# Application of the Behaviour Change Wheel to Optimise Infant Feeding in Bangladeshi and Pakistani Communities in the UK: Co‐Development of the Learning About Infant Feeding Together (LIFT) Intervention

## TL;DR

Researchers co-developed a culturally tailored infant feeding intervention for UK Bangladeshi and Pakistani communities to improve breastfeeding rates.

## Contribution

A new culturally appropriate intervention, LIFT, was co-developed using the Behaviour Change Wheel and REPLACE framework for UK South Asian communities.

## Key findings

- Cultural factors significantly influence infant feeding behaviors in UK Bangladeshi and Pakistani communities.
- Co-development with community members is essential for creating effective and culturally sensitive interventions.
- The LIFT intervention includes posters, leaflets, and an animation targeting six key infant feeding behaviors.

## Abstract

Breastfeeding rates in the UK are amongst the lowest in the world, largely driven by individual‐ and social‐level barriers. Evidence has also highlighted that cultural factors can play an important part, such as for the UK South Asian community. Although aggregated breastfeeding data indicates that initiation is high amongst the UK South Asian population, sub‐group data shows that this is substantially lower amongst people of Pakistani and Bangladeshi ethnicity. As such, culturally tailored interventions are called for. This research aimed to systematically develop an evidence‐based culturally tailored intervention to support the optimisation of infant feeding in these communities. The ‘Learning about Infant Feeding Together’ (LIFT) intervention was co‐developed by researchers, six community peer group champions, and a 3rd sector organisation supporting UK South Asian women. Development was guided by the REPLACE approach (a framework for the development of culturally specific community‐based interventions) and the Behaviour Change Wheel (a framework for describing, designing and evaluating behaviour change strategies). It involved three co‐development intervention workshops as part of a rigorous systematic intervention development approach. A culturally tailored intervention incorporating nine behaviour change techniques was produced. The intervention aims to increase breastfeeding by targeting six infant feeding behaviours identified as important, changeable and pertinent to the communities involved. The final intervention includes posters, leaflets, and an animation. The transparent reporting of intervention content and the approach taken to development will support the growth of evidence‐based practice in the field of infant feeding.

This research provides a demonstration of successfully co‐developing a culturally appropriate intervention for infant feeding, following principles of theory‐based frameworks, guided by high quality formative research to elucidate the specific socio‐cultural beliefs impacting infant feeding in the UK Bangladeshi and Pakistani population. Intervention materials were designed to complement face‐to‐face infant feeding support.

There is evidence of culturally driven infant feeding behaviours and barriers to breastfeeding amongst UK Pakistani and Bangladeshi communities.Formative research and co‐development with the target population aids in the development of culturally appropriate and sensitive interventions.The LIFT intervention was rigorously developed following theory‐based behaviour change frameworks (REPLACE approach and the Behaviour Change Wheel) but careful consideration and planning of co‐development work with community members is required.

There is evidence of culturally driven infant feeding behaviours and barriers to breastfeeding amongst UK Pakistani and Bangladeshi communities.

Formative research and co‐development with the target population aids in the development of culturally appropriate and sensitive interventions.

The LIFT intervention was rigorously developed following theory‐based behaviour change frameworks (REPLACE approach and the Behaviour Change Wheel) but careful consideration and planning of co‐development work with community members is required.