Employing the Theory of Planned Behavior to Predict Breastfeeding Intention and Intensity in Oman

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  • March 20, 2019
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  • Al-Barwani, Saada
    • Affiliation: School of Nursing
Abstract
  • Low breastfeeding initiation, duration and intensity are a global concern. Oman, located in the Arabian Peninsula, is no exception. As per the World Health Organization, the definition of exclusive breastfeeding (EBF) is infant receiving only breast milk or expressed breast milk, and no other liquids or solids for the first 6-month of life except for drops or syrups or medicines. EBF influence child development and survival. Currently, in Oman, about one in 10 infants are EBF for the first 6-month, although more than nine in 10 were EBF at birth. Factors that contribute to breastfeeding outcomes are not well researched in Oman. Thus, this dissertation aimed to examine maternal belief variables (attitudes, subjective norms and perceived behavior control), as well as the relationship of maternal intention, sociodemographic variables, knowledge, early breastfeeding support, and previous breastfeeding experience with breastfeeding intensity measured as the percent of feeding per 24-hour period that were from breastfeeding or breast milk. The theory of planned behavior (TPB) was employed in a structural equation modeling analysis. Three manuscripts were produced to accomplish the purpose of the overall study. The first manuscript was a systematic review of literature on the relationship between belief variables and intention and breastfeeding initiation and duration. The second manuscript was a systematic translation and back-translation of the revised-breastfeeding attrition prediction tool using content validity indexing, cognitive interviews, and pilot testing, which was later used to study Omani mothers. The third manuscript reports on the findings of a study conducted in Omani mothers that examined the theorized variables. The main findings of the three manuscripts were: all of the TPB beliefs variables were significantly associated with breastfeeding intention. Maternal intention significantly predicted breastfeeding outcome. Return to work or school was the only sociodemographic variable that had a significant influence (negative) on breastfeeding intensity. Breastfeeding knowledge influenced belief variables and early postpartum breastfeeding support was negatively associated intensity. Results of this dissertation indicate that maternal belief variables, returning to work or school, knowledge, and early breastfeeding support all should be considered by clinicians, researchers and policy makers in optimizing breastfeeding outcomes in Omani mothers.
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  • In Copyright
Advisor
  • Hodges, Eric
  • Knafl, Kathleen
  • Crandell, Jamie
  • Labbok, Miriam
  • Thoyre, Suzanne
  • Sullivan, Catherine
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2017
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