Ms Heather Trickey
Telephone:+44 (0)29 208 79609
Address:1-3 Museum Place
- PhD (Current), 'Ecological and systems approaches to infant feeding policy', Funding: MRC NCT DECIPHer Studentship, DECIPHer, Social Sciences, Cardiff University
- (DipHE) Breastfeeding Counselling (Current), University of Worcester
- MSc Environmental Epidemiology and Policy, London School of Hygiene and Tropical Medicine (1994)
- BSc Geography, Bristol University (1992)
- Ecological and systems approaches within public health
- Infant feeding: experiences, policy, intervention
- Policy evaluation and the research-policy interface
- Design and evaluation of complex interventions
- Participatory research methods
Over recent decades mothers’ decisions about feeding their babies have been framed as an area of public health concern. Increased scientific consensus around evidence for poorer health outcomes associated with formula feeding have led to a national and international policy drive to improve breastfeeding prevalence rates, with a global recommendation of exclusive breastfeeding to around six months with continued breastfeeding to up to two years and beyond. Over the same time period public health interventions have been increasingly informed by socio-ecological theory and, more recently, by complex systems theory – both of which emphasise wider context for decision-making and multiple influences on behaviour, shifting the focus on intervention away from individuals as isolated targets for change.
In Wales, a multi-faceted breastfeeding strategy, which was intended to influence the context for infant feeding decisions within different settings and to address social polarisation in feeding behaviours, has been in place since 2001. Despite this, whilst breastfeeding initiation rates have increased, so far there has been limited impact on breastfeeding continuation rates, and in less affluent communities where there is as yet no evidence of a shift towards a culture in which breastfeeding beyond the early days is normalised. Furthermore, mothers frequently feel pressured over their feeding decisions whether they breastfeed, or use formula milk, or both.
This PhD research draws on ecological thinking and concepts relating to complex adaptive systems to explore current policy challenges and to identify barriers and facilitators to effective and acceptable intervention beyond the health service. The research will modify, exemplify and develop complexity theory; linking macro-level understanding of social processes, mechanisms and policy goals to the experiences and behaviour of individuals within a case study area. The methodology is an embedded case-study. The experiences of breastfeeding peer supporters living within a low income community with traditionally low breastfeeding rates are contextualised within local social-ecology and an over-arching social policy context. Data is collected through observation and via focused interviews with peer supporters, with local , regional and national level policy and practitioner leads. Findings are generated through reflexive linking of data gathered from breastfeeding peer supporters to a wider analysis of structuring forces operating at different ecological levels.
DR Sally Holland, Dept. Social Sciences, Cardiff University
Dr Julia Sanders, South-East Wales Trials Unit, Cardiff University
Prof Laurence Moore, Glasgow University