The Effect of Message-Framing on Breastfeeding Self-Efficacy Among Nulliparous Women in Shushtar, Iran

Authors

  • Marzieh Araban Ph.D. in Health Education, Assistant Professor, Social Determinants of Health Research Center, Health Education and Health Promotion Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Keywords:

Breastfeeding Self-Efficacy; Nulliparous Women; Message-Framing

Abstract

Introduction: Exclusive breastfeeding for 6 months and continuing it for 2 years, along with complementary feeding, are the primary objectives of public health plans and nutrition around the world. Self-efficacy is a theoretical framework that could be a strong predictive for breastfeeding. This study aimed to determine the effect of message-framing on self-efficacy of breastfeeding in nulliparous women in Shushtar.

Methods: This quasi-experimental study was conducted in 2015 on 210 nulliparous women in Shushtar (Iran). The participants were randomly allocated into intervention and control groups. The study tool was the short form of breastfeeding self-efficacy scale that was completed on arrival of the study (days 3-5), at the end of week four and at the end of week eight. Data were analyzed by SPSS 19, using Chi-square, ANOVA, and repeated measurements.

Results: Mean age of participants was 24.52 years old with standard deviation of 95.4. Mean score of breastfeeding self-efficacy in gain-framed group at days 3-5, week four and week eight was 47.94, 57.43 and 52.8 respectively; in loss-framed group it was 47.76, 56.11 and 52.64 respectively; and in control group it was 45.16, 48.68 and 45.31 respectively. No significant difference was observed between the score of average self-efficacy of days 3-5 and week eight in control group (p=0.93). However, in gain-framed group (p=0.001) and loss-framed group (p=0.004), a significant difference was observed. 

Conclusion: Results of this study showed that message-framing promotes breastfeeding self-efficacy in nulliparous women and in this regard, there is no difference between gain-framed and loss-framed messages.

 

References

Horta BL, Bahl R, Martines JC, Victora CG. Evidence on the long-term effects of breastfeeding. WHO

Geneva. 2007.

Leon-Cava N, Lutter C, Ross J, Martin L. Quntifying the benefits of breastfeeding: a summary of the

evidence. PAHO Washington DC. 2002.

Wong DL, Hockenberry-Eaton M, Wilson D, Winkelstein LM, Ahmann E, Divito-Thomas PA. Whaley &

Wong's Nursing Care of Infants and Children. St. Louis: Mosby Co. 1999.

Bartick M, Reinhold A. The burden of suboptimal breastfeeding in the United States: a pediatric cost

analysis. Pediatrics. 2010; 125(5): 1048-56. doi: 10.1542/peds.2009-1616. PMID: 20368314.

Wu DS, Hu J, McCoy TP, Efird JT. The effects of a breastfeeding self-efficacy intervention on short-term

breastfeeding outcomes among primiparous mothers in Wuhan, China. J Adv Nurs. 2014; 70(8): 1867-79.

doi: 10.1111/jan.12349. PMID: 24400967.

Forster DA, McLachlan HL. Breastfeeding Initiation and Birth Setting Practices: A Review of the

Literature. J Midwifery Womens Health. 2007; 52(3): 273-80. doi: 10.1016/j.jmwh.2006.12.016. PMID:

Donath S, Amir L. Rates of breastfeeding in Australia by state and socio-economic status: Evidence from

the 1995 National Health Survey. J Paediatr Child Health. 2000; 36(2): 164-8. doi: 10.1046/j.1440- 1754.2000.00486.x. PMID: 10760016.

Varei SH, Mehrdad N, Bahrani N. The relation between breastfeeding self efficacy and position of

breastfeeding in mothers. Journal of Nursing& midwifery faculty of Tehran university of medical sciences.

; 15(3): 31-38.

Victora CG, Smith PG, Vaughan JP, Nobre LC, Lombardi C, Teixeira AM, et al. Evidence for protection

by breast-feeding against infant deaths from infectious diseases in Brazil. Lancet. 1987; 2(8554): 319-22.

doi: 10.1016/S0140-6736(87)90902-0. PMID: 2886775.

Victora CG, Barros FC, Vaughan JP, Teixeira AM. Birthweight and infant mortality: a longitudinal study

of 5914 Brazilian children. Int J Epidemiol. 1987; 16(2): 239-45. doi: 10.1093/ije/16.2.239. PMID:

Bandura A. self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev. 1977; 84(2): 191- 215. doi: 10.1037/0033-295X.84.2.191. PMID: 847061.

Dennis CL. Theoretical underpinning of breastfeeding confidence: A self-efficacy framework. J Hum Lact.

; 15(3): 195-201. doi: 10.1177/089033449901500303. PMID: 10578797.

