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Charlesworth J, McAlpine T, Martin A, Scott J, Mullan B. Development, psychometric assessment, and predictive validity of a breastfeeding subjective norms scale among an Australian prospective cohort of first-time parents. Br J Health Psychol 2023; 28:690-704. [PMID: 36740759 DOI: 10.1111/bjhp.12648] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/18/2023] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Breastfeeding has a number of benefits for both mothers and their infants. Research has examined the psychosocial influences on breastfeeding, yielding important findings in relation to particular constructs that play a significant role in this vital health behaviour. One such construct is subjective norms. However, there are mixed findings in relation to the role of subjective norms in breastfeeding behaviours. This may be due to the lack of consistent measure of subjective norms across studies. Further, the influence of fathers' subjective norms on breastfeeding continuation remains unclear due to a lack of measurement. Thus, the aim of the current study was to develop and assess a reliable and valid subjective norms scale specific to breastfeeding for use among both mothers and fathers. DESIGN/METHODS Subjective norms items were developed by researchers in the domain and were tested among 949 couples. RESULTS Findings indicated that both subjective norms scales had excellent reliability, construct validity, and predictive validity. It was also found that both the mothers' and fathers' subjective norms scales tapped into two key structures: breastfeeding in general, and breastfeeding in public. Further, maternal subjective norms were predictive of breastfeeding behaviours but not paternal subjective norms. CONCLUSIONS These findings indicate that the developed subjective norms scales are reliable and valid and capture key elements of breastfeeding subjective norms among both mothers and fathers. Use of this measure in future research can help better understand the role of both mothers' and fathers' subjective norms in influencing breastfeeding behaviours.
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Affiliation(s)
- Jessica Charlesworth
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Western Australia, Australia
- School of Population Health Curtin University, Perth, Western Australia, Australia
| | - Thomas McAlpine
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Western Australia, Australia
- School of Population Health Curtin University, Perth, Western Australia, Australia
| | - Annegret Martin
- School of Population Health Curtin University, Perth, Western Australia, Australia
| | - Jane Scott
- School of Population Health Curtin University, Perth, Western Australia, Australia
| | - Barbara Mullan
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Western Australia, Australia
- School of Population Health Curtin University, Perth, Western Australia, Australia
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Johnsunderraj SE, Francis F, Prabhakaran H. Child-to-child approach in disseminating the importance of health among children -A modified systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:116. [PMID: 37397102 PMCID: PMC10312397 DOI: 10.4103/jehp.jehp_8_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/09/2023] [Indexed: 07/04/2023]
Abstract
Health is a paramount issue in every society. Children's lives are more dominated by two main environments, which are the home and the school. Children's health is most affected when they encounter disease-laden environments; hence, schools have high influence in their health. Schools also serve as health promoting agencies and have a strong bidirectional relationship between a child's holistic wellbeing and education. Children are the best teachers who have the charisma to be influential change agents in reciprocating what is taught to them as healthy behavior. This paper is focused on the child-to-child approach in disseminating the importance of health among school-age children and the importance of molding them into change agents. The objective is to systematically review all literature works answering the question "Is Child-to-Child approach effective in disseminating health information's among school children?". Using critical appraisal skills program (CASP) framework and a data extraction form, articles were retrieved from different databases, including Scopus, CINAHL, PubMed, ProQuest, and EBSCOHost. These articles were published between 2003 and 2020. After critically appraising 85 articles based on the inclusion criteria, only 16 were found appropriate for addressing the purpose of this review. Major results of the review were that each of the studies had tested the effectiveness of the child to child approach using different health education topics such as prevention of worm infestation, eating behaviors, first aid measures, hand hygiene practices, importance of Vitamin A, and eye care. Studies reported that this approach empowered children with better health related knowledge and practice. This paper concludes that child-to-child approach plays an important role in disseminating health to children either as siblings, peer groups, and to parents.
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Affiliation(s)
| | - Frincy Francis
- College of Nursing, Sultan Qaboos University, Muscat, Oman
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3
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Çankaya S, Ataş A. The relationship of psychological well-being and cognitive emotions with breastfeeding self-efficacy in mothers in the postpartum period. Dev Psychobiol 2023; 65:e22371. [PMID: 36946683 DOI: 10.1002/dev.22371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/22/2022] [Accepted: 01/03/2023] [Indexed: 03/09/2023]
Abstract
To determine the relationship of psychological well-being and cognitive emotion regulation and breastfeeding self-efficacy in mothers in the postpartum period. The research was designed as cross-sectional and correlational and carried out between 1 November 2021 and 1 January 2022 in the pediatric outpatient clinic of a Medical Faculty Hospital of a province in the Central Anatolian Region of Turkey. Responses from a total of 325 mothers who were in postpartum 1-6 months were analyzed. Data were collected using a Personal Information Form, the Scales of Psychological Well-Being (SPWB), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). The following factors were found to be important associated risk factors that negatively affected breastfeeding self-efficacy in 29% of the mothers (F = 14.536, p < .001): mothers' poor mental health, using self-blaming maladaptive cognitive coping strategy, inability to use positive reappraisal coping strategy, and feeding the baby only formula or both breast milk and formula. Weak and positive correlations were found between psychological well-being of mothers and adaptive cognitive coping subdimensions, and negative and weak correlations were found between psychological well-being of the mothers and maladaptive cognitive coping subdimensions (p < .001). Breastfeeding self-efficacy of mothers in a well psychological state, who can use adaptive cognitive coping strategies, and who exclusively breastfeed their babies is positively affected.
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Affiliation(s)
- Seyhan Çankaya
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
| | - Ayşenur Ataş
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
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Froh EB, Spatz DL. Lactation Outcomes After Participation in a Tailored Prenatal Nutrition Consultation Among Women With Infants With Congenital Anomalies. J Obstet Gynecol Neonatal Nurs 2022; 51:590-598. [PMID: 35988697 DOI: 10.1016/j.jogn.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVE To describe lactation outcomes among of a cohort of mother-infant dyads in which the women had an individualized prenatal nutrition consultation intervention. DESIGN Descriptive cohort study. SETTING A free-standing children's hospital with a center for fetal diagnosis and treatment and a specialized maternity unit. PARTICIPANTS A total of 160 women who had prenatal nutrition consultations in 2014 to 2017 and gave birth to infants with known congenital anomalies and required intensive care after birth. METHODS We surveyed women regarding their lactation outcomes after the Breastfeeding Report Card metrics of the Centers for Disease Control and Prevention and obtained permission to abstract demographic and clinical information from the setting's electronic health record. We analyzed data with standard descriptive statistics. RESULTS Among the cohort, 86.9% (n = 139) of participants intended to provide human milk or combination feeding in the prenatal period. A total of 128 (92.1%) infants were first exposed to human milk enterally. At the time of discharge, 92.1% (n = 128) of the infants received human milk. The breastfeeding outcomes of the cohort significantly surpassed national data: initiation (98.1% vs. 84.1% national), breastfeeding at 3 months (89.4%), exclusive breastfeeding at 3 months (60% vs. 46.9% national), breastfeeding at 6 months (76.9% vs. 58.3% national), exclusive breastfeeding at 6 months (45% vs. 25.6% national), breastfeeding at 12 months (50.6% vs. 35.3% national), and breastfeeding beyond 12 months (34.4%). CONCLUSIONS Lactation outcomes among women who had prenatal nutrition consultations far surpassed national data, and this intervention has implications for family-centered prenatal care, informed decision making, and improved breastfeeding outcomes in the hospital setting and postdischarge.
