A Theory of Planned Behavior-Based Structural Model for Breast-Feeding

Duckett, Laura; Henly, Susan J.; Avery, Melissa D.; Potter, S.V.; Hills-Bonczyk, Sharon C.; Hulden, Rebecca; Savik, Kay

doi:10.1097/00006199-199811000-00006

Cited by 112 publications

(112 citation statements)

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“…On the other hand, many studies indicate that attitudes (9,20,21,(26)(27)(28)(29)(30)(31)(32)(33)(34) , self-efficacy (21,27,28,(31)(32)(33)(35)(36)(37)(38) and knowledge (10,22,39) are predictive of breast-feeding initiation and duration. Differences from our results could stem from difficulties in comparing across disparate breastfeeding behavioural outcomes, since we report on EBF and full breast-feeding rather than initiation and attrition.…”

Section: Discussionmentioning

confidence: 99%

Maternal prenatal attitudes and postnatal breast-feeding behaviours in rural Bangladesh

Yu¹,

Thomas²,

Owais³

et al. 2014

Public Health Nutr.

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Objective: To assess the relationships between maternal breast-feeding intention, attitudes, self-efficacy and knowledge at 7 months' gestation with exclusive or full breast-feeding at 3 months postpartum. Design: Prospective cohort study with structured home interviews during pregnancy and 3 months after delivery. Setting: Two rural sub-districts of Kishoreganj district, Bangladesh. Subjects: Mother-infant dyads. Results: Over 80 % of 2178 pregnant women intended to exclusively breast-feed (EBF). Maternal positive attitudes, self-efficacy and knowledge about breastfeeding were positively associated with EBF intention (all P < 0·05). All mothers except one reported initiating breast-feeding and 99·6 % of children were still breast-fed at 3 months. According to 24 h dietary recalls, we categorized 985 (45·2 %) infants as EBF at 3 months (47·8 % among mothers with EBF intention; 31·7 % among mothers with no EBF intention; P < 0·05) and 551 (25·3 %) infants as predominantly breast-fed at 3 months (24·2 % among mothers with EBF intention; 30·8 % among mothers with no EBF intention; P < 0·05). Prenatal EBF intention was associated with EBF (OR = 1·48, 95 % CI 1·14, 1·91) and with full breastfeeding (OR = 1·34, 95 % CI 1·04, 1·72) at age 3 months. EBF at age 3 months was not associated with maternal breast-feeding knowledge, attitudes or self-efficacy. Conclusions: Despite widespread expressed maternal EBF intention and universal breast-feeding initiation, prevalence of both exclusive and full breast-feeding at 3 months remains lower than WHO recommendations. EBF intention predicts breast-feeding behaviours, suggesting the importance of prenatal counselling to improve infant feeding behaviours.Keywords Breast-feeding Attitude Self-efficacy KnowledgeGlobally, over 55 % of infant deaths from diarrhoeal disease and acute respiratory infections are preventable by appropriate breast-feeding and complementary feeding (1) . Suboptimal infant feeding and endemic malnutrition contribute to mortality and morbidity, as well as to detrimental long-term developmental consequences, poorer educational performance and decreased productivity (2)(3)(4)(5)(6)(7) . Although the potential benefits of exclusive breastfeeding (EBF) through to infant age 6 months are widely recognized, EBF remains low in both developed and developing countries.Maternal psychosocial factors and intentions to breastfeed have been associated, to varying extents, with infant feeding behaviours in previous literature. A nationally representative US study among 2372 women found that intention to partially or fully breast-feed predicted breastfeeding duration (>6 months) (8) . Similarly, in a cohort of 566 Australian women, intention to breast-feed was also positively associated with breast-feeding duration (9) . In separate study among 733 women, attitudes about benefits and barriers to breast-feeding, health-care systems, as well as social support were associated with breast-feeding initiation (10) .Over the past two decades, many studies have incorporate...

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Section: Discussionmentioning

confidence: 99%

Maternal prenatal attitudes and postnatal breast-feeding behaviours in rural Bangladesh

Yu¹,

Thomas²,

Owais³

et al. 2014

Public Health Nutr.

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“…Among the health behaviours to have been examined are smoking (Godin, Valois, Lepage, & Desharnais, 1992), breast feeding (Duckett et al, 1998), medical screening (Norman & Conner, 1993;Rutter, 2000;Steadman & Rutter, 2004), food choice (Conner, Povey, Bell, & Norman, 1994;Sparks & Shepherd, 1992) and condom use (Chan & Fishbein, 1993). According to the most frequently used approached to intention, the Theory of Planned Behaviour (Ajzen, 1991(Ajzen, , 2005, intention to adhere to hypertension medication will be best predicted by the person's attitude to adhering, subjective norm about adhering, and perceived behavioural control over adhering -variables that were noted earlier in the Introduction.…”

Section: Behavioural Intentionsmentioning

confidence: 99%

Adherence to anti‐hypertensive medication: Proposing and testing a conceptual model

