Early Abstract:
Introduction: Breastfeeding has significant lifelong health benefits for mother and child that influences population health. Geographical spread, and distance to health services can impact access to in-person lactation consultant services for women living in country Australia. Little is known about the acceptance of using telehealth to deliver lactation support to women living rural and remote. The aim of this study was to investigate stakeholder perspectives of using telehealth to access or provide lactation consultant services through the Western Australian Country Health Service (WACHS) Lactation Consultant Telehealth Service (LCTS) and to explore the economic impact of using telehealth for clinical service delivery.
Methods: A two phased exploratory cross-sectional study with two key stakeholder groups; consumers who accessed the LCTS and clinicians referring to and delivering the service. Phase one involved an online survey, Phase Two involved short semi-structured interviews. Quantitative data were analysed using descriptive and inferential statistics. Qualitative data were analysed using inductive thematic analysis.
Results: A total of n=57 consumers responded to the survey. The majority (89.5%) reported they received the support and information they required, 89% said they would access the LCTS again and over a third (39.3%) felt that they would not have continued breastfeeding if they didn’t have access to the LCTS. Over three-quarters of respondents felt that the service enabled them to breastfeed their child for longer (78.9%). The mean estimated saving per woman using this LCTS was $168. There were n=24 clinician survey responses; all felt that the service was a good option for women living in remote regions and most (94.5%) felt they were able to help women by using the LCTS however; 76.5% thought that a service delivered face-to-face would be more effective. Most agreed that the LCTS was better than no service at all but there was an expressed need for hybrid models. From the survey and interview qualitative data, two key themes were identified (1. Clinical service delivery and 2. Service logistics and sustainability) and eight corresponding subthemes.
Conclusions: The WACHS LCTS was able to meet the needs of majority of the regional, rural and remote women seeking support, and enabled women to breastfeed for longer. Findings have utility for service providers, policy makers and health leaders providing new evidence of the benefits of LCTS in the largest (area) health service in the world. Limitations and gaps in evidence are highlighted with recommendations for further inquiry.
Keywords: antenatal, breastfeeding, clinical support, country, lactation consultant, midwife, postnatal, rural and remote, telehealth.