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5
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An online questionnaire study investigating the impact of psychosocial factors on the duration of breastfeeding. Midwifery 2022; 109:103314. [DOI: 10.1016/j.midw.2022.103314] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 02/19/2022] [Accepted: 03/15/2022] [Indexed: 11/18/2022]
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Parker K, Nunns M, Xiao Z, Ford T, Ukoumunne OC. Characteristics and practices of school-based cluster randomised controlled trials for improving health outcomes in pupils in the United Kingdom: a methodological systematic review. BMC Med Res Methodol 2021; 21:152. [PMID: 34311695 PMCID: PMC8311976 DOI: 10.1186/s12874-021-01348-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/14/2021] [Indexed: 02/06/2023] Open
Abstract
Background Cluster randomised trials (CRTs) are increasingly used to evaluate non-pharmacological interventions for improving child health. Although methodological challenges of CRTs are well documented, the characteristics of school-based CRTs with pupil health outcomes have not been systematically described. Our objective was to describe methodological characteristics of these studies in the United Kingdom (UK). Methods MEDLINE was systematically searched from inception to 30th June 2020. Included studies used the CRT design in schools and measured primary outcomes on pupils. Study characteristics were described using descriptive statistics. Results Of 3138 articles identified, 64 were included. CRTs with pupil health outcomes have been increasingly used in the UK school setting since the earliest included paper was published in 1993; 37 (58%) studies were published after 2010. Of the 44 studies that reported information, 93% included state-funded schools. Thirty six (56%) were exclusively in primary schools and 24 (38%) exclusively in secondary schools. Schools were randomised in 56 studies, classrooms in 6 studies, and year groups in 2 studies. Eighty percent of studies used restricted randomisation to balance cluster-level characteristics between trial arms, but few provided justification for their choice of balancing factors. Interventions covered 11 different health areas; 53 (83%) included components that were necessarily administered to entire clusters. The median (interquartile range) number of clusters and pupils recruited was 31.5 (21 to 50) and 1308 (604 to 3201), respectively. In half the studies, at least one cluster dropped out. Only 26 (41%) studies reported the intra-cluster correlation coefficient (ICC) of the primary outcome from the analysis; this was often markedly different to the assumed ICC in the sample size calculation. The median (range) ICC for school clusters was 0.028 (0.0005 to 0.21). Conclusions The increasing pool of school-based CRTs examining pupil health outcomes provides methodological knowledge and highlights design challenges. Data from these studies should be used to identify the best school-level characteristics for balancing the randomisation. Better information on the ICC of pupil health outcomes is required to aid the planning of future CRTs. Improved reporting of the recruitment process will help to identify barriers to obtaining representative samples of schools.
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Affiliation(s)
- Kitty Parker
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter, Room 2.16, South Cloisters, St Luke's Campus, 79 Heavitree Rd, Exeter, EX1 2LU, UK.
| | - Michael Nunns
- College of Medicine and Health, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - ZhiMin Xiao
- School of Health and Social Care, University of Essex, Colchester, CO4 3SQ, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, L5 Clifford Allbutt Building, Cambridge Biomedical Campus Box 58, Cambridge, CB2 0AH, UK
| | - Obioha C Ukoumunne
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter, Room 2.16, South Cloisters, St Luke's Campus, 79 Heavitree Rd, Exeter, EX1 2LU, UK
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7
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Grech P, Grech R. The role of health promotion theories in Stroke Awareness and Education. Appl Nurs Res 2021; 58:151415. [PMID: 33745555 DOI: 10.1016/j.apnr.2021.151415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
The aim of this paper is to provide an overview of health promotion theories and their application to Stroke Awareness and Education. Stroke stands as one of the leading causes of mortality and morbidity even though treatment is readily available. One of the major challenges in this area is that the effectiveness of treatment depends heavily on timely presentation to healthcare services. Unfortunately, many individuals do not seek help whilst experiencing symptoms or only do so after a significant delay. This paper explores the main health promotion theories related to this problematic health behaviour in relation to stroke.
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Affiliation(s)
- Paulann Grech
- Department of Mental Health, Faculty of Health Sciences, University of Malta, Malta.
| | - Reuben Grech
- Medical Imaging Department, Mater Dei Hospital, Malta
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8
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Capponi I, Roland F. Relationship between emotional labelling of breastfeeding situation and intention to breastfeed/support breastfeeding among French adolescents and young people. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-019-01037-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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9
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Lao HC, Tao VY, Wu AM. Theory of planned behaviour and healthy sleep of college students. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12094] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Henry C.f. Lao
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China,
| | - Vivienne Y.k. Tao
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China,
| | - Anise M.s. Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China,
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Chipojola R, Chiu HY, Huda MH, Lin YM, Kuo SY. Effectiveness of theory-based educational interventions on breastfeeding self-efficacy and exclusive breastfeeding: A systematic review and meta-analysis. Int J Nurs Stud 2020; 109:103675. [DOI: 10.1016/j.ijnurstu.2020.103675] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 05/25/2020] [Accepted: 05/31/2020] [Indexed: 10/24/2022]
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Development and Feasibility of a Safety Plan Mobile Application for Adolescent Suicide Attempt Survivors. Comput Inform Nurs 2020; 38:382-392. [PMID: 32079816 DOI: 10.1097/cin.0000000000000592] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Past suicide attempts are a powerful predictor of suicide. This study developed and evaluated the feasibility of a mobile application for creating safety plans, which include coping strategies that can be immediately accessed and used by suicide attempt survivors during a crisis. A safety plan mobile application, called Brake of My Mind, was developed (study 1). Heuristic evaluation (for experts) and user evaluations (for health professionals and adolescent suicide attempt survivors) were performed. A pilot test was then conducted based on the theory of planned behavior to evaluate the feasibility of Brake of My Mind (study 2). Three adolescent suicide attempt survivors used a pilot version of Brake of My Mind. Attitude toward suicide attempts, subjective norms, perceived behavioral control, and suicide intentions were assessed before, immediately after, and 1 week after using Brake of My Mind. Brake of My Mind showed very few low-priority usability problems, and it was considered a "good" and "acceptable" application. In study 2, median scores for attitudes toward suicide attempts, perceived behavioral control, and suicide intentions decreased over time after using Brake of My Mind. The subjective norm scores did not change. Brake of My Mind is an acceptable application for adolescent suicide attempt survivors that appears effective in decreasing their positive attitude toward suicide attempts.
