{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:20:20Z","timestamp":1780374020648,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","award":["HKU\u2010BF"],"award-info":[{"award-number":["HKU\u2010BF"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of the study was to investigate the impact of the use of baby\u2010friendly community initiative (BFCI) model on various stakeholders in the community.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Quasi\u2010experimental research design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      The study was conducted in public premises and online workshops from April 2019 to September 2022. Participants were followed up for a period of 1\u2009month, except for those employed at public premises. The program involved training based on an accredited BFCI framework to cultivate a breastfeeding\u2010friendly attitude and knowledge. A paired sample\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test was used to examine breastfeeding attitude and knowledge scores before and after BFCI training among staff employed from public premises. An analysis of variance was conducted to examine the breastfeeding self\u2010efficacy and attitude scores, measured repeatedly at different timepoints over 1\u2010month timepoint (T0, T1 and T2) among pregnant and postpartum women.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 2340 perinatal women and 1339 staff from public premises were recruited. For staff, there was an increase in the mean score of breastfeeding knowledge and attitude by 5.8 and 6.1, respectively, at T1. Similarly, for perinatal women, there was an increase in the mean score of breastfeeding self\u2010efficacy and attitude by 6.6 and 3.3, respectively, at T1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In summary, a BFCI model, with active community participation, accreditation and an award system, has been effective in promoting breastfeeding. Adapting the baby\u2010friendly hospital initiative to local contexts and employing a social theory model can enhance breastfeeding promotion and improve infant health outcomes. Prioritizing culturally sensitive breastfeeding education is crucial for successful BFCI implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the profession and\/or patient care<\/jats:title>\n                    <jats:p>Healthcare professionals should consider clients' culture and socio\u2010economic backgrounds when providing breastfeeding education to maximize effectiveness. The target audience for breastfeeding education should be expanded to include various community stakeholders beyond families.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:italic>What problem did the study address?<\/jats:italic>\n                      This study addressed the problem of knowledge gaps among stakeholders in building a breastfeeding\u2010friendly community, particularly in implementing a baby\u2010friendly community initiative (BFCI) as part of a baby\u2010friendly hospital initiative (BFHI). The research filled a service gap by providing effective interventions targeting community stakeholders and assessing the impact of a BFCI program on their knowledge and attitudes towards breastfeeding.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>What were the main findings?<\/jats:italic>\n                      The findings highlighted the effectiveness of a BFCI program in enhancing breastfeeding knowledge and attitudes among frontline staff and increasing breastfeeding confidence among mothers. These findings contribute to the understanding of the program's impact on different stakeholders in the community.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>Where and on whom will the research have an impact?<\/jats:italic>\n                      It impacts on global policymakers by providing insights for developing comprehensive guidelines for future BFCI implementations. It also contributes to the creation of a more baby\u2010friendly community, benefiting breastfeeding families and their infants by promoting and supporting breastfeeding families.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>This study has adhered to relevant EQUATOR guidelines using the TREND reporting guideline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What Does This Paper Contribute to the Wider Global Clinical Community?<\/jats:title>\n                    <jats:p>This study provides an overview of the establishment of a localized BFCI program. It also opens up a new direction for the community to investigate BFCI strategies for community stakeholders. It also provides evidence to support other countries in following a similar process, as each country approaches becoming breastfeeding\u2010friendly in its own unique way.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial and Protocol Registration<\/jats:title>\n                    <jats:p>No protocol.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.16267","type":"journal-article","created":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T00:49:19Z","timestamp":1718412559000},"page":"7040-7051","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Building a baby\u2010friendly community: Development, strategy, implementation and evaluation of a\n                    <scp>BFCI<\/scp>\n                    program"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3227-0799","authenticated-orcid":false,"given":"Kris Yuet Wan","family":"Lok","sequence":"first","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine University of Hong Kong  Pokfulam Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi Sze Lok","family":"Fan","sequence":"additional","affiliation":[{"name":"School of Nursing, Faculty of Health and Social Development The University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0735-2258","authenticated-orcid":false,"given":"Hoi Lam","family":"Ip","sequence":"additional","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine University of Hong Kong  Pokfulam Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily T. 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