Table 5.
Breastfeeding self-efficacy intervention studies.
| First author (year) | Study design and location | Variables (tools) | Sample size and participants | Findings | Level of evidence | Grade |
|---|---|---|---|---|---|---|
| Abbass-Dick et al. (2017) | Pre/post test experimental study (phase 2 of the study) Ontario, Canada |
IV: Intervention—An eHealth breastfeeding and co-parenting resource, interactive with multimodal delivery of information (developed based on feedback from Phase I) DV: BF Self-efficacy (BFSE Short Form) |
N = 31 mothers and N = 35 fathers (primiparous) Race/ethnicity not provided |
Maternal and paternal BF self-efficacy scores rose posttest | 2.d | A |
| Chan (2016) | Experimental design with random assignment Hong Kong |
IV: Intervention—2 hour BF workshop prenatally and 30–60 minute telephone session at 2 weeks PP. Control—standard care DV: BF exclusivity, BF Self-efficacy (BFSE Short Form) |
N = 71 primiparous mothers (35 intervention, 36 control) 95% Chinese |
BFSE scores significantly higher in intervention group from prenatal to 2 weeks PP (p < .01) and higher than control group at 2 weeks PP (p < .01) Exclusive BF in intervention group higher at each time point to 6 months, on significant at 8 weeks PP (p = .02) |
1.d | A |
| Dodt et al. (2015) | Experimental, pre/post-test design, interventional and control groups Brazil |
IV: Intervention—flip chart containing education on BFSE during PP period in hospital (between 6 hours PP and hospital discharge). Control—no flip chart DV: BF Self-efficacy (BFSE Short Form), BF rates |
N = 201 mothers (100 intervention, 101 control) (any parity) Primarily Brazilian |
Intervention group had higher change in BFSE scores from immediate PP period to 2 months PP (p = .032). Exclusive BF at 2 months PP: intervention group, 100%, control group 41% |
2.d | A |
| Hauck et al. (2007) | Experimental study Australia | IV: Intervention—Breastfeeding journal with education material provided at approximately 36-week gestation. Control—No journal provided DV: BF Self-efficacy (BFSE Scale) |
N = 276 primiparous mothers (136 intervention, 140 control) Primarily Australian *Both groups attended a prenatal BF workshop |
No statistically significant differences between the intervention and control groups in BFSE during the immediate PP period (p = .23) or the 12 weeks PP period (p = .75) | 2.c | B |
| Joshi et al. (2016) | Two-group, repeated measures quasi-experimental study Nebraska |
IV: Intervention—Computer based BF educational support program administered last 6 weeks of pregnancy. Control—printed educational material on BF. DV: BF exclusivity, BF Self-efficacy (BFSE Short Form) |
N = 46 mothers (any parity) Rural, Hispanic |
Intervention group at higher intent to BF 1 week PP Not significant but BFSE scores decreased from 6 weeks to 6 months in the control group, and increased in the intervention group |
2.c | A |
| Liu et al. (2017) | Comparative, quasi-experimental study China |
IV: Intervention—1 hour prenatal BF workshop and 1-hour BF counseling session within 24 hours of birth. Control—standard care. DV: BF exclusivity at 8 weeks PP, BF Self-efficacy (BFSE Short Form) |
N = 130 (65 each group) primiparous mothers Primarily Chinese |
Intervention group had significantly higher BFSE scores at 4 weeks PP (p < .0001) & 8 weeks PP (p < .0001) than the control group At 8 weeks PP 24.6% of intervention infants were exclusively BF, compared to 1.5% of control group infants (p < .0001) |
2.c | A |
| McQueen et al. (2011) | RCT (pilot study) Ontario, Canada |
IV: Intervention—Individual BFSE enhancing sessions, 2 PP in hospital and 1 a week after birth. Control—standard care. Provided third trimester. DV: BF Self-efficacy (BFSE Short Form), BF duration and exclusivity. 4 weeks PP |
N = 150 (69 intervention, 81 control) primiparous mothers 81% Caucasian, 14% Aboriginals of North America |
Mothers in the intervention group had higher rates of BF self-efficacy, duration, and exclusivity at 4 and 8 weeks PP, but not significant Intervention was feasible |
1.c | A |
| Nichols (2009) | Experimental study Queensland, Australia |
IV: Intervention—BFSE interactive workbook. Control—Workbook on parenting, no mention of BF. DV: BF duration and exclusivity, BF self-efficacy (BFSE Scale) |
N = 90 (number in each group not provided) mothers (any parity) Primarily Australian |
Mothers in the intervention group at higher BFSE (p = .03) | 2.c | A |
| Noel-Weiss (2006) | RCT Canada | IV: Intervention—delivered prenatally, after 34 weeks gestation, a 2.5 hour BF workshop based on Bandura’s self-efficacy theory and adult learning. Control—standard care DV: BF Self-efficacy (BFSE Short Form), duration of BF |
N = 110 primiparous mothers Race/ethnicity not provided |
BFSE higher in intervention group Exclusive BF higher in intervention group at 4 and 8 weeks PP |
1.c | A |
| Wu (2014) | Experimental, pre/post test, 2 group design Wuhan, China |
IV: Intervention—3 phase (2 face-to-face in the immediate PP period, 1 via telephone 1-week after hospital discharge) individual sessions focused on self-efficacy and BF. Control—Standard care. DV: BF self-efficacy (BFSE Short Form), |
N = 74 primiparous mothers (37 each group) Primarily Chinese |
Intervention group had significantly higher BFSE at 4 weeks (R2 = .74, p < .001) and 8 weeks PP (R2 = .74, p < .001) | 2.d | A |