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The impact of knowledge and social influences on adolescents' breast-feeding beliefs and intentions

Published online by Cambridge University Press:  02 January 2007

Vivien Swanson*
Affiliation:
Department of Psychology, University of Stirling, Stirling, FK9 4LA, UK
Kevin Power
Affiliation:
Department of Psychology, University of Stirling, Stirling, FK9 4LA, UK
Binder Kaur
Affiliation:
Department of Psychology, University of Stirling, Stirling, FK9 4LA, UK
Harden Carter
Affiliation:
Lothian Health Board, 148 Pleasance, Edinburgh, EH8 9RS, UK
Kim Shepherd
Affiliation:
University of Paisley, Paisley, PA1 2BE, UK
*
*Corresponding author: Email [email protected]
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Abstract

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Objectives

Many health promotion educational interventions assume that increasing knowledge directly influences beliefs, intentions and behaviour, whereas research suggests that knowledge alone is insufficient for behavioural change. Social cognition frameworks such as the Theory of Reasoned Action propose a central role for beliefs and social normative influences. This Scottish study evaluates the role of knowledge and social influences (subjective norms, exposure to breast-feeding, social barriers) on beliefs and future intentions to breast-feed or bottle-feed. Social influences from family and peers are investigated.

Design

A cross-sectional between-subjects observational design was used. A questionnaire was administered to a sample of 229 (46%) male and 267 (54%) female adolescents aged 11–18 years.

Setting

Participants completed questionnaires during lessons at three secondary schools in Central Scotland.

Results

Knowledge about health benefits of breast-feeding was generally poor. Analyses found that perceived social barriers to breast-feeding moderated the relationship between knowledge and beliefs. More knowledge, positive beliefs and supportive subjective norms also predicted future intentions to breast-feed. Parental norms exerted greater influence than peer norms on adolescents' breast-feeding beliefs.

Conclusions

Knowledge and social influences are important predictors of positive breast-feeding beliefs and future intentions to breast-feed in adolescents. This has important implications for breast-feeding health promotion interventions in young people.