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12
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Moukarzel S, Abou Jaoudeh M, Farhat A, Saade M, Mamas C, Daly AJ. Exploring the latitude of attitude: Intentions to breastfeed among adolescents in Lebanese schools. MATERNAL AND CHILD NUTRITION 2019; 16:e12888. [PMID: 31486280 PMCID: PMC7038873 DOI: 10.1111/mcn.12888] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 07/31/2019] [Accepted: 08/20/2019] [Indexed: 11/28/2022]
Abstract
School-based breastfeeding education (SBBE) may help improve breastfeeding rates in the long-term by targeting children and adolescents' knowledge, attitudes, skills, and intentions. Breastfeeding rates in Lebanon are suboptimal. Psychosocial drivers of breastfeeding intention among the youth are unknown. We administered a survey to 658 high school students (448 females; 210 males) at two large Lebanese schools to understand intentions, intention drivers, and views on SBBE as means to guide SBBE programme design on the basis of the theory of planned behaviour. We collected information on demographics, intention to breastfeed/support wife to breastfeed future. Intention was predicted by attitude related to breastfeeding health outcomes and family normative beliefs-χ2 (25) = 115, P < .001 for males, and χ2 (39.3) = 186, P < .001 for females. Among females, intention was also positively associated with being breastfed, higher socio-economic status, and being more accepting of public breastfeeding. Seventy-eight per cent of students felt they were not learning enough about breastfeeding in school but were interested in SBBE through didactic teaching methods and interactive experiences. Findings indicate that breastfeeding intention among adolescent students is not merely influenced by the extent of knowledge but by more complicated psychosocial drivers that may differ by gender. Our findings also suggest a misalignment exists between what schools are providing with what students feel they need, thereby opening up a potential space for intervention.
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Affiliation(s)
- Sara Moukarzel
- Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence, University of California San Diego, California, USA.,Department of Education Studies, University of California San Diego, California, USA.,Faculty of Nursing and Health Sciences, Notre Dame University, Zouk Mosbeh, Lebanon
| | - Maya Abou Jaoudeh
- Faculty of Nursing and Health Sciences, Notre Dame University, Zouk Mosbeh, Lebanon
| | - Antoine Farhat
- Faculty of Nursing and Health Sciences, Notre Dame University, Zouk Mosbeh, Lebanon
| | - Marianne Saade
- Faculty of Nursing and Health Sciences, Notre Dame University, Zouk Mosbeh, Lebanon
| | - Christoforos Mamas
- Department of Education Studies, University of California San Diego, California, USA
| | - Alan J Daly
- Department of Education Studies, University of California San Diego, California, USA
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Kassianos AP, Ward E, Rojas-Garcia A, Kurti A, Mitchell FC, Nostikasari D, Payton J, Pascal-Saadi J, Spears CA, Notley C. A systematic review and meta-analysis of interventions incorporating behaviour change techniques to promote breastfeeding among postpartum women. Health Psychol Rev 2019; 13:344-372. [PMID: 31117897 DOI: 10.1080/17437199.2019.1618724] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 04/11/2019] [Indexed: 01/01/2023]
Abstract
The benefits of exclusive breastfeeding are well documented, yet few women adhere to recommendations. We report the Behaviour Change Techniques (BCTs) within interventions trialled internationally after pregnancy to promote exclusive and mixed breastfeeding as well as evidence of effectiveness. PsycINFO, EMBASE and MEDLINE databases were screened. Twenty-three (n = 23) studies met inclusion criteria. Three authors independently extracted data, coded interventions using the BCT v.1 taxonomy, and assessed study quality. There was a moderate significant effect of the interventions promoting exclusive breastfeeding up to four weeks postpartum (OR 1.77, [95% CI: 1.47-2.13]) but this effect slightly declined beyond thirteen weeks (OR 1.63, [95% CI: 1.07-2.47]). Twenty-nine BCTs were identified within interventions. 'Credible source' and 'instruction on how to perform the behaviour' were the most prevalent and 'social support (unspecified)' contributed to the effectiveness of exclusive breastfeeding interventions five to eight weeks postpartum. Using BCTs with cognitive and behavioural aspects may help women develop coping mechanisms promoting exclusive breastfeeding. Further trials are needed in countries with low breastfeeding rates such as the UK. The use of programme theory during intervention development and clear description of intervention components is recommended. This meta-analysis provides guidance for trials evaluating postpartum breastfeeding interventions.
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Affiliation(s)
| | - Emma Ward
- b Norwich Medical School, University of East Anglia , Norwich , UK
| | - Antonio Rojas-Garcia
- a Department of Applied Health Research, UCL , London , UK
- c NIHR CLAHRC North Thames , London , UK
| | - Allison Kurti
- d Department of Psychiatry and Psychological Science, University of Vermont , Burlington , VT , USA
| | - Fiona C Mitchell
- e Psychological Sciences and Health, University of Strathclyde , Glasgow , UK
| | - Dian Nostikasari
- f Kinder Institute for Urban Research, Rice University , Houston , TX , USA
| | - Jamie Payton
- g Department of Computer and Information Sciences, Temple University , Philadelphia , PA , USA
| | | | - Claire Adams Spears
- h Department of Health Policy and Behavioral Sciences, Georgia State University School of Public Health , Atlanta , GA , USA
| | - Caitlin Notley
- b Norwich Medical School, University of East Anglia , Norwich , UK
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Abstract
BACKGROUND Numerous efforts to promote breastfeeding resulted in a steady increase in the rates of breastfeeding initiation and duration. Increasing numbers of breastfeeding interventions are focused on breastfeeding maintenance and exclusivity and based on behavioral theories. Few studies critically analyzed the use of theories in breastfeeding intervention development and evaluation. RESEARCH AIM The aim of this critical review was to examine the existing literature about breastfeeding intervention, and investigate the role of theory in its development, implementation, and evaluation to provide future directions and implications for breastfeeding interventions. METHODS This critical review examined the existing breastfeeding intervention studies that used self-efficacy theories (SE), theory of planned behavior (TPB), and social cognitive theory (SCT) and were published during the past decade. Using five databases, studies in which researchers explicitly applied these three theories to frame the intervention were selected. Studies were critically reviewed for fidelity to theory in intervention design, delivery, and evaluation. RESULTS Eighteen studies were reviewed: nine SE-, five TPB-, and four SCT-based. Most interventions were focused on building mothers' breastfeeding self-efficacy to improve breastfeeding exclusivity and duration. To achieve this goal, researchers who developed SE-based interventions used individual approaches, whereas other researchers who based studies on TPB incorporated social and environmental changes. SE-based studies were more likely to include theory-based instruments, but TPB- and SCT-based studies demonstrated less consistent choices of measurement. Researchers in most studies did not test the relationships between the proposed theoretical constructs and breastfeeding outcomes as guided by theories. Inconsistent outcomes resulted among the studies due to variations in study follow-ups. CONCLUSION Sound applications of single or multiple theories demonstrate a great potential to help practitioners and researchers develop effective breastfeeding interventions and evaluate true impacts on positive breastfeeding outcomes.
