Efficacy Of Web-based Breastfeeding Education

The Efficiency Of Web-Based Breastfeeding Education In Pregnancy According To The Theory Of Breastfeeding Self-Efficacy

Breastfeeding is the safest and healthiest method of feeding an infant and positively affects the health of both the mother and the baby in the short and long term.

Breastfeeding self-efficacy refers to the mother's perceived ability and self-confidence to breastfeed her baby.

Studies have reported that web-based support programs increase the quality of life in individuals, are useful in symptom management, and are effective in raising awareness on the subjects intended to provide support and in gaining positive attitudes and behaviors.

Today, web-based support programs are created thanks to advances in science and technology; It has advantages such as being cheap, easily accessible, not causing any harm when done under control, providing flexibility in the participant's use of time, and accessing the training content whenever needed. Due to the pandemic process, the investigators are in and with the effect of developing technology, training is provided for the needs of individuals by using many alternative education methods such as web-based education and distance education in the field of health, as in many areas. Studies have reported that web-based support programs increase the quality of life in individuals, are useful in symptom management, and are effective in raising awareness on the subjects intended to provide support and in gaining positive attitudes and behaviors.

The study is planned to be carried out between 01.01.2023 and 31.07.2024 in the Family Health Centers affiliated with the Taşköprü District Health Directorate of Kastamonu. The study universe consists of 24-36 weeks pregnant women who come to the Family Health Centers of the Taşköprü District Health Directorate. The sample of the study consisted of 90 primiparous pregnant women, 45 of whom were in the control and 45 in the experimental group, who met the inclusion criteria.

Data collection tools will be applied to women at pregnancy, postpartum 7th day, PP in the 3rd month, and PP in the 6th month.

Appropriate methods will be used in the evaluation of the data. The significance level will be determined as α=0.05.

Study Overview

• Status: Enrolling by invitation
• Conditions: Volunteering to Participate in the Study
• Intervention / Treatment: Other: THE GROUP THAT WILL TAKE WEB-BASED BREASTFEEDING EDUCATION IN PREGNANCY

Detailed Description

Breastfeeding is the safest and healthiest method of feeding an infant and positively affects the health of both the mother and the baby in the short and long term. Breast milk not only meets the nutritional needs of the newborn, but also protects it from many diseases, makes a great contribution to its mental and physical development, and most importantly, it provides a unique bond between mother and baby.

According to TDHS 2018 data, the rate of exclusive breastfeeding for the first six months is 41%, and this rate decreases with age. The rate of breastfeeding for 0-1-month-old children is 59%, 2-3-month-olds 45%, and 4-5-month-olds 14%.

One of the most important factors affecting breastfeeding is the mother's perception of self-efficacy. Breastfeeding self-efficacy refers to the mother's perceived ability and self-confidence to breastfeed her baby. Perception of breastfeeding self-efficacy; It determines whether the mother will breastfeed or not, how much effort she will put into it, her thoughts on breastfeeding, and her ability to cope with the difficulties she will face during the breastfeeding process emotionally.

Considering the existence of real or potential problems with breastfeeding, breastfeeding counseling is required for every expectant mother. This counseling will ensure that expectant mothers will be prepared for all kinds of breastfeeding problems that they may experience in the postpartum period. Studies have reported that web-based support programs increase the quality of life in individuals, are useful in symptom management, and are effective in raising awareness on the subjects intended to provide support and in gaining positive attitudes and behaviors.

For successful initiation, maintenance and termination of breastfeeding, mothers should be provided with a balanced diet during pregnancy, necessary breast care, physical and mental health, and training on breastfeeding.

Today, web-based support programs created thanks to advances in science and technology; It has advantages such as being cheap, easily accessible, not causing any harm when done under control, providing flexibility in the participant's use of time, and accessing the training content whenever needed. Due to the pandemic process the investigators are in and with the effect of developing technology, trainings are provided for the needs of individuals by using many alternative education methods such as web-based education and distance education in the field of health, as in many areas. Studies have reported that web-based support programs increase the quality of life in individuals, are useful in symptom management, and are effective in raising awareness on the subjects intended to provide support and in gaining positive attitudes and behaviors.