Type
Research Article
Copyright
Copyright © The Authors 2006

References

1Ellis, DJ. Secondary school students' attitudes and beliefs about breastfeeding. Journal of School Health 1983; 53(10): 600–4.CrossRefGoogle ScholarPubMed
2Hamlyn, B, Brooker, S, Oleinikova, K, Wands, S. Infant Feeding Survey 2000. London: Department of Health, 2002.Google Scholar
3World Health Organization (WHO). Health Statistics 2003. Geneva: WHO, 2003.Google Scholar
4Forster, D, McLachlan, H, Lumley, F, Beanland, C, Waldenstrom, U, Amir, L. Two mid-pregnancy interventions to increase the initiation and duration of breastfeeding: a randomized controlled trial. Birth 2004; 31(3): 176–82.CrossRefGoogle ScholarPubMed
5Tappin, D, Mackenzie, JM, Brown, AJ, Girdwood, RWA, Britten, J, Broadfoot, M, et al. Breastfeeding rates are increasing in Scotland. Health Bulletin 2001; 59(2): 102–8.Google ScholarPubMed
6Pobocik, RS, Benavente, JC, Schwab, AC, Boudreau, N, Morris, CH, Houston, MS. Effect of a breastfeeding education and support program on breastfeeding initiation and duration in a culturally diverse group of adolescents. Journal of Nutrition Education 2000; 32(3): 139–45.CrossRefGoogle Scholar
7Protheroe, L, Dyson, L, Renfrew, M, Bull, J, Mulvahill, C. The Effectiveness of Public Health Interventions to Promote the Initiation of Breastfeeding. NHS Health Development Agency Evidence Briefing. London: Health Development Agency, 2003.Google Scholar
8World Health Organization (WHO). Protection, Promotion and Support of Breastfeeding in Europe: Review of Interventions. EU Project Contract No. SPC 2002359. Geneva: WHO, 2004.Google Scholar
9Swanson, V, Power, KG. A theoretically based, cross-cultural study of infant feeding in new mothers and their partners. In: Watson, J, Platt, S, eds. Researching Health Promotion. London: Routledge, 2000; 183206.Google Scholar
10Shepherd, CK, Power, KG, Carter, H. Examining the correspondence of breastfeeding and bottle-feeding couples' infant feeding attitudes. Journal of Advanced Nursing 2000; 31(3): 651–60.CrossRefGoogle ScholarPubMed
11Kim, Y. The effects of a breastfeeding campaign on adolescent Korean women. Paediatric Nursing 1998; 24(3): 235–40.Google ScholarPubMed
12Goulet, C, Lampron, A, Marcil, I, Ross, L. Attitudes and subjective norms of male and female adolescents towards breastfeeding. Journal of Human Lactation 2003; 19(4): 402–10.CrossRefGoogle Scholar
13Littman, H, Medendorp, SV, Goldfarb, J. The decision to breastfeed. The importance of fathers' approval. Clinical Pediatrics 1994; 33(4): 214–9.CrossRefGoogle ScholarPubMed
14Kessler, LA, Gielen, AC, Diener-West, M, Paige, D. The effect of a woman's significant other on her breastfeeding decision. Journal of Human Lactation 1995; 11(2): 103–9.CrossRefGoogle ScholarPubMed
15Scott, JA, Binns, CW, Aroni, RA. The influence of reported paternal attitudes on the decision to breastfeed. Journal of Paediatrics and Child Health 1997; 33(4): 305–7.CrossRefGoogle Scholar
16Arora, S, McJunkin, C, Wehrer, J, Kuhn, P. Major factors influencing breastfeeding rates: mothers' perception of father's attitude and milk supply. Paediatrics 2000; 106(5): 15.CrossRefGoogle ScholarPubMed
17Ajzen, I, Fishbein, M. Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ: Prentice-Hall, 1980.Google Scholar
18Ajzen, I. The theory of planned behaviour. Organizational Behavior and Human Decision Processes 1991; 50: 179211.CrossRefGoogle Scholar
19Manstead, ASR, Proffitt, C, Smart, JL. Predicting and understanding mothers' infant feeding intentions and behaviour: testing the theory of reasoned action. Journal of Personality and Social Psychology 1983; 44(4): 657–71.CrossRefGoogle ScholarPubMed
20O'Campo, P, Faden, R, Gielen, A, Wang, M. Prenatal factors associated with breast-feeding duration: recommendations for prenatal interventions. Birth 1992; 19(4): 195201.CrossRefGoogle ScholarPubMed
21Janke, JR. Development of the breast-feeding attrition prediction tool. Nursing Research 1994; 43(2): 100–4.CrossRefGoogle ScholarPubMed
22Wambach, KA. Breastfeeding intention and outcome: a test of the theory of planned behaviour. Research in Nursing & Health 1997; 20(1): 51–9.3.0.CO;2-T>CrossRefGoogle Scholar
23Duckett, L, Henly, S, Avery, M, Potter, S, Hills-Bonczyk, S, Hulden, R, et al. A theory of planned behaviour-based structural model for breast-feeding. Nursing Research 1998; 47(6): 325–36.CrossRefGoogle Scholar
24Humphreys, AS, Thompson, NJ, Miner, KR. Assessment of breastfeeding intention using the transtheoretical model and the theory of reasoned action. Health Education Research 1998; 13(3): 331–41.CrossRefGoogle Scholar
25Conner, M, Armitage, CJ. Extending the theory of planned behaviour: a review and avenues for further research. Journal of Applied Social Psychology 1998; 28(15): 1429–64.CrossRefGoogle Scholar
26Sheeran, P, Orbell, S. Augmenting the theory of planned behaviour; roles of anticipated regret and descriptive norms. Journal of Applied Social Psychology 1999; 29: 2107–42.CrossRefGoogle Scholar
