are interested in learning about breastfeeding in school. Despite recommendations to include infant feeding education in secondary school classrooms, teachers’ practices and attitudes regarding this topic have been the subject of minimal research. The purpose of this study was to explore North Carolina, USA, family and consumer sciences teachers’ infant feeding education practices and their views on incorporating breastfeeding education in the curricula of family and consumer sciences classes that cover topics related to parenting and nutrition.MethodsThe study used a purposive sample of 19 teachers who participated in semi-structured qualitative telephone interviews exploring their attitudes and practices relating to infant feeding education. We transcribed and analyzed the interviews using the constant comparative method through the lens of the Theory of Planned Behavior by examining the participants’ attitudes, subjective norms, and perceived behavioral controls.ResultsTeachers had predominantly positive attitudes towards the inclusion of breastfeeding education in high school parenting, child development, and nutrition courses, citing the need to normalize breastfeeding and support students’ ability to make informed choices when they become parents. Teachers’ subjective norms included concerns about parents’ and administrators’ views on the appropriateness of the content and apprehension about negative student responses. Perceived behavioral controls included student maturity, teachers’ own experiences and comfort with infant feeding, and the view that curriculum guidelines limit content selection.ConclusionsThe results of this study can be used in the development and implementation of secondary school education programs that increase knowledge about infant feeding and positive attitudes towards breastfeeding for all members of the community. Teachers’ concerns need to be addressed in the implementation of these programs.}, number={1}, journal={INTERNATIONAL BREASTFEEDING JOURNAL}, author={Singletary, Nicola and Bruce, Jackie and Goodell, L. Suzanne and Fogleman, April}, year={2022}, month={Sep} }
 @article{singletary_goodell_fogleman_2020, title={Exploring North Carolina Family and Consumer Sciences Teachers' Attitudes Towards Breastfeeding and Infant Feeding Education Practices}, volume={36}, ISSN={["1552-5732"]}, DOI={10.1177/0890334419867104}, abstractNote={Background The World Health Organization (WHO) and the United Kingdom Committee for UNICEF recommend that secondary schools include infant feeding education in the curriculum. However, little attention has been given to the study of educators’ views and practices regarding infant feeding education. Aims The aims of this research were to (1) explore North Carolina Family and Consumer Sciences teachers’ attitudes towards infant feeding education in secondary schools and (2) describe North Carolina Family and Consumer Sciences teachers’ infant feeding education practices. Methods Researchers conducted interviews ( N = 19) and a survey ( N = 137) using a sequential mixed methods design. The constant comparative method was used to analyze interview transcripts. Subsequently, a 33-item survey was developed to assess teachers’ attitudes and practices, and this survey was tested for validity and reliability. Results The majority of participants supported including infant feeding ( n = 119, 86.9%) and breastfeeding ( n = 116, 84.7%) education in high school. Approximately half of the participants supported including infant feeding ( n = 71, 51.9%) and breastfeeding ( n = 64, 46.7%) education in middle school. Participants reported that they taught infant feeding at both levels; topics taught included complementary foods, patterns of infant feeding, and the safe preparation of infant formula. Breastfeeding content was covered primarily in the high school Parenting and Child Development course. Conclusions North Carolina Family and Consumer Sciences teachers have positive attitudes towards teaching about breastfeeding at the secondary school level. Content about infant nutrition and breastfeeding is currently included in courses that cover child development and human nutrition. }, number={4}, journal={JOURNAL OF HUMAN LACTATION}, author={Singletary, Nicola and Goodell, L. Suzanne and Fogleman, April}, year={2020}, month={Nov}, pages={766–775} }
 @misc{singletary_chetwynd_goodell_fogleman_2017, title={Stakeholder views of breastfeeding education in schools: a systematic mixed studies review of the literature}, volume={12}, ISSN={["1746-4358"]}, DOI={10.1186/s13006-017-0106-0}, abstractNote={Breastfeeding provides numerous health benefits for mothers and infants, but worldwide breastfeeding rates fall below recommendations. As part of efforts to increase breastfeeding initiation and duration, the World Health Organization and UNICEF UK recommend educational interventions to increase awareness and positive attitudes towards breastfeeding beginning during the school years. Breastfeeding education in the school setting offers the opportunity to improve the knowledge base, address misconceptions, and positively influence beliefs and attitudes for students from a wide range of socioeconomic and cultural backgrounds. The purpose of this paper is to present a comprehensive narrative review of the literature regarding student and teacher (stakeholder) views of breastfeeding and breastfeeding education programs in schools to inform future research in the area. Articles were located through a systematic search of online databases and journals using the following keywords in various combinations: (1) breastfeeding, lactation, breast-feeding, "bottle feeding", "infant feeding" (2) student, educator, teacher, "school administrator" and (3) schools, "secondary education", "primary education", "K-12", "high school", "middle school", "elementary school", education, adolescents, curriculum, and a manual search of article references. Studies were screened for inclusion against specific criteria and included papers were assessed using the Mixed Methods Appraisal Tool (MMAT). This review suggests that adolescents have a deficit in breastfeeding knowledge and express negative conceptions about breastfeeding. Breastfeeding is being discussed in some school environments, but the extent of lessons and the specific messages that teachers communicate have not been explored. Students appear to be interested in receiving more information about breastfeeding, especially if delivered by health professionals or breastfeeding mothers. The majority of teachers are supportive of incorporating breastfeeding education in family and consumer sciences, sexual education, and health classes; however, time constraints and limited knowledge of infant feeding recommendations may be barriers to implementation of appropriate lesson plans. Students generally support and are receptive to breastfeeding education; however, research on educator attitudes, knowledge, and experiences are necessary for appropriate implementation of breastfeeding education in varying school settings around the world.}, journal={INTERNATIONAL BREASTFEEDING JOURNAL}, author={Singletary, Nicola and Chetwynd, Ellen and Goodell, L. Suzanne and Fogleman, April}, year={2017}, month={Mar} }