Assessment of breastfeeding intention using the Transtheoretical Model and the Theory of Reasoned Action

Abstract

Identification of theoretical frameworks that effectively describe the factors that influence breast-feeding intention could enhance the development of breast-feeding promotion strategies. This study assessed the capability of two behavioral science theories--the Transtheoretical Model (TM) and the Theory of Reasoned Action (TRA)--to explain the breast-feeding intentions of 1001 low-income primarily minority pregnant women (mean age 23 years) receiving services from a health center in Atlanta Georgia (US) in 1995. It was assumed that the intention to bottle-feed is the baseline condition from which women will change toward the intention to breast-feed for increasingly greater durations. The questionnaire examined the decisional balance and attitudes toward breast-feeding the processes of change subjective norms and the stages of change. Instrument sections significantly differentiated women planning to breast-feed from those planning to formula-feed on 18 of 20 statements representing the decisional balance (TM)/attitudes toward breast-feeding (TRA) constructs and on 17 of 20 statements representing the processes of change (TM) construct. Significant positive correlations existed between both the stages of change for breast-feeding (TM) and breast-feeding intention (TRA) constructs and the remaining constructs from both theories. As subjects stage of change for breast-feeding (TM) increased their mean total subjective norm (TRA) scores also increased indicating greater social support for breast-feeding at later stages. Similarly as stage of change for breast-feeding increased mean attitudes toward breast-feeding scores increased (i.e. precontemplation 11.448; contemplation 24.821; preparation 42.684; action 41.830; and maintenance 55.020). Breast-feeding promotion campaigns based on the constructs of these two theories may improve breast-feeding initiation rates by increasing womens intention to breast-feed.