Application of the Extended Theory of Planned Behavior to Predict Exclusive Breastfeeding Intention, In Pregnant Nulliparous Women. A Cross-Sectional Study (original) (raw)
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Journal of Research and Health, 2024
Background: Breastfeeding is one of the most effective ways to ensure a child's health. This study investigated the effect of an extended theory of planned behavior (TPB) on exclusive breastfeeding (EBF). Methods: In this randomized educational trial, 132 pregnant women were divided into two intervention groups and one control group using a multi-stage random clustering method. The first intervention group received interventions based on the TPB. In the extended theory group, interventions to promote breastfeeding self-efficacy and social support for breastfeeding were also provided. In order to collect information, the constructs of the planned behavior questionnaire, Dennis's breastfeeding self-efficacy questionnaire and boateng's breastfeeding social support questionnaire were used, all of which have confirmed validity and reliability. Data were analyzed using the paired t-test, analysis of covariance, one-way analysis of variance, and chi-square and Bonferroni tests. Results: All the constructs of the TPB in both groups improved after the intervention (P<0.05). The results also showed that although the breastfeeding self-efficacy score was improved in the extended group (0.009), the three groups did not show significant differences in this regard (P=0.241). Although the social support score improved in the extended group, this difference was not statistically significant (P=0.145). The analysis of variance revealed that the scores for intention and behavior had significant differences among the three groups (P=0.0001). However, the post hoc Bonferroni test showed no significant difference between the two intervention groups (P>0.05). Conclusion: This study showed that the constructs of both the TPB and the extended TPB could effectively promote EBF behavior. It appears that combining the use of planned behavior theory constructs with social support structures and breastfeeding self-efficacy can be effective in promoting breastfeeding behavior.
International Journal of Pediatrics, 2017
BackgroundAlthough exclusive breastfeeding (EBF) is highly emphasized by the experts, nulliparous women do not adhere to this behavior at a desirable level. Since it seems that mothers’ beliefs and values play an important role in their adherence to these behaviors, the present study, aimed to perform a careful analysis of the behavior and evaluation of factors associated with the EBF in nulliparous women referring to healthcare centers in Bushehr using theory of planned behavior.Materials and Methods This is a cross-sectional study, which was conducted on 400 nulliparous mothers with children less than six-months who referred to healthcare centers in Bushehr, Iran. Stratified random-sample was used and data were collected using a researcher-made questionnaire and were later analyzed using statistical tests, including Pearson, Spearman, linear regression and logistic regression in SPSS version 22.0 Software.ResultsThe results showed that 62.5% of infants were exclusively breast-fed....
Caspian Journal of Health Research, 2022
Background: One of the most important ways to improve neonatal health is Exclusive Breastfeeding (EBF). Objective: In this study, the determinants of EBF intention were investigated through Structural Equation Modeling (SEM) in nulliparous pregnant women. Materials & Methods: This cross-sectional study was conducted among 249 pregnant women in Kerman in 2020. Data was collected using a questionnaire, including, questions related to knowledge, attitude, self-efficacy, and the intention of EBF. SEM in Amos statistical software version 20 was used to examine the relationships between the studied variables. Results: The mean age of participants was 26.98±6.16 years and the majority of them were housewife. There was significant correlation between the intention of EBF and self-efficacy (r=0.597, P<0.001) knowledge (r=0.337, P<0.001) and attitude (r=0.344, P<0.001). Breastfeeding self-efficacy was the strongest predictor of intention to EBF (β=0.352, P<0.001). Conclusion: This...
Psychology and …, 2008
This study employed the theory of planned behaviour (TPB) and additional variables (descriptive norm, moral norm, self-identity) to investigate the factors underlying breastfeeding intention and subsequent breastfeeding at four time points (during hospital stay, at hospital discharge, 10 days postpartum, and six weeks postpartum) in a sample of women selected from defined areas of economic hardship (N = 248). A model containing the TPB, additional variables and demographic factors provided a good prediction of both intention (R 2 = .72; attitude, perceived behavioural control, moral norm and self-identity significant predictors) and behaviour -breastfeeding at birth (88.6% correctly classified; household deprivation, intention, attitude significant), at discharge from hospital (87.3% correctly classified; intention, attitude significant), 10 days after discharge (83.1% correctly classified; education, intention, attitude, descriptive norm significant), and 6 weeks after discharge (78.0% correctly classified; age, household deprivation, ethnicity, moral norm significant).
