The Effect of Model-based Education on Breastfeeding Self-efficacy and Success

November 16, 2025 updated by: Esra Yalcin

The Effect of Education Provided Using Video and Podcast Applications Developed With the Health Action Process Approach Model on Breastfeeding Self-Efficacy and Breastfeeding Success in Primiparous Mothers: A Mixed Study

This study was designed as a randomised, pretest-posttest study, assessing breastfeeding self-efficacy and breastfeeding in first-time mothers following a separate video and podcast training session using the Health Action Process Approach Model. The study will be conducted with primiparous pregnant women in their third trimester, with no restrictions on breastfeeding. In the first phase of the study, a semi-trained interview format based on the SESY Model will be administered to 15 pregnant women at a fertility school to address nutritional deficiencies. Deficiencies in the pregnant women will be identified. To address these deficiencies, the researcher will develop a breastfeeding education book based on the SESY Model, produce a video, and produce the same content as a podcast. Both groups will complete the Introductory Information Form, the Breastfeeding Attitudes Assessment Scale, and the Breastfeeding Self-Efficacy Scale-Short Form. After completing their surveys, the control groups, which are pregnant women, will only receive the Breastfeeding Brochure from the Ministry of Health of the Republic of Turkey. Pregnant women in the intervention groups receive breastfeeding education throughout the cycle, in addition to videos and podcasts. Pregnant women will be asked to watch the videos and listen to the podcast until they give birth. Pregnant women will be contacted on the day of their birth to ask if there are any websites they would like to learn more about and to re-watch the video and listen to the podcast. Pregnant women will be contacted for an evaluation one month after birth to complete the Breastfeeding Attitudes Assessment Scale, Breastfeeding Self-Efficacy Scale-Short Form, LATCH Breastfeeding Diagnostic and Assessment Scale, and Breastfeeding Follow-Up Form I. To emphasize the importance of breastfeeding in the first six months and ensure continuity of breastfeeding, pregnant women will be contacted again at six months to complete a post-test and the Breastfeeding Attitudes Assessment Scale, Breastfeeding Self-Efficacy Scale-Short Form, LATCH Breastfeeding Diagnostic and Assessment Scale, and Breastfeeding Follow-Up Form II.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This study was designed as a phenomenological, randomized, pretest-posttest study to measure breastfeeding self-efficacy and breastfeeding success in first-time mothers following education delivered using a separate video and podcast application using the Health Action Process Approach Model. The study will be conducted in a maternity school and a breastfeeding room at a hospital in Türkiye. The research population will consist of all pregnant women who pay their dues to the hospital's maternity clinic. The sample will consist of primiparous pregnant women who refuse to participate, have no communication problems in Turkish, have at least a primary school education, are in a healthy pregnancy, are scheduled for vaginal or cesarean delivery, are in their third trimester, and have no breastfeeding restrictions. In the first phase of the study, a semi-trained interview format based on the SESY Model will be administered to 15 pregnant women at the reproductive school to address their breastfeeding needs. During the session, any distractions (clocks, pictures, charts, etc.) in the room will be removed. To prevent interruptions during the interview, a warning message will be sent to the door, and the pregnant woman will be asked to silence her phone. Care will be taken to maintain a conversational tone, allowing the pregnant woman to express herself freely. Information about the interview duration will be provided at the pregnant woman's request. The interview will last approximately 15-20 minutes. The interview will examine pregnant women's knowledge of breastfeeding, their attitudes toward breastfeeding, their expectations, potential problems, breastfeeding concerns, and their focus on these issues. Deficiencies in the pregnant women will be identified. Content analysis and descriptive analysis will be used to identify breastfeeding-related solutions and identify the appropriate training locations. Due to these deficiencies, the researcher will prepare a breastfeeding education booklet based on the SESY model, produce a video, and the same content will be produced as a podcast. Experts will be consulted on the content before and after the video and podcast are produced. The appropriate order of the opinions will be determined by the video and podcast, while the control group will only use the Breastfeeding Brochure from the Ministry of Health of the Republic of Turkey. To record the test, pregnant women in both the intervention and control groups will be contacted and invited to the hospital conference room. Both groups will complete the Introductory Information Form, the Breastfeeding Attitudes Assessment Scale, and the Breastfeeding Self-Efficacy Scale-Short Form. After completing the questionnaires, pregnant women in the control groups will only receive the Breastfeeding Brochure from the Ministry of Health of the Republic of Turkey. Pregnant women in the intervention group will receive breastfeeding education at the school, along with videos and podcasts. Pregnant women will be asked to watch the video and listen to the podcast until delivery. On the day of delivery, pregnant women will be contacted to ask if there are any sites where they would like to receive information and will be asked to rewatch the video and listen to the podcast. Pregnant women will be contacted for an evaluation at the first month postpartum and will complete the Breastfeeding Attitudes Assessment Scale, the Breastfeeding Self-Efficacy Scale-Short Form, the LATCH Breastfeeding Diagnostic and Assessment Scale, and the Breastfeeding Follow-up Form I. In order to ensure the importance of breast milk and the continuity of breastfeeding in the first 6 months, pregnant women will be contacted again in the 6th month to complete the post-test and Breastfeeding Attitude Measurement Assessment, Breastfeeding Self-Efficacy Scale-Short Form, LATCH Breastfeeding Diagnosis and Assessment Scale and Breastfeeding Follow-up Form II.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
100