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Affiliation(s)
- Yeon K Bai
- 1 Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ, USA
| | - Soyoung Lee
- 2 Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
| | - Kaitlin Overgaard
- 1 Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ, USA
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15
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Silva NVDND, Pontes CM, Sousa NFCD, Vasconcelos MGLD. [Health Technologies and their contributions to the promotion of breastfeeding: an integrative review of the literature]. CIENCIA & SAUDE COLETIVA 2019; 24:589-602. [PMID: 30726390 DOI: 10.1590/1413-81232018242.03022017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 04/05/2017] [Indexed: 11/22/2022] Open
Abstract
Technologies can be promoters of breastfeeding. The scope of this review is therefore to identify health technologies and their contribution to the promotion of breastfeeding. A search was conducted in the following databases: Lilacs, SCOPUS, Medline and CINAHL, using the key words "breastfeeding," "technology" and "health promotion." The final sample consisted of 24 original articles, among which 19 technologies were identified and classified in managerial, educational and healthcare groupings. Educational technologies were predominant (12) and presented greater contributions to the promotion of breastfeeding. The combination of different technologies has revealed positive results in maintaining breastfeeding. The lack of studies with the use of managerial technologies during the lactation process, as well as the development of other research that prove the effects of each technology on increasing the prevalence of breastfeeding, was clearly detected in the review.
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Affiliation(s)
- Naélia Vidal de Negreiros da Silva
- Departamento de Enfermagem, Centro de Ciências da Saúde, Universidade Federal de Pernambuco. R. Prof. Moraes Rêgo S/N, Cidade Universitária. 50670-901 Recife PE Brasil.
| | - Cleide Maria Pontes
- Departamento de Enfermagem, Centro de Ciências da Saúde, Universidade Federal de Pernambuco. R. Prof. Moraes Rêgo S/N, Cidade Universitária. 50670-901 Recife PE Brasil.
| | - Nayara Francisca Cabral de Sousa
- Departamento de Enfermagem, Centro de Ciências da Saúde, Universidade Federal de Pernambuco. R. Prof. Moraes Rêgo S/N, Cidade Universitária. 50670-901 Recife PE Brasil.
| | - Maria Gorete Lucena de Vasconcelos
- Departamento de Enfermagem, Centro de Ciências da Saúde, Universidade Federal de Pernambuco. R. Prof. Moraes Rêgo S/N, Cidade Universitária. 50670-901 Recife PE Brasil.
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Addicks SH, McNeil DW. Randomized Controlled Trial of Motivational Interviewing to Support Breastfeeding Among Appalachian Women. J Obstet Gynecol Neonatal Nurs 2019; 48:418-432. [PMID: 31181186 DOI: 10.1016/j.jogn.2019.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To determine the effectiveness of a single session of prenatal motivational interviewing (MI) to enhance breastfeeding outcomes. DESIGN A randomized controlled trial with two groups (MI and psychoeducation) with repeated measures: preintervention, postintervention, and at 1 month postpartum. SETTING The intervention was conducted at a university-associated clinic, community locations, and participants' homes. Postpartum follow-up was conducted by telephone. PARTICIPANTS A total of 81 women with low-risk pregnancies enrolled at 28 to 39 weeks gestation who lived in Appalachia. METHODS Participants were randomly assigned to MI or psychoeducation on infant development. Pre- and postintervention outcome measures included intention to breastfeed, confidence in and importance of breastfeeding plan, and breastfeeding attitudes. At 1 month postpartum, participants completed a telephone interview to assess actual breastfeeding initiation, exclusivity, and plans to continue breastfeeding. RESULTS At 1 month postpartum, women in the MI group were more likely to report any current breastfeeding than women in the psychoeducation group, regardless of parity, χ2(1, N = 79) = 4.30, p = .040, Φ = .233. At the postintervention time point, the MI intervention had a significant effect on improving attitudes about breastfeeding among primiparous women only (p < .05). CONCLUSION One session of MI was effective to promote breastfeeding at 1 month postpartum and to enhance positive attitudes toward breastfeeding among primiparous women in Appalachia.
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Investigating the effectiveness of school-based breastfeeding education on breastfeeding knowledge, attitudes and intentions of adolescent females. Midwifery 2019; 70:64-70. [DOI: 10.1016/j.midw.2018.12.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 11/16/2018] [Accepted: 12/11/2018] [Indexed: 11/19/2022]
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18
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MacMillan Uribe AL, Olson BH. Exploring Healthy Eating and Exercise Behaviors Among Low-Income Breastfeeding Mothers. J Hum Lact 2019; 35:59-70. [PMID: 29723099 DOI: 10.1177/0890334418768792] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND: Postpartum weight retention is often a significant contributor to overweight and obesity. Lactation is typically not sufficient for mothers to return to pre-pregnancy weight. Modifiable health behaviors (e.g., healthy eating and exercise) are important for postpartum weight loss; however, engagement among mothers, especially those who are resource-limited, is low. A deeper understanding of low-income breastfeeding mothers' healthy-eating and exercise experience, a population that may have unique motivators for health-behavior change, may facilitate creation of effective intervention strategies for these women. RESEARCH AIM: To describe the healthy-eating and exercise experiences of low-income postpartum women who choose to breastfeed. METHODS: Focus group discussions were conducted with low-income mothers ( N = 21) who breastfed and had a child who was 3 years old or younger. Transcript analysis employed integrated grounded analysis using both a priori codes informed by the theory of planned behavior and grounded codes. RESULTS: Three major themes were identified from five focus groups: (a) Mothers were unable to focus on their own diet and exercise due to preoccupation with infant needs and more perceived barriers than facilitators; (b) mothers became motivated to eat healthfully if it benefited the infant; and (c) mothers did not seek out information on maternal nutrition or exercise but used the Internet for infant-health information and health professionals for breastfeeding information. CONCLUSION: Low-income breastfeeding mothers may be more receptive to nutrition education or interventions that focus on the mother-infant dyad rather than solely on maternal health.