Analysis of selected determinants of intention to breastfeed
Central European Journal of Nursing and Midwifery
Aim: Breastfeeding and consumption of breast milk positively affect the health of children and mothers. The goal of this research was an analysis of intention to breastfeed in pregnant women and the impact of selected factors on intention to breastfeed. Design: Cross – sectional study. Methods: Research was conducted involving 176 women in the 5th– 9th month of pregnancy. We analyzed their intention to breastfeed using the Infant Feeding Intentions Scale (IFI). Among the analyzed factors we included: socio-demographic variables, smoking during pregnancy, women’s attitudes to breastfeeding, and the body image of pregnant women (the Body Image States Scale – BISS). Results: The intention to breastfeed in pregnant women was very high (M = 13.15; SD = 2.6). In the 1st month after birth, 85.2% of women plan to breastfeed to the fullest extent, falling to 77.2% in the 3rd month, and 62.5% in the 6th month. Variables included in linear regression explain 30% of the variation in intention t...
2021
Background The Theory of Planned Behavior (TPB) has guided the investigation of breastfeeding since the 1980’s, incorporating the major constructs of attitudes, subjective norms/normative beliefs, perceived behavioral control, and intentions. The purpose of this research study was to define a TPB-based structural latent variable model so as to explain variance in breastfeeding intentions and behaviors among a cohort of Midwest breastfeeding mothers. Methods The longitudinal descriptive study utilized questionnaire data collected from a convenience sample of 100 women with low-risk pregnancies with the intention to breastfeed at three separate time points (> 30 weeks antepartum, 10 and 60 days postpartum). Data were coded and analyzed using IBM SPSS, SAS and the lavaan package in R. Results Participants were predominantly White (94%, n=94), married (95%, n=95), college-educated (96%, n=96), and had previous breastfeeding experience (75%, n=75). The majority gave birth vaginally (7...
Initiation and continuation of breastfeeding: theory of planned behaviour
Journal of Advanced Nursing, 2005
Aims. This paper reports a study investigating new mothers’ subjective norms in relation to both breast‐ and bottle‐feeding. The influence of norms on women's infant feeding decisions and the relative influence of social referents at varying degrees of social distance were assessed.Background. Increasing breastfeeding initiation and continuation rates is a key challenge for health educators. The perceived influence of other people's views (subjective norms), including the views of women's partners and health care professionals, is an important predictor of infant feeding behaviour.Methods. Semi‐structured questionnaires were administered to 203 new mothers in central and northern Scotland and followed‐up by postal questionnaire at 6 weeks. Infant feeding intentions, feeding behaviour at birth and follow‐up, behavioural beliefs and subjective norms for both breastfeeding and bottle‐feeding were assessed. The data were collected in 1998–1999.Results. Subjective norms w...
Exclusive Breastfeeding Intention among Pregnant Mothers
Kesmas: National Public Health Journal
Exclusive breastfeeding intention is a mother’s intention to provide her baby only breast milk since the infant was born until at the age of 6 months. Intention in prenatal period is the direct affirmation of exclusive breastfeeding. This study aimed to find out the most dominant factor related to exclusive breastfeeding intention among pregnant women at a mother and child hospital in South Tangerang. A cross-sectional study design was conducted primarily. The samples were 143 pregnant women on their third semester pregnancy selected by purposive sampling. Intention was measured by the Infant Feeding Intention scale questionnaire. Meanwhile, attitude, subjective norms, and perceived behavioral control were measured by the modified Breastfeeding Attrition Prediction Tool questionnaire. Data were analyzed using the multivariate logistic regression analysis. It was 61.5% mother had strong exclusive breastfeeding intention. Perceived behavioral control dominantly influenced the exclusiv...
Journal of Lifestyle Medicine
Background: Promotion of exclusive breast feeding is known as a savior strategy, to reduce infantile mortality. The theory of planned behavior is an appropriate theory to explain the effect of psychosocial factors on infant feeding behavior. This study aimed to evaluate impact of planned behavior theory-based education on the behavior of pregnant women related to exclusive breast feeding in Arak city, 2016-17. Methods: This study is an interventional study that was done on 101 pregnant women with gestational age of 32-28 weeks in health centers of Arak city. All individuals were divided into experimental and control groups randomly. Valid and reliable questionnaires were completed before, on and 3 months after intervention. Experimental group received educational intervention in 3 sessions. Date was analyzed using SPSS 16 software (Chi-square, T, R.M.ANOVA Tests). Results: The results showed that, after implementation of the intervention, mean of scores for attitudes, subjective norms, Perceived behavioral control, intention and exclusive breast feeding behavior has increased significantly in the experimental group compared with the control group. Conclusion: The findings of this study, showed the efficiency and effectiveness of educational intervention based on the theory of planned behavior on exclusive breast feeding behavior. Designing and implementing educational programs based on the theory of planned behavior is proposed to encourage women to breast-feed exclusively to encourage women to breast-feed exclusively.
