2023: Two-year Impact Factor: 2.4
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CiteScore (2024):5.2
Open Access

Health Promot Perspect. 2024;14(1): 70-79.
doi: 10.34172/hpp.42599
PMID: 38623350
PMCID: PMC11016141
  Abstract View: 511
  PDF Download: 377

Original Article

Theory-based antecedents of breastfeeding among pregnant women in the United States

Manoj Sharma 1,2 ORCID logo, Christopher Johansen 1 ORCID logo, Miguel Fudolig 3 ORCID logo, Chia-Liang Dai 4 ORCID logo, Sidath Kapukotuwa 1 ORCID logo, Liliana Davalos 1 ORCID logo, Laurencia Bonsu 1* ORCID logo

1 Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas (UNLV), NV 89119, USA
2 Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89106, USA
3 Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas (UNLV), NV 89119, USA
4 Department of Teaching and Learning, College of Education, University of Nevada, Las Vegas, (UNLV), NV 89119, USA
*Corresponding Author: Laurencia Bonsu, Email: bonsul1@unlv.nevada.edu


Background: Breastfeeding provides several positive health benefits for the newborn child, yet breastfeeding rates remain low in the United States (US). Theory-based approaches have the potential to improve breastfeeding promotion interventions. Hence, the study examined the correlates of intention to breastfeed among US pregnant women based on the multi-theory model (MTM) of health behavior change.

Methods: Using a cross-sectional design, a 36-item online survey was administered to a nationally representative sample of 315 pregnant women in the US. The instrument was psychometrically validated for face, content, and construct validity by a panel of six experts over two rounds. Further, construct validation was done by confirmatory factor analysis (CFA). Hierarchical regression modeling was employed to explain the intention to start breastfeeding and sustain exclusive breastfeeding for up to six months and with complementary foods for up to 24 months.

Results: Internal consistency using Cronbach’s alpha was found to be acceptable. It was found that behavioral confidence and changes in the physical environment positively affected the initiation of breastfeeding (P<0.01; adjusted R2=0.478). All three constructs of MTM namely practice for change, emotional transformation, and changes in the social environment were significant predictors for the sustenance of breastfeeding at six months (P<0.01; adjusted R2=0.591) and at 24 months (P<0.01; adjusted R2=0.347).

Conclusion: Based on the findings of this study it is essential for educators and healthcare providers to design MTM-based interventions to promote breastfeeding among pregnant women in the US.

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Submitted: 13 Oct 2023
Accepted: 16 Dec 2023
ePublished: 14 Mar 2024
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