TY - JOUR
T1 - Effectiveness of an integrated breastfeeding education program to improve self-efficacy and exclusive breastfeeding rate
T2 - A single-blind, randomised controlled study
AU - Tseng, Juei Fen
AU - Chen, Su Ru
AU - Au, Heng Kien
AU - Chipojola, Roselyn
AU - Lee, Gabrielle T.
AU - Lee, Pi Hsia
AU - Shyu, Meei Ling
AU - Kuo, Shu Yu
N1 - Publisher Copyright:
© 2020
PY - 2020/11
Y1 - 2020/11
N2 - Background: Low self-efficacy affects new mothers’ ability to sustain breastfeeding. Interventions that increase self-efficacy could improve sustained breastfeeding. Objectives: To develop an integrated breastfeeding education program based on self-efficacy theory, and evaluate the effect of the intervention on first-time mothers’ breastfeeding self-efficacy and attitudes. Design: A single-blind, randomised controlled trial. Setting: A prenatal clinic of a teaching hospital. Participants: First-time mothers with a singleton pregnancy (12–32 weeks’ gestation) and their support partners were selected by convenience sampling (N = 104) and allocated by block-randomization to an intervention or control group. Methods: A 3-week breastfeeding intervention program was developed based on self-efficacy theory. The intervention group received the breastfeeding program; the control group received standard care. Data between groups were compared for scores on breastfeeding self-efficacy, infant feeding attitude, and breastfeeding practice, which were assessed using the Breastfeeding Self-Efficacy Scale-Short Form, the Iowa Infant Feeding Attitude Scale, and a structured questionnaire, respectively. Repeated data measurements were collected at baseline, 36-weeks’ gestation, and postpartum at 1-week, and 1-, 3-, and 6-months. Results: Ninety-three mothers completed the study. Data were compared for the self-efficacy intervention group (n = 50) with the control group (n = 43). Baseline measures did not differ between groups. The intervention group had significantly higher breastfeeding self-efficacy at 36 weeks’ gestation (mean difference (MD): 7.3, p < .001), and postpartum at 1-week (p < .001), 1-month (p < .001) and 3-months (p < .01) with MD: 6.7, 7.9, and 8.1, respectively; differences in scores from baseline were also significantly greater from 36 weeks’ gestation to 3-months (MD from 9.1~9.9, p < .001) and 6-months postpartum (MD: 7.0, p < .05). Infant feeding attitude scores significantly improved from 36 weeks’ gestation to 6-months postpartum for the intervention group (MD from 3.5~7.4, p < .05). Rates for exclusive and predominant breastfeeding postpartum were significantly higher for the intervention group vs control (p < .02) at 1-week (98% vs. 86%), 1-month (100% vs. 90.7%), and 3-months (94% vs. 76.7%). Odds ratio (OR) postpartum for exclusive and predominant breastfeeding was greater for the intervention group at 3-months (OR = 4.7, 95% Confidence interval (CI), 1.2 -18.6; p = .05) and for exclusive breastfeeding at 6-months (OR: 2.82, 95% CI 1.0–8.1; p = .05). Conclusions: The breastfeeding education intervention improved breastfeeding self-efficacy, infant feeding attitudes, and exclusive breastfeeding rates. The breastfeeding education program could be effective for sustaining breastfeeding in new mothers. Trial registration: Registered with www.clinicaltrials.gov (NCT03807726)
AB - Background: Low self-efficacy affects new mothers’ ability to sustain breastfeeding. Interventions that increase self-efficacy could improve sustained breastfeeding. Objectives: To develop an integrated breastfeeding education program based on self-efficacy theory, and evaluate the effect of the intervention on first-time mothers’ breastfeeding self-efficacy and attitudes. Design: A single-blind, randomised controlled trial. Setting: A prenatal clinic of a teaching hospital. Participants: First-time mothers with a singleton pregnancy (12–32 weeks’ gestation) and their support partners were selected by convenience sampling (N = 104) and allocated by block-randomization to an intervention or control group. Methods: A 3-week breastfeeding intervention program was developed based on self-efficacy theory. The intervention group received the breastfeeding program; the control group received standard care. Data between groups were compared for scores on breastfeeding self-efficacy, infant feeding attitude, and breastfeeding practice, which were assessed using the Breastfeeding Self-Efficacy Scale-Short Form, the Iowa Infant Feeding Attitude Scale, and a structured questionnaire, respectively. Repeated data measurements were collected at baseline, 36-weeks’ gestation, and postpartum at 1-week, and 1-, 3-, and 6-months. Results: Ninety-three mothers completed the study. Data were compared for the self-efficacy intervention group (n = 50) with the control group (n = 43). Baseline measures did not differ between groups. The intervention group had significantly higher breastfeeding self-efficacy at 36 weeks’ gestation (mean difference (MD): 7.3, p < .001), and postpartum at 1-week (p < .001), 1-month (p < .001) and 3-months (p < .01) with MD: 6.7, 7.9, and 8.1, respectively; differences in scores from baseline were also significantly greater from 36 weeks’ gestation to 3-months (MD from 9.1~9.9, p < .001) and 6-months postpartum (MD: 7.0, p < .05). Infant feeding attitude scores significantly improved from 36 weeks’ gestation to 6-months postpartum for the intervention group (MD from 3.5~7.4, p < .05). Rates for exclusive and predominant breastfeeding postpartum were significantly higher for the intervention group vs control (p < .02) at 1-week (98% vs. 86%), 1-month (100% vs. 90.7%), and 3-months (94% vs. 76.7%). Odds ratio (OR) postpartum for exclusive and predominant breastfeeding was greater for the intervention group at 3-months (OR = 4.7, 95% Confidence interval (CI), 1.2 -18.6; p = .05) and for exclusive breastfeeding at 6-months (OR: 2.82, 95% CI 1.0–8.1; p = .05). Conclusions: The breastfeeding education intervention improved breastfeeding self-efficacy, infant feeding attitudes, and exclusive breastfeeding rates. The breastfeeding education program could be effective for sustaining breastfeeding in new mothers. Trial registration: Registered with www.clinicaltrials.gov (NCT03807726)
KW - Breastfeeding education program
KW - Breastfeeding self-efficacy
KW - Exclusive breastfeeding
KW - Postpartum
KW - Randomised controlled trial
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U2 - 10.1016/j.ijnurstu.2020.103770
DO - 10.1016/j.ijnurstu.2020.103770
M3 - Article
C2 - 32961461
AN - SCOPUS:85091120916
SN - 0020-7489
VL - 111
JO - International Journal of Nursing Studies
JF - International Journal of Nursing Studies
M1 - 103770
ER -