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Those who have no communication problems in Turkish
  • Have at least a primary school degree
  • Have a healthy pregnancy
  • Are planning a vaginal or cesarean delivery
  • Are in their third trimester
  • Have no breastfeeding restrictions
  • Are primiparous

Exclusion Criteria:

  • Pregnant women who: • Are foreign nationals

    • Refuse to participate in the study
    • Have a high-risk pregnancy
    • Have vision or hearing problems
    • Have a low-birth-weight baby
    • Have a premature birth
    • Have multiple births
    • Have babies incubated after birth
    • Have a chronic disease will not be included in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: experimental group
To administer the pre-test, pregnant women will complete the Introductory Information Form, the Breastfeeding Attitudes Assessment Scale, and the Breastfeeding Self-Efficacy Scale-Short Form. After completing the questionnaires, they will receive breastfeeding education and a video and podcast created by the researcher based on the Health Action Process Approach Model. Pregnant women will be contacted on the day of delivery and asked to re-watch the video and listen to the podcast. One month postpartum, pregnant women will complete the Breastfeeding Attitudes Assessment Scale, the Breastfeeding Self-Efficacy Scale-Short Form, the LATCH Breastfeeding Diagnosis and Assessment Scale, and the Breastfeeding Follow-up Form I. A post-test will be administered at six months, and they will complete the Breastfeeding Attitudes Assessment Scale, the Breastfeeding Self-Efficacy Scale-Short Form, the LATCH Breastfeeding Diagnosis and Assessment Scale, and the Breastfeeding Follow-up Form II.
Behavioral: Breastfeeding Education
Before the intervention, interviews will be conducted with pregnant women based on the Health Action Process Approach Model to identify any deficiencies related to breastfeeding. As a result, videos and podcasts based on the model will be produced. The intervention group will receive breastfeeding education, distribute these videos and podcasts, and be asked to watch them. Pregnant women will be contacted after birth to provide reminders. The control group will not receive any interventions and will only receive the breastfeeding guidelines from the Turkish Ministry of Health.
No Intervention: control group
To administer the pretest, pregnant women will complete the Introductory Information Form, the Breastfeeding Attitudes Assessment Scale, and the Breastfeeding Self-Efficacy Scale-Short Form. After completing the questionnaires, they will be provided with a Breastfeeding Brochure from the Turkish Ministry of Health. One month after birth, pregnant women will complete the Breastfeeding Attitudes Assessment Scale, the Breastfeeding Self-Efficacy Scale-Short Form, the LATCH Breastfeeding Diagnosis and Assessment Scale, and the Breastfeeding Follow-up Form I. A posttest will be administered at six months, and pregnant women will complete the Breastfeeding Attitudes Assessment Scale, the Breastfeeding Self-Efficacy Scale-Short Form, the LATCH Breastfeeding Diagnosis and Assessment Scale, and the Breastfeeding Follow-up Form II.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Breastfeeding Attitude Assessment Scale (BATAS)
Time Frame: Pre-test: before the intervention, post-test after the intervention at 1 month postpartum and 6 months postpartum
The Breastfeeding Attitude Assessment Scale was developed by Arslan in 1997. The scale aims to measure breastfeeding attitudes in mothers who have given birth. The 46-item scale is a 5-point Likert-type scale. It includes 22 positive and 24 negative breastfeeding attitude items. Positive items are scored as "Strongly Agree" (4), "Agree" (3), "Undecided" (2), "Slightly Agree" (1), and "Strongly Disagree" (0), while negative items are scored as "Strongly Agree" (0), "Agree" (1), "Undecided" (2), "Slightly Agree" (3), and "Strongly Disagree" (4). The highest possible score is 184. A high score indicates that mothers have positive attitudes toward breastfeeding. In validity and reliability studies conducted on the scale, Cronbach's alpha was calculated as 0.63.
Pre-test: before the intervention, post-test after the intervention at 1 month postpartum and 6 months postpartum
Breastfeeding Self-Efficacy Scale-Short Form
Time Frame: Pre-test: before the intervention, post-test after the intervention at 1 month postpartum and 6 months postpartum
The Breastfeeding Self-Efficacy Scale (BSS) was developed by Dennis in 1999 to assess mothers' breastfeeding self-efficacy levels. The first form consisted of 33 items. In 2003, Dennis removed some items to create a new 14-item "Breastfeeding Self-Efficacy Scale Short Form." It consists of a 5-point Likert-type scale. The lowest possible score is 14, while the highest is 70. Scoring is as follows: "Not at all sure (1)," "Not very sure (2)," "Sometimes sure (3)," "I'm sure (4)," and "Always sure (5)." Higher scores indicate higher breastfeeding self-efficacy. The Turkish validity and reliability of the short form of the scale was conducted by Aluş-Tokat and Okumuş in 2009. The Cronbach's alpha value for the Turkish version of the Antenatal Breastfeeding Self-Efficacy Scale was found to be 0.87. The Cronbach's alpha value for the Turkish version of the Postpartum Breastfeeding Self-Efficacy Scale was found to be 0.86.
Pre-test: before the intervention, post-test after the intervention at 1 month postpartum and 6 months postpartum