27Trafimow, D, Finlay, K. The importance of subjective norms for a minority of people: between-subjects and within-subjects analyses. Personality and Social Psychology Bulletin 1996; 22: 820–8.CrossRefGoogle Scholar
28Cialdini, RB, Reno, RR, Kallgren, CA. A focus theory of normative conduct: recycling the concept of norms to reduce littering in public places. Journal of Personality and Social Psychology 1990; 58: 1015–26.CrossRefGoogle Scholar
29Fekadu, Z, Kraft, P. Expanding the theory of planned behaviour: the role of social norms and group identification. Journal of Health Psychology 2002; 7(1): 3343.CrossRefGoogle ScholarPubMed
30Terry, DJ, Hogg, MA, White, KA. The theory of planned behaviour: self-identity, social identity, and group norms. British Journal of Social Psychology 1999; 38(Pt 3):225–44.CrossRefGoogle ScholarPubMed
31Povey, R, Conner, M, Sparks, P, James, R, Shepherd, R. The theory of planned behaviour and healthy eating: examining additive and moderating effects of social influence variables. Psychology & Health 2000; 14: 9911006.CrossRefGoogle ScholarPubMed
32Wang, QM, Fitzhugh, EC, Westerfield, RC, Eddy, JM. Family and peer influences on smoking behaviour among American adolescents: an age trend. Journal of Adolescent Health 1995; 16(3): 200–3.CrossRefGoogle ScholarPubMed
33Rai, AA, Stanton, B, Wu, Y, Li, X, Galbraith, J, Cottrell, L, et al. Relative influences of perceived parental monitoring and perceived peer involvement on adolescent risk behaviours: an analysis of six cross-sectional data sets. Journal of Adolescent Health 2003; 33(2): 108–18.CrossRefGoogle ScholarPubMed
34Lau, RR, Quadrel, MJ, Hartman, K. Development and change of young adults' preventive health beliefs and behaviour: influence from parents and peers. Journal of Health and Social Behavior 1990; 31(3): 240–59.CrossRefGoogle ScholarPubMed
35Gregg, JEM. Attitudes of teenagers in Liverpool to breast feeding. British Medical Journal 1989; 299(6692): 147–8.CrossRefGoogle ScholarPubMed
36Greene, J, Stewart-Knox, B, Wright, M. Feeding preferences and attitudes to breastfeeding and its promotion among teenagers in Northern Ireland. Journal of Human Lactation 2003; 19(1): 5765.CrossRefGoogle ScholarPubMed
37Forrester, IT, Wheelock, G, Warren, AP. Assessment of students' attitudes towards breastfeeding. Journal of Human Lactation 1997; 13(1): 33–7.CrossRefGoogle Scholar
38Dykes, F, Griffiths, H. Societal influences upon initiation and continuation of breastfeeding. British Journal of Midwifery 1998; 6(2): 76–8.CrossRefGoogle Scholar
39Cusson, RM. Attitudes toward breast-feeding among female high-school students. Paediatric Nursing 1985; 11(3): 189–91.Google ScholarPubMed
40McIntyre, E, Hiller, JE, Turnbull, D. Attitudes towards infant feeding among adults in a low socio-economic community: what social support is there for breastfeeding? Breastfeeding Review 2000; 9(1): 1324.Google Scholar
41Campbell, H, Jones, I. Promoting breastfeeding: a view of the current position and a proposed agenda for action in Scotland. Journal of Public Health Medicine 1996; 18(4): 406–14.CrossRefGoogle Scholar
42Shepherd, CK, Power, KG, Carter, H. Characteristics of responders and non-responders in an infant feeding study. Journal of Public Health Medicine 1998; 20(3): 273–9.Google Scholar
43World Health Organization (WHO). Protecting, Promoting and Supporting Breastfeeding. Geneva: WHO, 1989.Google Scholar
44Carstairs, V, Morris, R. Deprivation and Health in Scotland. Aberdeen: Aberdeen University Press, 1991.Google Scholar
45Eagley, AH, Chaiken, S. The Psychology of Attitudes. Fort Worth, TX: Harcourt Brace Jovanovitch, 1983.Google Scholar
46Conner, M, Sparks, P. The theory of planned behaviour and health behaviours Predicting Health Behaviour. In: Conner, M, Norman, P, eds. Predicting Health Behaviour. Buckingham: Open University Press, 1999; 121–63.Google Scholar
47Libbus, MK. Perspectives of common breastfeeding situations: a known group comparison. Journal of Human Lactation 1992; 8(4): 199203.CrossRefGoogle ScholarPubMed
48Aitken, LS, West, SG. Multiple Regression: Testing and Interpreting Interactions. Newbury Park, CA: Sage, 1991.Google Scholar
49Earle, M, Robson, K. Analysis of Responses to the Consultation on the Breastfeeding (Scotland) Bill. Edinburgh: Scottish Parliament Information Centre, 2003.Google Scholar
50Borsari, B, Carey, K. Descriptive and injunctive norms in college drinking: a meta-analytic integration. Journal of Studies on Alcohol 2003; 64(3): 331–41.CrossRefGoogle ScholarPubMed
51Sargent, JD, Beach, ML, Dalton, MA, Mott, LA, Tickle, JJ, Ahrens, MB, et al. Effect of seeing tobacco use in films on trying smoking among adolescents: cross sectional study. British Medical Journal 2001; 323(7326): 1394–7.CrossRefGoogle ScholarPubMed
52Karvonen, S, West, P, Sweeting, H, Rahkonen, O, Young, R. Lifestyle, social class and health related behaviour: a cross-cultural comparison of 15 year olds in Glasgow and Helsinki. Journal of Youth Studies 2001; 4(4): 393413.CrossRefGoogle Scholar