Beth Halfyard

Newfoundland and Labrador Centre for Health Information, St. John's, Newfoundland and Labrador, Canada

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Publications (4)12.51 Total impact

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    ABSTRACT: Abstract BACKGROUND: Maternal attitudes to infant feeding are predictive of intent and initiation of breastfeeding. OBJECTIVES: The Iowa Infant Feeding Attitude Scale (IIFAS) has not been validated in the Canadian population. This study was conducted in Newfoundland and Labrador, a Canadian province with low breastfeeding rates. Objectives were to assess the reliability and validity of the IIFAS in expectant mothers; to compare attitudes to infant feeding in urban and rural areas; and to examine whether attitudes are associated with intent to breastfeed. METHODS: The IIFAS assessment tool was administered to 793 pregnant women. Differences in the total IIFAS scores were compared between urban and rural areas. Reliability and validity analysis was conducted on the IIFAS. The receiver operating characteristic (ROC) of the IIFAS was assessed against mother's intent to breastfeed. RESULTS: The mean ± SD of the total IIFAS score of the overall sample was 64.0 ± 10.4. There were no significant differences in attitudes between urban (63.9 ± 10.5) and rural (64.4 ± 9.9) populations. There were significant differences in total IIFAS scores between women who intend to breastfeed (67.3 ± 8.3) and those who do not (51.6 ± 7.7), regardless of population region. The high value of the area under the curve (AUC) of the ROC (AUC = 0.92) demonstrates excellent ability of the IIFAS to predict intent to breastfeed. The internal consistency of the IIFAS was strong, with a Cronbach's alpha greater than .80 in the overall sample. CONCLUSION: The IIFAS examined in this provincial population provides a valid and reliable assessment of maternal attitudes toward infant feeding. This tool could be used to identify mothers less likely to breastfeed and to inform health promotion programs.
    Journal of Human Lactation 11/2014; · 1.64 Impact Factor
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    ABSTRACT: Breastfeeding has numerous health benefits. In 2010, the province of Newfoundland and Labrador had the lowest breastfeeding initiation rate (64.0%) in Canada. Formula feeding is associated with well-known health risks. Exclusive formula feeding is the "cultural norm" in some regions of the province. Women appear resistant to changing their infant feeding behaviors and remain committed to their decision to formula-feed. The primary aim of this qualitative study was to examine individual factors that shaped mothers' decisions to formula-feed their infants. Nineteen mothers who were currently formula feeding their children participated in the study. Qualitative research in the form of focus groups was conducted in three communities in the province in 2010. A thematic content analysis identified the main themes that influenced mothers' decisions to formula-feed their infants. The main themes included issues concerning the support needed to breastfeed, the convenience associated with formula feeding, and the embarrassment surrounding breastfeeding in public. These findings help to better understand why mothers choose formula feeding over breastfeeding and may help to inform the development of public health interventions targeted at this population of mothers.
    BMC Public Health 07/2013; 13(1):645. · 2.08 Impact Factor
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    ABSTRACT: The beneficial health effects associated with Universal Salt Iodization are well known. Yet, little is known about the possible adverse health effects in people with high iodine intake and the safe daily intake upper limit in the Chinese population. The objective of this study was to explore the safe upper level of total daily iodine intake among adults in China. A 4-wk, double-blind, placebo-controlled, randomized controlled trial was conducted in 256 euthyroid adults. Participants were randomly assigned to 12 intervention groups with various iodine supplement doses ranging from 0 to 2000 μg/d. Total iodine intake included iodine from both supplements and diet. Multiple outcome measures were used to evaluate possible adverse effects, including thyroid function, thyroid size, and urinary iodine. The mean iodine intake from the diets and salt intake of the participants were 105 ± 25 and 258 ± 101 μg/d, respectively. In comparison with the placebo group, all iodide-supplemented groups responded with significant increases in median urinary iodine concentrations (P < 0.05) and in thyroid-stimulating hormone concentration (P < 0.05). Thyroid volume decreased after 4 wk in the high-iodine intervention groups (1500-2000 μg). Subclinical hypothyroidism appeared in the groups that received 400 μg I (5%) and 500-2000 μg I (15-47%). This study showed that subclinical hypothyroidism appeared in the participants who took the 400-μg I supplement, which provided a total iodine intake of ∼800 μg/d. Thus, we caution against a total daily iodine intake that exceeds 800 μg/d in China and recommend further research to determine a safe daily upper limit.
    American Journal of Clinical Nutrition 12/2011; 95(2):367-73. · 6.50 Impact Factor
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    ABSTRACT: The Illness Intrusiveness Ratings Scale (IIRS) measures illness-induced disruptions to 13 different aspects of lifestyles, activities, and interests. A stable three-factor structure has been well documented in studies conducted in Western countries. However, in Asia, the general validity of this scale has not been examined. This study investigated the factor structure of the Chinese version of the IIRS in 641 inpatients at a Chinese hospital for cancer patients. The European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was also administered and compared with the IIRS. Exploratory principal component analysis identified a two-factor structure, "health and living" and "relationships and personal development", which accounted for 58.65% of the total variance. A "goodness-of-fit" test supported a two-factor solution (P=.070). The IIRS was significantly correlated with scores of every scale in the EORTC QLQ-C30. These findings support the validity of the Chinese version of the IIRS but did not support a cross-cultural equivalence of the factor structure. This study was only performed in hospitalized cancer patients; therefore, further evaluation involving patients with other diseases is warranted.
    Journal of psychosomatic research 01/2011; 70(1):67-72. · 2.91 Impact Factor
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    ABSTRACT: Newfoundland and Labrador (NL) has the highest incidence rate of both colorectal cancer (CRC) and smoking prevalence in Canada. The objective of this study was to examine if CRC is associated with smoking in this population. Newly diagnosed cases identified between 1999 and 2003 were frequency-matched by 5-year age group and sex with controls selected from the residents of NL through random digit dialing. A total of 702 cases and 717 controls consented to participate in the study and completed a set of self-administered questionnaires. Measures of tobacco use included type of tobacco, age of initiation of smoking, years of smoking, years since started smoking, number of cigarettes smoked daily, pack years, and years since abstention from smoking. Odds ratios were estimated using multivariate logistic regression. In comparison with non-smokers, former and current smokers were at a significantly elevated risk of CRC with corresponding odds ratios of 1.36 and 1.96. The risk significantly increased with cigarette smoking years, the amount of cigarettes smoked daily, and cigarette pack years. The risk significantly decreased with years of abstention from smoking cigarettes. This association was stronger among drinkers and in men. In addition, this effect was observed to be slightly stronger for rectum than colon cancer. In summary, cigarette smoking increased the risk of CRC in the NL population. The risk of CRC associated with cigarette smoking varies by sex, drinking status, and site of CRC.
    Canadian journal of public health. Revue canadienne de santé publique 101(4):281-9. · 1.02 Impact Factor

Publication Stats

16 Citations
12.51 Total Impact Points


  • 2013
    • Newfoundland and Labrador Centre for Health Information
      St. John's, Newfoundland and Labrador, Canada
  • 2011
    • Memorial University of Newfoundland
      • Division of Community Health and Humanities
      St. John's, Newfoundland and Labrador, Canada