Studies on this subject are generally studies that briefly mention breastfeeding under the title of baby care and are not long enough. For this reason, the investigators aim to provide maximum benefit by giving this training to expectant mothers who have never given birth before, that is, who will breastfeed their baby for the first time, by addressing the issue of breastfeeding only.

The study is planned to be carried out between 01.01.2023 and 31.07.2024 in the Family Health Centers affiliated to the Taşköprü District Health Directorate of Kastamonu. The universe of the study consists of 24-36 weeks pregnant women who come to the Family Health Centers of the Taşköprü District Health Directorate. The sample of the study consisted of 90 primiparous pregnant women, 45 of whom were in the control and 45 in the experimental group, who met the inclusion criteria.

The data of the study will be applied to both groups at the same time. No training will be given to the control group, and web-based breastfeeding training consisting of 4 modules will be given to the experimental group during their pregnancy. As data collection tools; Pregnant data collection form, Postpartum information form, IOWA infant feeding attitude scale, IMDAT scale, Edinburgh depression scale, Breastfeeding motivation scale, Insufficient milk perception scale, Breastfeeding self-efficacy scale and System usability scale will be used. Data collection tools will be applied to women at pregnancy, postpartum 7th day, PP 3rd month and PP 6th month.

Appropriate methods will be used in the evaluation of the data. The significance level will be determined as α=0.05.

• Study Type: Interventional
• Enrollment (Estimated): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey, 34854
    • Marmara University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Volunteering to participate in the study.
2. Being primiparous at 24-36 weeks of pregnancy.
3. To be able to speak and speak Turkish.
4. To be at least a primary school graduate.
5. Having a computer or smartphone at home and being able to use it.
6. No risk in pregnancy.
7. The woman does not have any chronic disease.

Exclusion Criteria:

1. The emergence of a risky situation during pregnancy.
2. Premature birth of the woman participating in the study.
3. Carrying out a risky birth and hospitalization of the mother or baby due to it.
4. Termination of pregnancy prematurely for any reason (such as infant death)
5. The fact that the pregnant women in the experimental group did not complete the training modules before birth.
6. The fact that the women participating in the study did not respond to the directed scales and questionnaires.
7. The woman's desire to quit working without giving any reason.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: THE GROUP THAT WILL NOT TAKE WEB-BASED BREASTFEEDING EDUCATION IN PREGNANCY; This group will not take web-based education.
Experimental: THE GROUP THAT WİLL TAKE WEB-BASED BREASTFEEDİNG EDUCATION İN PREGNANT; this group will take web-based education.	Other: THE GROUP THAT WILL TAKE WEB-BASED BREASTFEEDING EDUCATION IN PREGNANCY; The data of the study will be applied to both groups at the same time. No training will be given to the control group, and web-based breastfeeding training consisting of 4 modules will be given to the experimental group during their pregnancy. As data collection tools; Pregnant data collection form, Postpartum information form, IOWA infant feeding attitude scale, IMDAT scale, Edinburgh depression scale, Breastfeeding motivation scale, Insufficient milk perception scale, Breastfeeding self-efficacy scale and System usability scale will be used. Data collection tools will be applied to women at pregnancy, postpartum 7th day, PP 3rd month and PP 6th month. Appropriate methods will be used in the evaluation of the data. The significance level will be determined as α=0.05. The sample of the study consisted of 90 primiparous pregnant women, 45 of whom were in the control and 45 in the experimental group, who met the inclusion criteria.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of postpartum women	In the study, R v3.6.1 program was used for Power analysis, alpha error was 5%, beta error was 20%, it was predicted that between the variables as a result of the study process, and a minimum of 90 (45 case groups, 50 control group)	6 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluation of Infant Feeding Attitude	The Infant Feeding Attitude Scale is used. It includes 17 items with a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Eight statements indicate positive attitude toward breastfeeding and nine statements indicate positive attitude toward formula feeding. The statements indicating positive attitude to breastfeeding were reverse-scored before calculating the total scores of all items. An example for attitude is: "Formula-feeding is more convenient than breastfeeding", and "Breastfeeding increases mother-infant bonding". The total IIFAS score can range from 17 to 85 with higher scores reflecting more positive attitude towards breastfeeding. The total IIFAS is further classified as positive to breastfeeding (a score of 70-85), neutral (a score of 49-69) and positive to formula feeding	Antenatal and postpartum 6th month
Evaluation of Depression Level	Edinburgh Postnatal/Postpartum Depression Scale is a self-assessment scale developed to determine the risk of depression in the postpartum period and to measure the level and severity of depression. The scale consists of 10 questions in total. Each question provides a four-point Likert-type measurement. Items in questions 3, 5, 6, 7, 8, 9 and 10 of the scale are scored as 3, 2, 1, 0 and indicate gradually decreasing severity. The items in questions 1, 2 and 4 are scored as 0, 1, 2, 3, indicating increasing severity. The total score of the scale is obtained by summing these items. The minimum total score is 0 and the maximum score is 30. The cut-off score of the scale has been reported as 12/13.	Postpartum 7th day, 3rd month, and 6th month
Evaluation of Perception of Insufficient Milk	Perception of Insufficient Milk questionnaire is used. The questionnaire consisted of five sections: urine amount, breast condition, stool amount, weight and satisfaction. The characteristics of each section were evaluated on a scale of 0,1,2 points, and a full score of 10 was considered as the best breast milk intake and 7 and below as inadequate breast milk intake.	Postpartum 7th day, 3rd month, and 6th month
Evaluation of Breastfeeding Self-Efficacy	The Breastfeeding Self-Efficacy Short Form is a 5-point Likert-type scale (1= "I am never sure" and 5 = "I am always sure"). The minimum score is 14 and the maximum score is 70. A higher score indicates higher breastfeeding self-efficacy.	Postpartum 7th day, 3rd month, and 6th month

