Breastfeeding and problematic integration: results of a focus-group study

Application of Problematic Integration Theory in Health Communication: A Scoping Review

Problematic integration theory is a theory in communication that deals with the processing of messages by humans. It is helpful to study challenges and their solutions in the health communication context to develop effective relationships, treat patients, and, ultimately, ensure the well-being of society. A scoping review was conducted. Three databases were searched following the PRISMA-ScR statement without a time frame. Independent screening of titles, abstracts, and full texts was performed, and the studies selected based on the inclusion and exclusion criteria were assessed. The required information was then extracted from the studies and entered into Excel software. A total of 43 studies related to PI theory were identified in the databases. The results indicated that PI theory is used to interpret feelings, beliefs, challenges, concerns, and problematic dilemmas in five thematic categories: elderly care, cancer care, infertility, pregnancy, and childbirth care, illness care, and sexual care. Each of the papers also offers distinctive and valuable considerations for interventions such as communication strategies, coping mechanisms, uncertainty and certainty management, information management, education, training, support groups, and campaigns to improve decision-making and meet the challenges of health communication.

A Pilot Study of the Impact of Brief Exposure to Images of Breastfeeding Mothers on Attitudes Toward Mother's Breastfeeding in Public

The wider societal attitudes held toward mothers' breastfeeding in public seem to impact infant feeding choices. The present study employed an online (N = 396) experimental pretest-posttest design set to examine whether a mere exposure effect of briefly viewing and rating the valence of four different images of public breastfeeding (i.e., mother and baby alone, females in background, males in background, and females and males in background) would impact on participants' attitudes toward a mother breastfeeding in public. There was a marginal increase in the positive attitudes toward public breastfeeding at Time 2 when compared with Time 1 following exposure to the four images. These findings support a potential positive mere exposure effect in enhancing attitudes toward breastfeeding in public. This suggests a greater use of promotional material using visual stimuli may improve societal acceptance of breastfeeding in public.

"It's natural and healthy, but I don't want to see it": Using Entertainment-Education to Improve Attitudes Toward Breastfeeding in Public

While it has been well established that breastfeeding provides the best nourishment for children, few women achieve the recommended breastfeeding duration. Negative media messages have been identified as one explanation for the lack of individual and public support for breastfeeding. This study explored the influence of media on the knowledge and attitudes of a nearly childless population to ascertain if and how entertainment media can positively impact perceptions of breastfeeding. Using cultivation and parasocial interaction, this research measured entertainment television's effect on breastfeeding attitudes using randomized-group experiments involving 375 students. Overall, participants generally held positive attitudes but were uncomfortable seeing breastfeeding. Moreover, results indicate that viewing a prime-time television clip that depicted public breastfeeding not only significantly lessened the extent to which participants believed that breastfeeding was a private activity but also improved attitudes and support for breastfeeding in public. This study concludes that more pro-breastfeeding media messages in entertainment media could help create a climate conducive to breastfeeding success.

Integrating Pregnancy Ambivalence and Effectiveness in Contraceptive Choice

Approximately 70% of pregnancies among young unmarried women living in the United States are unintended. Unintended pregnancy results in negative health and economic outcomes for infants, children, women, and families. Further research into the decision-making process of contraceptive selection is needed to meet young women's contraceptive needs in the United States. Overall, 53 women ages 18-24 years completed in-depth qualitative interviews. Researchers used analytical techniques from grounded theory and HyperRESEARCH 3.5.2 qualitative data analysis software to identify emergent themes. Problematic integration theory provided a theoretical lens to identify young women's probabilistic and evaluative orientations toward contraception. Researchers identified two profound values at stake to participants regarding their contraceptive decisions: avoiding pregnancy in the present, and protecting future fertility. Participants resisted long-acting reversible contraception (LARC) methods (e.g., the intrauterine device and the implant) due to concerns about safety and fears about infertility. Participants experienced ambivalence toward the idea of pregnancy, which complicated contraceptive decisions, especially regarding long-term methods. Uncertainty led participants to rationalize their use of less effective methods and reduced information seeking. Findings from this study offer practical suggestions for practitioners and health communication campaign planners. Contraceptive access campaigns should focus on the effectiveness, safety, and convenience of LARC methods. Messages should help young women make contraceptive choices that better fit their needs in order to reduce unintended pregnancy.

Patient Decision Aids for Prenatal Genetic Testing: Probability, Embodiment, and Problematic Integration

Patient decision aids (PDAs) are documents that attempt to support patient participation in biomedical decision making by discussing information and options. Scholars have called for further elaboration and application of communication theory relating to the construction and uses of PDAs. This article analyzes gateway documents, a genre of PDAs that includes texts from noncommercial websites returned during an initial inquiry for decision-making information. Problematic integration theory informs and extends a meaning of balance in a sample of four PDAs for prenatal genetic testing. The study addresses several communication opportunities, including discussions of benefits, disadvantages, providers' scientific knowledge, and patients' embodied knowledge. The PDA authors' emphases on statistical risk without more inclusive considerations of embodied knowledge highlight a conclusion that the documents in the sample are imbalanced. This research serves to introduce a theoretical communication context for analysis of PDAs that may assist scholars in further contributions to the interdisciplinary field of biomedical communication.

Development of environmentally friendly messages to promote longer durations of breastfeeding for already breastfeeding mothers

Durations of breastfeeding activity in the United States fall short of established recommendations by leading public health institutions. In response to this problem, this study sought to develop environmentally friendly messages to promote continued breastfeeding for moms already breastfeeding in order to help them reach recommended breastfeeding durations. Messages were successfully cultivated to encourage moms already breastfeeding to meet recommended breastfeeding durations. In addition, this study cultivated strategies by which to use environmentally friendly messages to urge mothers who still need to decide whether to breastfeed or formula feed to breastfeed, although this was not the purpose of the research. Avenues for future communication-based breastfeeding research were also elucidated. The Elaboration Likelihood Model serves as useful theory to assess the role of environmentally friendly messages in the promotion of continued breastfeeding.