Critical Review of Theory Use in Breastfeeding Interventions

Yeon Bai, Soyoung Lee, Kaitlin Overgaard

Research output: Contribution to journalReview articleResearchpeer-review

1 Citation (Scopus)

Abstract

Background: Numerous efforts to promote breastfeeding resulted in a steady increase in the rates of breastfeeding initiation and duration. Increasing numbers of breastfeeding interventions are focused on breastfeeding maintenance and exclusivity and based on behavioral theories. Few studies critically analyzed the use of theories in breastfeeding intervention development and evaluation. Research aim: The aim of this critical review was to examine the existing literature about breastfeeding intervention, and investigate the role of theory in its development, implementation, and evaluation to provide future directions and implications for breastfeeding interventions. Methods: This critical review examined the existing breastfeeding intervention studies that used self-efficacy theories (SE), theory of planned behavior (TPB), and social cognitive theory (SCT) and were published during the past decade. Using five databases, studies in which researchers explicitly applied these three theories to frame the intervention were selected. Studies were critically reviewed for fidelity to theory in intervention design, delivery, and evaluation. Results: Eighteen studies were reviewed: nine SE-, five TPB-, and four SCT-based. Most interventions were focused on building mothers’ breastfeeding self-efficacy to improve breastfeeding exclusivity and duration. To achieve this goal, researchers who developed SE-based interventions used individual approaches, whereas other researchers who based studies on TPB incorporated social and environmental changes. SE-based studies were more likely to include theory-based instruments, but TPB- and SCT-based studies demonstrated less consistent choices of measurement. Researchers in most studies did not test the relationships between the proposed theoretical constructs and breastfeeding outcomes as guided by theories. Inconsistent outcomes resulted among the studies due to variations in study follow-ups. Conclusion: Sound applications of single or multiple theories demonstrate a great potential to help practitioners and researchers develop effective breastfeeding interventions and evaluate true impacts on positive breastfeeding outcomes.

Original languageEnglish
Pages (from-to)478-500
Number of pages23
JournalJournal of Human Lactation
Volume35
Issue number3
DOIs
StatePublished - 1 Aug 2019

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Breast Feeding
Self Efficacy
Research Personnel
Maintenance
Databases

Keywords

  • breastfeeding
  • breastfeeding promotion
  • breastfeeding support
  • lactation
  • program evaluation
  • theory of planned behavior

Cite this

Bai, Yeon ; Lee, Soyoung ; Overgaard, Kaitlin. / Critical Review of Theory Use in Breastfeeding Interventions. In: Journal of Human Lactation. 2019 ; Vol. 35, No. 3. pp. 478-500.
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Critical Review of Theory Use in Breastfeeding Interventions. / Bai, Yeon; Lee, Soyoung; Overgaard, Kaitlin.

In: Journal of Human Lactation, Vol. 35, No. 3, 01.08.2019, p. 478-500.

Research output: Contribution to journalReview articleResearchpeer-review

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