Azhari S, Baghany R, Akhlaghi F, EbrahimZadeh S, Salehi J. Comparison of two methods of training on

breastfeeding self efficacy in primiparous mothers. Sabzevar University of Medical Sciences Journal. 2009;

(4): 244-51.

Banks SM, Salovey P, Greener S, Rothman AJ, Moyer A, Beauvais J, et al. The effects of message framing

on mammography utilization. Health psychology. 1995; 14(2): 178-84. doi: 10.1037/0278-6133.14.2.178.

PMID: 7789354.

Rothman AJ, Salovey P. Shaping perceptions to motivate healthy behavior: the role of message framing.

Psychol Bull. 1997; 121(1): 3-19. doi: 10.1037/0033-2909.121.1.3. PMID: 9000890.

Pakpour Haji Agha A, Nourozi S, Yekaninejad MS, Mansouri A, Chaibakhsh S. Effect of message framing

on improving oral health behaviors in students in Qazvin, Iran. Journal of Isfahan Dental School. 2013;

(6): 512-21.

Van 't Riet J, Ruiter RA, Werrij MQ, De Vries H. Self-efficacy moderates message-framing effects: The

case of skin-cancer detection. Psychol Health. 2010; 25(3): 339-49. doi: 10.1080/08870440802530798.

PMID: 20204928.

Goodall C, Appiah O. Adolescents' perceptions of Canadian cigarette package warning labels: investigating

the effects of message framing. Health Commun. 2008; 23(2): 117-27. doi: 10.1080/10410230801967825.

PMID: 18443999.

Mirmohammad Ali M, Bahiraii A, Rahimi A, Hashemzadeh M, Sohrabi N, Sohrabi Z. Effect of educational

package on breastfeeding self-efficacy in postpartum period. Payesh. 2014; 13(2): 221-8.

Araban M, Falahiyan Mehrjardi F, Shahry P, Montazeri A. The Persian version of Breastfeeding Self- Efficacy Scale-Short Form (BSES-SF): translation and psychometric assessment. Payesh. 2016; 15(1): 87- 93.

Chen ZW, Fang LZ, Chen LY, Dai HL. Comparison of an SMS text messaging and phone reminder to

improve attendance at a health promotion center: a randomized controlled trial. Journal of Zhejiang

University Science B. 2008; 9(1): 34-8.

Piette JD, Weinberger M, Kraemer FB, Mcphee SJ. impact of Automated Calls with Nurse Follow-UP on

Diabetes Treatment Outcomes in a Department Health Care System : a randomized controlled trial.

Diabetes Care. 2001; 24(2): 202-8. doi: 10.2337/diacare.24.2.202. PMID: 11213866.

Sacco WP, Malone JI, Morrison AD, Friedman A, Wells K. Effect of a brief, regular telephone intervention

by paraprofessionals for type 2 diabetes. J Behav Med. 2009; 32(4): 349-59. doi: 10.1007/s10865-009- 9209-4. PMID: 19365719.

Kim HS, Oh JA. Adherence to diabetes control recommendations: impact of nurse telephone calls. J Adv

Nurs. 2003; 44(3): 256-61. doi: 10.1046/j.1365-2648.2003.02800.x. PMID: 14641395.

O’Keefe DJ, Jensen JD. The relative effectiveness of gain-framed and loss-framed persuasive appeals

concerning obesity-related behaviors: Meta-analytic evidence and implications. Leveraging consumer

psychology for effective health communications: The obesity challenge. 2011; 171-85.

Roth AM, Van Der Pol B, Fortenberry JD, Dodge B, Reece M, Certo D, et al. The Impact of Brief

Messages on HSV-2 Screening Uptake Among Female Defendants in a Court Setting: A Randomized

Controlled Trial Utilizing Prospect Theory. J Health Commun. 2015; 20(2): 230-6. doi:

1080/10810730.2014.920062. PMID: 25494832, PMCID: PMC4356496.

O’Keefe DJ, Wu D. Gain-framed messages do not motivate sun protection: A meta-analytic review of

randomized trials comparing gain-framed and loss-framed appeals for promoting skin cancer prevention.

Int J Environ Res Public Health. 2012; 9(6): 2121-33. doi: 10.3390/ijerph9062121. PMID: 22829794,

PMCID: PMC3397368.

Lee BJ, Gu MO. Comparison of the effects between positive message and negative message in diabetes

mellitus education. Korean Diabetes Journal. 2009; 33(4): 344-52. doi: 10.4093/kdj.2009.33.4.344.

Grady JL, Entin EB, Entin EE, Brunyé TT. Using message framing to achieve long-term behavioral

changes in persons with diabetes. Appl Nurs Res. 2011; 24(1): 22-8. doi: 10.1016/j.apnr.2009.03.007.

PMID: 20974059.

Published

2022-01-18