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Affiliation(s)
| | - Beth H Olson
- 1 Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
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Katsuno C, Gregorio ER, Lomboy MFTC, Nonaka D, Hernandez PMR, Estrada CAM, Pimentel JMT, Bernadas RMGC, Kobayashi J. Quality of public school toilets and the frequency of changing sanitary napkins among students in public secondary schools in the City of Manila, Philippines. Trop Med Health 2019; 47:5. [PMID: 30655715 PMCID: PMC6329056 DOI: 10.1186/s41182-018-0131-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 12/20/2018] [Indexed: 11/22/2023] Open
Abstract
Background In sub-tropical countries, poor menstrual hygiene management has been reported. One cause of poor menstrual hygiene management can be poor quality toilets. However, associations between poor quality toilets and menstrual-related behaviors have been poorly understood. The present study aimed to assess the association between the quality of school toilets and the frequency of changing sanitary napkins in school toilet among Filipino students. Methods A cross-sectional study was conducted in six secondary schools of the City of Manila, Philippines, in 2017. A self-administered survey questionnaire with female students collected data on the outcome variable, self-reported daily frequency of changing sanitary napkins in school toilet, and other predictor variables. An observational survey collected data on the main predictor variable, surveyor-rated toilet quality variables. A total of 526 students were included in the analyses. Logistic regression with generalized estimating equation model was used to assess the association between the outcome and predictor variables. Results No significant association was found both between toilet quality and the outcome. Although the association was not significant, the odds ratio (OR) of “sanitary bin is available in toilet” was 2.54 compared to “sanitary bin is not available in toilet.” The results of multivariate analysis showed that participants who reported stronger perceived behavioral control or stronger subjective norm were significantly more likely to change sanitary napkins, compared to those with lower perceived control score or lower subjective norm score, respectively (adjusted OR 2.29, 95% confidence interval 1.24 to 4.25; adjusted OR 2.63, 95% confidence interval 1.45 to 4.76). Conclusions The present study showed that the quality of school toilets was not associated with the frequency of changing sanitary napkins among the studied population. However, it does not mean that the cause-effect relationship was rejected. Further studies involving more schools are necessary to confirm this relationship. Improving subjective norm and perceived behavior control might improve menstrual hygiene behavior.
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Affiliation(s)
- Chikako Katsuno
- 1Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Uehara 207, Nishihara-cho, Okinawa, 903-0215 Japan
| | - Ernesto R Gregorio
- 2Department of Health Promotion and Education, College of Public Health, University of the Philippines Manila/SEAMEO Regional Center for Public Health, Hospital Administration, Environmental & Occupational Health, 625 Pedro Gil Street, Ermita, Manila, Philippines
| | - Marian Fe Theresa C Lomboy
- 3Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila/SEAMEO Regional Center for Public Health, Hospital Administration, Environmental & Occupational Health, 625 Pedro Gil Street, Ermita, Manila, Philippines
| | - Daisuke Nonaka
- 1Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Uehara 207, Nishihara-cho, Okinawa, 903-0215 Japan
| | - Paul Michael R Hernandez
- 1Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Uehara 207, Nishihara-cho, Okinawa, 903-0215 Japan.,3Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila/SEAMEO Regional Center for Public Health, Hospital Administration, Environmental & Occupational Health, 625 Pedro Gil Street, Ermita, Manila, Philippines
| | - Crystal Amiel M Estrada
- 1Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Uehara 207, Nishihara-cho, Okinawa, 903-0215 Japan
| | - Jennel Mae T Pimentel
- 3Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila/SEAMEO Regional Center for Public Health, Hospital Administration, Environmental & Occupational Health, 625 Pedro Gil Street, Ermita, Manila, Philippines
| | - Rhea Marie Grace C Bernadas
- 3Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila/SEAMEO Regional Center for Public Health, Hospital Administration, Environmental & Occupational Health, 625 Pedro Gil Street, Ermita, Manila, Philippines
| | - Jun Kobayashi
- 1Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Uehara 207, Nishihara-cho, Okinawa, 903-0215 Japan.,3Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila/SEAMEO Regional Center for Public Health, Hospital Administration, Environmental & Occupational Health, 625 Pedro Gil Street, Ermita, Manila, Philippines
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Martins FDP, Leal LP, Linhares FMP, Santos AHDS, Leite GDO, Pontes CM. Effect of the board game as educational technology on schoolchildren's knowledge on breastfeeding1. Rev Lat Am Enfermagem 2018; 26:e3049. [PMID: 30183874 PMCID: PMC6136527 DOI: 10.1590/1518-8345.2316.3049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 06/13/2018] [Indexed: 11/22/2022] Open
Abstract
Objective: to evaluate the effect of the board game as an educational technology on
schoolchildren’s knowledge on breastfeeding. Method: cluster-randomized clinical trial, held in nine schools, with 99 children in
the third grade of elementary school (control group = 51 and intervention
group = 48). The pretest was conducted in both groups; intervention
consisted in the application of the educational technology immediately after
pretest to the intervention group; and the post-test was applied on the 7th
and 30th days to both groups. For the analysis of children’s knowledge on
breastfeeding, we considered the pre- and post-test score means, using the
Mann-Whitney test - for comparing the means between groups - and the
Wilcoxon test - within the same group. Results: there was no statistically significant difference between the groups in the
pretest. In the follow-up, when comparing the groups, there were higher
means in the intervention group, on the 7th (19.68 ±1.788) and on the 30th
(20.16±1.260) days, with statistically significant difference. Within the
intervention group, there was significant increase of the means in the
pretest (15.89±3.082) for the 30th day (20.16±1.260). Conclusion: such educational intervention has significantly contributed to the increase
in scores of children’s knowledge on breastfeeding for the intervention
group. UTN: U1111-1184-7386.
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Affiliation(s)
- Fernanda Demutti Pimpão Martins
- Doctoral student, Universidade Federal de Pernambuco, Recife, PE, Brazil. Scholarship holder at Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Luciana Pedrosa Leal
- PhD, Adjunct Professor, Departamento de Enfermagem, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | | | | | | | - Cleide Maria Pontes
- PhD, Full Professor, Departamento de Enfermagem, Universidade Federal de Pernambuco, Recife, PE, Brazil
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Bai YK, Dinour LM. Validation of a Theory of Planned Behavior-Based Questionnaire to Examine Factors Associated With Milk Expression. J Hum Lact 2017; 33:658-665. [PMID: 28984534 DOI: 10.1177/0890334417695205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND A proper assessment of multidimensional needs for breastfeeding mothers in various settings is crucial to facilitate and support breastfeeding and its exclusivity. The theory of planned behavior (TPB) has been used frequently to measure factors associated with breastfeeding. Full utility of the TPB requires accurate measurement of theory constructs. Research aim: This study aimed to develop and confirm the psychometric properties of an instrument, Milk Expression on Campus, based on the TPB and to establish the reliability and validity of the instrument. METHODS In spring 2015, 218 breastfeeding (current or in the recent past) employees and students at one university campus in northern New Jersey completed the online questionnaire containing demography and theory-based items. Internal consistency (α) and split-half reliability ( r) tests and factor analyses established and confirmed the reliability and construct validity of this instrument. RESULTS Milk Expression on Campus showed strong and significant reliabilities as a full scale (α = .78, r = .74, p < .001) and theory construct subscales. Validity was confirmed as psychometric properties corresponded to the factors extracted from the scale. Four factors extracted from the direct construct subscales accounted for 79.49% of the total variability. Four distinct factors from the indirect construct subscales accounted for 73.68% of the total variability. CONCLUSION Milk Expression on Campus can serve as a model TPB-based instrument to examine factors associated with women's milk expression behavior. The utility of this instrument extends to designing effective promotion programs to foster breastfeeding and milk expression behaviors in diverse settings.
