Factors Influencing the Intention of Perinatal Nurses to Adopt the Baby-Friendly Hospital Initiative in Southeastern Quebec, Canada: Implications for Practice

Abstract

Nurses play a major role in promoting the baby-friendly hospital initiative (BFHI), yet the adoption of this initiative by nurses remains a challenge in many countries, despite evidences of its positive impacts on breastfeeding outcomes. The aim of this study was to identify the factors influencing perinatal nurses to adopt the BFHI in their practice. Methods. A sample of 159 perinatal nurses from six hospital-based maternity centers completed a survey based on the theory of planned behavior. Hierarchical multiple linear regression analyses were performed to assess the relationship between key independent variables and nurses' intention to adopt the BFHI in their practice. A discriminant analysis of nurses' beliefs helped identify the targets of actions to foster the adoption the BFHI among nurses. Results. The participants are mainly influenced by factors pertaining to their perceived capacity to overcome the strict criteria of the BFHI, the mothers' approval of a nursing practice based on the BFHI, and the antenatal preparation of the mothers. Conclusions. This study provides theory-based evidence for the development of effective interventions aimed at promoting the adoption of the BFHI in nurses' practice.

Factors associated with breastfeeding support from health care professionals by implementing a Clinical Practice Guideline

“…In the area in which the breastfeeding CPG was implemented, breastfeeding support by the professionals has improved postimplementation in three of the four Theory of Planned Behavior components, with the greatest improvement in the subjective norms scale, which is related to social pressures to enact a behavior . These results are similar to findings in Canadian nurses . Higher subjective norms scores have been associated with the cultural changes that accompany CPG implementation, socializing the value of breastfeeding and increasing peer pressure among professionals .…”

“…27 These results are similar to findings in Canadian nurses. 21 Higher subjective norms scores have been associated with the cultural changes that accompany CPG implementation, socializing the value of breastfeeding and increasing peer pressure among professionals. 26,28 These processes have been found to promote a spirit that favors the development of evidence-based practice.…”

“…13,35 The percentage of adequate responses was higher in the BFHIaccredited area than in the postimplementation area for some items. BFHI accreditation has been associated with high scores in subjective norms and attitudes toward breastfeeding practices, 21,36 and a higher proportion of professionals in the BFHI-accredited area reported providing practical breastfeeding assistance, suggesting that consolidation of this important behavior change may require more time. Thus, a similar study in primary care nurses found that beliefs were modified at 16 weeks after Registered Nurses' Association of Ontario breastfeeding CPG implementation but that breastfeeding support was not.…”

“…Studies in students of health sciences and registered nurses found that knowledge and previous experience of lactation were associated with positive attitudes toward breastfeeding, which were important predictors of the intentionality of professionals . Another study in nurses observed that subjective norms, behavioral control, and moral norms were associated with the adoption of breastfeeding support behaviors …”

“…[18][19][20] Another study in nurses observed that subjective norms, behavioral control, and moral norms were associated with the adoption of breastfeeding support behaviors. 21 The objective of this study was to identify factors associated with breastfeeding support behaviors of health care professionals in a health area in which a Registered Nurses' Association of Ontario CPG for breastfeeding was implemented, comparing the results with: professionals in the same health area before CPG implementation, those in a standardcare health area, and those in a Baby-Friendly Hospital Initiative (BFHI)-accredited area.…”