British journal of health psychology, 2012
Background. Despite reported differences in breastfeeding rates amongst women of different ethnic groups, little research has investigated whether the thoughts and feelings (social cognitions) of women from these different groups during pregnancy influence their later breastfeeding behaviour.Objective. This study investigates the extent to which social cognitions (based on the Theory of Planned Behaviour; TPB) predict differences in breastfeeding intentions, initiation, and maintenance between White British (WB) and South Asian (SA) women.Design and methods. Two hundred and fifty women (predominantly WB or SA) in the last trimester of pregnancy completed a questionnaire based on the TPB. The women were followed up 6 months later and their breastfeeding during the previous 6 months was recorded.Results. The TPB predicted significant variance in breastfeeding across the sample and was able to account for differences between SA and WB women. Affective attitudes (emotional reactions to breastfeeding) and moral norms (reactions about whether breastfeeding is right or wrong) were the strongest predictors of intentions. Intentions and affective attitudes were predictive of breastfeeding initiation, whilst only affective attitudes were predictive of breastfeeding maintenance.Conclusion. Stronger intentions to breastfeed led to higher rates of breastfeeding amongst SA women. In turn, intentions were predicted by emotional and moral beliefs about breastfeeding, beliefs that were less positive amongst a WB sample. This suggests that those tasked with encouraging breastfeeding may need to have a different conversation with women about breastfeeding that goes beyond a focus on costs and benefits.Background. Despite reported differences in breastfeeding rates amongst women of different ethnic groups, little research has investigated whether the thoughts and feelings (social cognitions) of women from these different groups during pregnancy influence their later breastfeeding behaviour.Objective. This study investigates the extent to which social cognitions (based on the Theory of Planned Behaviour; TPB) predict differences in breastfeeding intentions, initiation, and maintenance between White British (WB) and South Asian (SA) women.Design and methods. Two hundred and fifty women (predominantly WB or SA) in the last trimester of pregnancy completed a questionnaire based on the TPB. The women were followed up 6 months later and their breastfeeding during the previous 6 months was recorded.Results. The TPB predicted significant variance in breastfeeding across the sample and was able to account for differences between SA and WB women. Affective attitudes (emotional reactions to breastfeeding) and moral norms (reactions about whether breastfeeding is right or wrong) were the strongest predictors of intentions. Intentions and affective attitudes were predictive of breastfeeding initiation, whilst only affective attitudes were predictive of breastfeeding maintenance.Conclusion. Stronger intentions to breastfeed led to higher rates of breastfeeding amongst SA women. In turn, intentions were predicted by emotional and moral beliefs about breastfeeding, beliefs that were less positive amongst a WB sample. This suggests that those tasked with encouraging breastfeeding may need to have a different conversation with women about breastfeeding that goes beyond a focus on costs and benefits.Statement of contributionWhat is already known on this subjectSouth Asian women living in Britain are more likely to breastfeed their infants than White British women. The constructs of the Theory of Planned Behaviour have been shown to predict breastfeeding initiation and maintenance. However, few studies measure longer term breastfeeding or test whether TPB constructs from the extended TPB measured before the delivery of the baby predict breastfeeding initiation or maintenance. No studies have explored this amongst a British South Asian population.South Asian women living in Britain are more likely to breastfeed their infants than White British women. The constructs of the Theory of Planned Behaviour have been shown to predict breastfeeding initiation and maintenance. However, few studies measure longer term breastfeeding or test whether TPB constructs from the extended TPB measured before the delivery of the baby predict breastfeeding initiation or maintenance. No studies have explored this amongst a British South Asian population.What this study addsThis study demonstrates that intentions and affective attitudes are strong predictors of initiation of breastfeeding, but that only affective attitude predicted maintenance of breastfeeding for 6 months. Moreover, we demonstrated that stronger intentions were able to explain the higher breastfeeding initiation rates and affective attitudes were able to explain the greater likelihood of maintenance of breastfeeding amongst South Asian women.This study demonstrates that intentions and affective attitudes are strong predictors of initiation of breastfeeding, but that only affective attitude predicted maintenance of breastfeeding for 6 months. Moreover, we demonstrated that stronger intentions were able to explain the higher breastfeeding initiation rates and affective attitudes were able to explain the greater likelihood of maintenance of breastfeeding amongst South Asian women.