Quine

Steadman

Thompson

et al. 2011

British J Health Psychol

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This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link:http://openaccess.city.ac.uk/5529/ Link to published version: http://dx.doi.org/10.1111/j. 2044-8287.2011.02034.x Copyright and reuse: City Research Online aims to make research outputs of City, University of London available to a wider audience. Copyright and Moral Rights remain with the author(s) and/or copyright holders. URLs from City Research Online may be freely distributed and linked to. hypertensive medication is proposed and tested. The model suggests that adherence is influenced by three sets of variables: demography, health status and perceived effects of medication; cognitions and motivation; and intention to adhere. Methods and DesignPatients with known hypertension were recruited from three primary care practices in South-East England and were asked to complete a postal questionnaire. A total of 1070 responses were received. The questionnaire asked about the three sets of predictor variables, and adherence. Eight weeks after the first questionnaire, a second was posted to all respondents, this time asking about adherence over the intervening period. ResultsThe three sets of predictor variables were treated as blocks in a hierarchical model, so that each successive block added to the variance in adherence explained by the previous blocks. The data were analysed by hierarchical multiple regression. The predictors accounted for 19% of the variance in adherence at Time 1, and 34% at Time 2. The leading individual predictors at Time 1 were age, gender, conscientiousness, hypertensive identity, perceived behavioural control, and intention. At Time 2, they were the same, except that gender made way for adherence at Time 1. ConclusionsThe model offers a parsimonious account, and the findings suggest a number of approaches to designing interventions to modify behaviour. , 1997Horne & Weinman, 1999, 2002Legare, Godin, Dodin, Turcot, & Lapierre, 2003;Lynch et al., 2000;Schmier & Leidy, 1998;Trachtenberg, Dugan, & Hall, 2005). Despite these explanations, the social-psychological mechanisms involved in medication adherence are poorly understood and no single conceptual framework has been developed in which to study it (Morrell, Park, Kidder, & Martin, 1997).The aim of the present study was to investigate the predictors of medication adherence by developing a conceptual model, using a prospective longitudinal design to investigate possible causal pathways. This was pursued in the context of adherence to antihypertensive medication. We chose to study hypertension because it is a common conditionAdherence to anti-hypertensive medication 4 of 32 that is a risk factor for other potentially fatal conditions, such as myocardial infarction and stroke, and because blood pressure control in the UK is known to be sub-optimal --even among those treated for hypertension, of whom only half to two-thirds are thought to be adherent (Ebrahim, 1998;Primatesta, Brookes, & Poulter, 20...

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“…However, one which measured intentions before giving birth found that they were a strong predictor of behaviour, with r = .67 for breastfeeding initiation and r = .42 for breastfeeding at 6 weeks (McMillan et al ., 2008). Other prospective studies have shown direct associations (not mediated by intentions) between breastfeeding behaviour and attitudes, subjective norms, and PBC/self‐efficacy (Duckett et al ., 1998; Lawton et al ., 2012; Manstead, Plevin, & Smart, 1984; Manstead, Proffitt, & Smart, 1983; McMillan et al ., 2008). Therefore, there is evidence that the components of the TPB are relevant to understanding infant feeding intentions and behaviour, although they may not be best operationalized in the TPB model.…”

Section: Introductionmentioning

confidence: 99%

Explaining infant feeding: The role of previous personal and vicarious experience on attitudes, subjective norms, self‐efficacy, and breastfeeding outcomes

Bartle

Harvey

2017

British J Health Psychol

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ObjectivesBreastfeeding confers important health benefits to both infants and their mothers, but rates are low in the United Kingdom and other developed countries despite widespread promotion. This study examined the relationships between personal and vicarious experience of infant feeding, self‐efficacy, the theory of planned behaviour variables of attitudes and subjective norm, and the likelihood of breastfeeding at 6–8 weeks post‐natally.DesignA prospective questionnaire study of both first‐time mothers (n = 77) and experienced breastfeeders (n = 72) recruited at an antenatal clinic in South East England.MethodsParticipants completed a questionnaire at 32 weeks pregnant assessing personal and vicarious experience of infant feeding (breastfeeding, formula‐feeding, and maternal grandmother’s experience of breastfeeding), perceived control, self‐efficacy, intentions, attitudes (to breastfeeding and formula‐feeding), and subjective norm. Infant feeding behaviour was recorded at 6–8 weeks post‐natally. Multiple linear regression modelled the influence of vicarious experience on attitudes, subjective norm, and self‐efficacy (but not perceived control) and modelled the influence of attitude, subjective norm, self‐efficacy, and past experience on intentions to breastfeed. Logistic regression modelled the likelihood of breastfeeding at 6–8 weeks.ResultsPrevious experience (particularly personal experience of breastfeeding) explained a significant amount of variance in attitudes, subjective norm, and self‐efficacy. Intentions to breastfeed were predicted by subjective norm and attitude to formula‐feeding and, in experienced mothers, self‐efficacy. Breastfeeding at 6 weeks was predicted by intentions and vicarious experience of formula‐feeding.ConclusionVicarious experience, particularly of formula‐feeding, has been shown to influence the behaviour of first‐time and experienced mothers both directly and indirectly via attitudes and subjective norm. Interventions that reduce exposure to formula‐feeding (perhaps by limiting advertising) or cushion mothers from its effects may enable more mothers to meet their breastfeeding goals. Statement of contribution What is already known on this subject? Rates of breastfeeding in the United Kingdom are low and resistant to change.Self‐efficacy may be an important and modifiable factor for breastfeeding initiation and maintenance. What does this study add? Self‐efficacy may only be a relevant factor among mothers who already have personal experience of breastfeeding.Vicarious experience of formula‐feeding has been shown to be related to a lower rate of breastfeeding at 6 weeks.

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A Theory of Planned Behavior-Based Structural Model for Breast-Feeding

Abstract: The TPB-BrF is a comprehensive, theoretically based, empirically verified model that can serve as a useful heuristic for understanding the personal motivational components of breast-feeding behavior.

Cited by 112 publications

References 36 publications

Maternal prenatal attitudes and postnatal breast-feeding behaviours in rural Bangladesh

Maternal prenatal attitudes and postnatal breast-feeding behaviours in rural Bangladesh

Adherence to anti‐hypertensive medication: Proposing and testing a conceptual model

Explaining infant feeding: The role of previous personal and vicarious experience on attitudes, subjective norms, self‐efficacy, and breastfeeding outcomes

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