Collaborators and Investigators

• Sponsor: Nurdan Demirci
• Investigators: Study Director: Nurdan Demirci, Prof, Marmara University; Principal Investigator: Elif velioğlu, PhDc, Marmara University

Publications and helpful links

General Publications

• Victora CG, Bahl R, Barros AJ, Franca GV, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC; Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016 Jan 30;387(10017):475-90. doi: 10.1016/S0140-6736(15)01024-7.
• Kleinpell R, Ely EW, Williams G, Liolios A, Ward N, Tisherman SA. Web-based resources for critical care education. Crit Care Med. 2011 Mar;39(3):541-53. doi: 10.1097/CCM.0b013e318206b5b5.
• Maloney S, Haas R, Keating JL, Molloy E, Jolly B, Sims J, Morgan P, Haines T. Breakeven, cost benefit, cost effectiveness, and willingness to pay for web-based versus face-to-face education delivery for health professionals. J Med Internet Res. 2012 Apr 2;14(2):e47. doi: 10.2196/jmir.2040.
• Dennis CL, Faux S. Development and psychometric testing of the Breastfeeding Self-Efficacy Scale. Res Nurs Health. 1999 Oct;22(5):399-409. doi: 10.1002/(sici)1098-240x(199910)22:53.0.co;2-4.
• Dennis CL. The breastfeeding self-efficacy scale: psychometric assessment of the short form. J Obstet Gynecol Neonatal Nurs. 2003 Nov-Dec;32(6):734-44. doi: 10.1177/0884217503258459.

Helpful Links

• 2018 Turkey Demographic and Health Survey,Hacettepe University Institute of Population Studies Ankara, Turkey

Study record dates

Study Major Dates

• Study Start (Actual): May 15, 2024
• Primary Completion (Estimated): August 10, 2024
• Study Completion (Estimated): September 15, 2024

Study Registration Dates

• First Submitted: October 2, 2023
• First Submitted That Met QC Criteria: May 30, 2024
• First Posted (Actual): June 5, 2024

Study Record Updates

• Last Update Posted (Actual): June 5, 2024
• Last Update Submitted That Met QC Criteria: May 30, 2024
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Other Study ID Numbers: Marmara U- elıfvlgl-001

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No