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Affiliation(s)
- Yeon K Bai
- 1 Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ, USA
| | - Lauren M Dinour
- 1 Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ, USA
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Watkins AL, Dodgson JE, McClain DB. Online Lactation Education for Healthcare Providers: A Theoretical Approach to Understanding Learning Outcomes. J Hum Lact 2017; 33:725-735. [PMID: 28938078 DOI: 10.1177/0890334417724348] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Breastfeeding competencies are not standardized in healthcare education for any of the health professions. A few continuing education/professional development programs have been implemented, but research regarding the efficacy of these programs is scarce. Research aim: After a 45-hour lactation course, (a) Does breastfeeding knowledge increase? (b) Do beliefs and attitudes about infant feeding improve? (c) Does perceived behavioral control over performance of evidence-based lactation support practices increase? and (d) Do intentions to carry out evidence-based lactation support practices increase? METHODS A nonexperimental pretest-posttest self-report survey design was conducted with a nonprobability sample of participants ( N = 71) in a lactation course. Theory of Planned Behavior variables were measured and a before-after course analysis was completed. RESULTS Significantly higher scores were found on the posttests for knowledge, beliefs about breastfeeding scale, and the perceived behavioral control scale. Participants' self-efficacy increased after the course; their beliefs about social norms and their ability to effect change in their workplaces did not change significantly. Participants' intention to perform actions that are consistent with the evidence-based breastfeeding supportive behaviors increased significantly. Positive beliefs about formula feeding significantly increased; this was unexpected. CONCLUSION The Theory of Planned Behavior provided a useful approach for examining more meaningful learning outcomes than the traditional knowledge and/or satisfaction outcomes. This study was the first to suggest that more meaningful learning outcomes are needed to evaluate lactation programs. However, it is not enough to educate healthcare providers in evidence-based practice; the places they practice must have the infrastructure to support evidence-based practice.
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Affiliation(s)
| | - Joan E Dodgson
- 2 School of Nursing, Saint Louis University, Saint Louis, MO, USA
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Abstract
OBJECTIVES To identify factors that may increase intentions to seek help for an early dementia diagnosis. Early dementia diagnosis in Ireland is low, reducing the opportunity for intervention, which can delay progression, reduce psychological distress and increase social supports. METHOD Using the theory of planned behaviour (TPB), and a mixed methods approach, three focus groups were conducted (N = 22) to illicit attitudes and beliefs about help seeking for an early dementia diagnosis. The findings informed the development of the Help Seeking Intentions for Early Dementia Diagnosis (HSIEDD) questionnaire which was piloted and then administered to a sample of community dwelling adults from Dublin and Kildare (N = 95). RESULTS Content analysis revealed participants held knowledge of the symptoms of dementia but not about available interventions. Facilitators of help seeking were family, friends and peers alongside well informed health professionals. Barriers to seeking help were a lack of knowledge, fear, loss, stigma and inaccessible services. The quantitative findings suggest the TPB constructs account for almost 28% of the variance in intentions to seek help for an early diagnosis of dementia, after controlling for sociodemographic variables and knowledge of dementia. In the final step of the regression analysis, the main predictors of help seeking were knowledge of dementia and subjective norm, accounting for 6% and 8% of the variance, respectively. CONCLUSION Future interventions should aim to increase awareness of the support available to those experiencing early memory problems, and should highlight the supportive role that family, friends, peers and health professionals could provide.
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Affiliation(s)
- Susan Devoy
- a School of Psychology , Ulster University , Northern Ireland , UK
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Shepherd L, Walbey C, Lovell B. The Role of Social-Cognitive and Emotional Factors on Exclusive Breastfeeding Duration. J Hum Lact 2017; 33:606-613. [PMID: 28602112 DOI: 10.1177/0890334417708187] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous research has suggested that exclusive breastfeeding is likely to be predicted by social-cognitive variables and fear. However, there is little research assessing the role of regret and self-conscious emotions (e.g., pride and guilt) in promoting exclusive breastfeeding. Research aim: The primary aim of this research was to determine whether social-cognitive variables, fear, regret, and self-conscious emotions predict exclusive breastfeeding duration. The secondary aim of this research was to assess whether these factors predict infant-feeding choice (i.e., exclusively breastfed, combination fed, or generally formula fed). METHODS In this nonexperimental one-group self-report survey, 375 mothers rated social-cognitive variables toward breastfeeding (attitude, subjective norm, perceived control, and self-efficacy), their fear toward inadequate nutrition from breastfeeding and breastfeeding damaging their physical appearance, and the extent to which mothers may feel pride toward breastfeeding and negative self-conscious emotions (guilt and shame) and regret for not breastfeeding their infant. RESULTS Exclusive breastfeeding duration was positively predicted by self-efficacy, pride, and regret but negatively predicted by the fear toward inadequate nutrition. We also found that in contrast with exclusive breastfeeding, generally formula feeding an infant was associated with lower self-efficacy, pride, and regret but higher subjective norm and fear toward inadequate nutrition through breastfeeding. CONCLUSION The authors argue that it is important to consider the role of self-conscious emotions and regret on exclusive breastfeeding.