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
LATCH Breastfeeding Diagnostic and Assessment Scale
Time Frame: after intervention: 1st and 6th months postpartum
The LATCH breastfeeding diagnosis and assessment scale is a diagnostic method used to assess breastfeeding success, first developed in 1986 using a scoring method similar to the APGAR scoring system. This measurement tool was developed to objectively diagnose breastfeeding, identify breastfeeding problems, establish a common language among healthcare professionals, and be used in research. It consists of five assessment criteria: L (latch on the breast), A (audible swallowing), T (type of nipple), C (comfort breast/nipple), and H (hold/help). Each item is scored between 0 and 2. The maximum total score is 10, with a higher score indicating higher breastfeeding success. A Turkish reliability study of the instrument was conducted by Yenal and Okumuş. The Cronbach's alpha value for the original version of the scale was 0.93, while it was found to be 0.95 in the Turkish adaptation study.
after intervention: 1st and 6th months postpartum
SESY-Based Breastfeeding Tracking Form I (Month 1)
Time Frame: after intervention: 1st and 6th months postpartum
Breastfeeding Follow-up Form I, prepared by the researcher in line with the literature (Yılmaz, 2014; Avcı, 2024; Arslan, 2020; Köprülü, 2024), was created to evaluate breastfeeding success and monitor the babies' breastfeeding status by contacting individuals in the intervention and control groups at the first month. The form, consisting of 27 questions, assessed the mother's continued breastfeeding status.
after intervention: 1st and 6th months postpartum
SESY-Based Breastfeeding Tracking Form II (6th Month)
Time Frame: after intervention: 1st and 6th months postpartum
The Breastfeeding Follow-up Form II, prepared by the researcher in line with the literature (Yılmaz, 2014; Avcı, 2024; Arslan, 2020; Köprülü, 2024), was created to monitor breastfeeding continuity by contacting individuals in the intervention and control groups at six months. The 28-question form inquired about the mother's breastfeeding continuity, the initiation of complementary feeding, support systems, and starting work.
after intervention: 1st and 6th months postpartum

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Esra Yalcin

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 15, 2025

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 30, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 30, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 16, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 16, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 19, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 19, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 16, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • SBF-EY-2323

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

To protect participant confidentiality and because data is collected only for this study, individual participant data will not be collected.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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