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Affiliation(s)
- Lee Shepherd
- 1 Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Cherokee Walbey
- 1 Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Brian Lovell
- 1 Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
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Swanson V, Hannula L, Eriksson L, Wallin MH, Strutton J. 'Both parents should care for babies': A cross-sectional, cross-cultural comparison of adolescents' breastfeeding intentions, and the influence of shared-parenting beliefs. BMC Pregnancy Childbirth 2017; 17:204. [PMID: 28662687 PMCID: PMC5492462 DOI: 10.1186/s12884-017-1372-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 06/05/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Many young men and women expect to co-parent their newborn infant. This may have a positive or negative impact on decisions to breastfeed, which is an important health behaviour, influenced by cultural and psycho-social norms. We investigated the relationship between shared parenting, infant feeding beliefs and intentions in male and female (non-parent) adolescents, comparing Nordic countries (Sweden, Norway, Finland) with high breastfeeding rates with others with low rates (Scotland, USA). METHODS We utilised cross-sectional surveys of male and female adolescents (n = 1064, age 12-18) administered directly in schools or via the internet. We assessed attitudes to breast and formula feeding and shared parenting, using a Theory of Planned Behaviour framework, assessing beliefs, attitudes, norms and control as predictors of intention. RESULTS Male and female adolescents' breastfeeding intentions varied in line with national cultural norms. Young people from Nordic countries (high breastfeeding rates) were significantly more likely to intend to breastfeed than those from Scotland or the USA (low breastfeeding rates). Positive beliefs about breastfeeding, norms and 'exposure' to breastfeeding and feeding confidence were consistently stronger in Nordic countries, whereas young people in Scotland had more positive beliefs, norms and 'exposure' to formula feeding. Differences in parenting beliefs, norms and confidence were less consistent. In logistic regression, cultural group, positive breastfeeding beliefs and exposure, norms, and shared parenting beliefs were significant predictors of breastfeeding feeding intention. CONCLUSIONS Positive beliefs about shared parenting and equal gender norms were related to future breastfeeding intentions for female and male adolescents. Health education programmes for young people could encourage positive breastfeeding choices by considering how this would fit with young people's ideal parenting roles, and by emphasising benefits of complementary maternal and paternal roles in breastfeeding newborn infants.
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Affiliation(s)
- Vivien Swanson
- School of Natural Sciences, University of Stirling, Stirling, FK9 4LA Scotland
| | - Leena Hannula
- Faculty of Health Care and Nursing, Helsinki Metropolia University of Applied Sciences, Helsinki, Finland
| | - Linda Eriksson
- School of Health in Social Science, University of Edinburgh Medical School, Teviot Place, Edinburgh, EH8 9AG Scotland
| | | | - Joan Strutton
- Psychology and Counselling, Texas A & M University – Central Texas, Killeen, TX 756-49 USA
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Singletary N, Chetwynd E, Goodell LS, Fogleman A. Stakeholder views of breastfeeding education in schools: a systematic mixed studies review of the literature. Int Breastfeed J 2017; 12:14. [PMID: 28360927 PMCID: PMC5368914 DOI: 10.1186/s13006-017-0106-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 03/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breastfeeding provides numerous health benefits for mothers and infants, but worldwide breastfeeding rates fall below recommendations. As part of efforts to increase breastfeeding initiation and duration, the World Health Organization and UNICEF UK recommend educational interventions to increase awareness and positive attitudes towards breastfeeding beginning during the school years. Breastfeeding education in the school setting offers the opportunity to improve the knowledge base, address misconceptions, and positively influence beliefs and attitudes for students from a wide range of socioeconomic and cultural backgrounds. The purpose of this paper is to present a comprehensive narrative review of the literature regarding student and teacher (stakeholder) views of breastfeeding and breastfeeding education programs in schools to inform future research in the area. METHODS Articles were located through a systematic search of online databases and journals using the following keywords in various combinations: (1) breastfeeding, lactation, breast-feeding, "bottle feeding", "infant feeding" (2) student, educator, teacher, "school administrator" and (3) schools, "secondary education", "primary education", "K-12", "high school", "middle school", "elementary school", education, adolescents, curriculum, and a manual search of article references. Studies were screened for inclusion against specific criteria and included papers were assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS This review suggests that adolescents have a deficit in breastfeeding knowledge and express negative conceptions about breastfeeding. Breastfeeding is being discussed in some school environments, but the extent of lessons and the specific messages that teachers communicate have not been explored. Students appear to be interested in receiving more information about breastfeeding, especially if delivered by health professionals or breastfeeding mothers. The majority of teachers are supportive of incorporating breastfeeding education in family and consumer sciences, sexual education, and health classes; however, time constraints and limited knowledge of infant feeding recommendations may be barriers to implementation of appropriate lesson plans. CONCLUSIONS Students generally support and are receptive to breastfeeding education; however, research on educator attitudes, knowledge, and experiences are necessary for appropriate implementation of breastfeeding education in varying school settings around the world.
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Affiliation(s)
- Nicola Singletary
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Box 7624, Raleigh, NC 27695-7624 USA
| | - Ellen Chetwynd
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Box 7624, Raleigh, NC 27695-7624 USA
| | - L. Suzanne Goodell
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Box 7624, Raleigh, NC 27695-7624 USA
| | - April Fogleman
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Box 7624, Raleigh, NC 27695-7624 USA
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Austen EL, Dignam J, Hauf P. Using breastfeeding images to promote breastfeeding among young adults. Health Psychol Open 2016; 3:2055102916671015. [PMID: 35223072 PMCID: PMC8864535 DOI: 10.1177/2055102916671015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Young adults’ reactions to breastfeeding images were assessed using
varied approaches. In Study 1, participants viewed posters from a
breastfeeding campaign; many anticipated negative reaction to the
campaign. In Study 2, participants viewed novel infant-feeding
posters; breastfeeding posters were viewed for less time than
bottle-feeding posters, regardless of the task assigned. In Study 3,
participants were asked to rate their comfort level viewing
infant-feeding images; greater discomfort was reported for
breastfeeding images. Taken together, we argue that many young adults
expect, and experience, discomfort viewing breastfeeding, but it is
important to continue using breastfeeding images in promotion
efforts.
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Steinmetz H, Knappstein M, Ajzen I, Schmidt P, Kabst R. How Effective are Behavior Change Interventions Based on the Theory of Planned Behavior? ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2016. [DOI: 10.1027/2151-2604/a000255] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Abstract. The theory of planned behavior (TPB) is a prominent framework for predicting and explaining behavior in a variety of domains. The theory is also increasingly being used as a framework for conducting behavior change interventions. In this meta-analysis, we identified 82 papers reporting results of 123 interventions in a variety of disciplines. Our analysis confirmed the effectiveness of TPB-based interventions, with a mean effect size of .50 for changes in behavior and effect sizes ranging from .14 to .68 for changes in antecedent variables (behavioral, normative, and control beliefs, attitude, subjective norm, perceived behavioral control, and intention). Further analyses revealed that the interventions’ effectiveness varied for the diverse behavior change methods. In addition, interventions conducted in public and with groups were more successful than interventions in private locations or focusing on individuals. Finally, we identified gender and education as well as behavioral domain as moderators of the interventions’ effectiveness.
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Affiliation(s)
- Holger Steinmetz
- Department of International Business Studies, University of Paderborn, Germany
| | - Michael Knappstein
- Schumpeter School of Business and Economics, Wuppertal University, Germany
| | - Icek Ajzen
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - Peter Schmidt
- Faculty of Social Science, University of Giessen, Germany
| | - Rüdiger Kabst
- Department of Management, University of Paderborn, Germany
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Rostami F, Syed Hassan ST, Yaghmai F, Ismaeil SB, BinSuandi T. The Effect of Educational Intervention on Nurses' Attitudes Toward the Importance of Family-Centered Care in Pediatric Wards in Iran. Electron Physician 2015; 7:1261-9. [PMID: 26435826 PMCID: PMC4590562 DOI: 10.14661/1261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 07/28/2015] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Family-centered care sustains the unity of the child's and the family's health. The aim of this study was to determine nurses' attitudes toward parents' participation in the care of their hospitalized children in Iran in 2015. METHODS In this experimental study, 200 pediatric nurses from hospitals affiliated with the Shaheed Beheshti University of Medical Sciences in Tehran were selected using the multi-stage, random-sampling method. Data were gathered using a questionnaire that covered demographic information and nurses' attitudes. The questionnaire consisted of 31 items and was completed by the nurses in three stages: 1) before intervention (pre-test), 2) immediately after intervention (post-test), and 3) three months after intervention (follow-up). The data were analyzed via SPSS software and using descriptive and analytical methods. Descriptive statistics, the Spearman Correlation Coefficient, and Repeated Measure Analysis (the Bonferroni method) were used to assess the data. RESULTS The results indicated that there was a significant increase in the mean score of attitude after intervention [M (pre) = 3.35%, M (post) = 3.97%, p < 0.001)]. Most of subjects had neutral attitudes toward family participation in their children's care. There were no significant relationship between the nurses' socio-demographic characteristics and their attitudes. CONCLUSION The nurses' attitudes toward the family's participation in the care of their hospitalized children were moderate. The nurses' attitudes should be improved by taking part in continuous training programs.
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Affiliation(s)
- Forouzan Rostami
- Ph.D. Candidate of Community Health, Community Health Unit, Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Malaysia
- Department of Nursing, Faculty of Nursing and Midwifery, Islamic Azad University, Chaloos Branch, Chaloos, Iran
| | - Syed Tajuddin Syed Hassan
- Professor, Department of Medicine, Nursing Unit, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Malaysia
| | - Farideh Yaghmai
- Farideh Yaghmaei, BSN, MSN, Public Health PhD. Associate Professor-Department of Nursing Zanjan Branch, Islamic Azad University, Zanjan, Iran
| | - Suriani Binti Ismaeil
- Senior Lecturer (Medical), Community Health unit, Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Malaysia
| | - Turiman BinSuandi
- Professor, Educational unit, Faculty of Education, Universiti Putra Malaysia (UPM), Malaysia
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Effectiveness of a nutrition education package in improving feeding practices, dietary adequacy and growth of infants and young children in rural Tanzania: rationale, design and methods of a cluster randomised trial. BMC Public Health 2014; 14:1077. [PMID: 25318980 PMCID: PMC4216379 DOI: 10.1186/1471-2458-14-1077] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 10/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Strategies to improve infant and young child nutrition in low- and middle- income countries need to be implemented at scale. We contextualised and packaged successful strategies into a feasible intervention for implementation in rural Tanzania. Opportunities that can optimise delivery of the intervention and encourage behaviour change include mothers willingness to modifying practices; support of family members; seasonal availability and accessibility of foods; established set-up of village peers and functioning health system. The primary objective of the study is to evaluate the effectiveness of a nutrition education package in improving feeding practices, dietary adequacy and growth as compared to routine health education. METHODS/DESIGN A parallel cluster randomised controlled trial will be conducted in rural central Tanzania in 9 intervention and 9 control villages. The control group will receive routine health education offered monthly by health staff at health facilities. The intervention group will receive a nutrition education package in addition to the routine health education. The education package is comprised of four components: 1) education and counselling of mothers, 2) training community-based nutrition counsellors and monthly home visits, 3) sensitisation meetings with health staff and family members, and 4) supervision of community-based nutrition counsellors. The duration of the intervention is 9 months and infants will be recruited at 6 months of age. Primary outcome (linear growth as length-for-age Z-scores) and secondary outcomes (changes in weight-for-length Z-scores; mean intake of energy, fat, iron and zinc from complementary foods; proportion of children consuming 4 or more food groups and recommended number of semi-solid/soft meals and snacks per day; maternal level of knowledge and performance of recommended practices) will be assessed at baseline and ages 9, 12 and 15 months. Process evaluation will document reach, dose and fidelity of the intervention and context at 8 and 15 months. DISCUSSION Results of the trial will provide evidence of the effectiveness of the nutrition education package in community settings of rural Tanzania. They will provide recommendations for strengthening the nutrition component of health education in child health services. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02249754, September 25, 2014.
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Giles M, Millar S, Armour C, McClenahan C, Mallett J, Stewart-Knox B. Promoting positive attitudes to breastfeeding: the development and evaluation of a theory-based intervention with school children involving a cluster randomised controlled trial. MATERNAL AND CHILD NUTRITION 2013; 11:656-72. [PMID: 24028173 DOI: 10.1111/mcn.12079] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The objective of this study was to design, implement and evaluate an intervention based on the theory of planned behaviour (TPB) to enhance young peoples' motivations to breastfeed/support a partner to breastfeed. Six semi-structured focus groups were first conducted with 48 13-14-year-olds from two schools in Northern Ireland. The salient beliefs elicited were subsequently used to design a TPB-based questionnaire that was then administered to 2021 13-14-year-old pupils (852 males; 1169 females) from 36 post-primary schools to identify the most important determinants of breastfeeding. The results were used to inform the design and implementation of an intervention package that was subsequently evaluated using a cluster randomised controlled trial involving 44 randomly selected schools across Northern Ireland. Questionnaires were administered to 18 intervention and 26 control schools at baseline and again at 1 and 6 months post-intervention to evaluate its effectiveness. Multi-level modelling was employed to analyse the data. The results revealed significant effects on women's intention to breastfeed, β = 0.208, t(1275) = 2.715, P = 0.007; attitudes, β = 0.223, t(1275) = 4.655, P < 0.001; moral attitudes, β = 0.231, t(1275) = 4.211, P < 0.001; subjective norm, β = 0.118, t(1275) = 2.521, P = 0.012; and knowledge, β = 0.109, d.f. (1275) = 7.843, P < 0.001. However, for men, the results revealed significant effects on only the construct of knowledge, β = 0.104, t(541) = 4.345, P < 0.001.The research has provided evidence to support the need for breastfeeding education in schools and has shown how a theoretical framework may be used to inform the design and evaluation of a health behaviour intervention.
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Affiliation(s)
- Melanie Giles
- School of Psychology, University of Ulster, Coleraine, UK
| | - Samantha Millar
- UKCRC Centre of Excellence for Public Health NI, Institute of Clinical Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, UK
| | - Cherie Armour
- School of Psychology, University of Ulster, Coleraine, UK
| | | | - John Mallett
- School of Psychology, University of Ulster, Coleraine, UK
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