title: Bobbi Be Best: the development and evaluation of an audio program and discussion guide to promote exclusive breastfeeding in Cameroon, Central Africa.
abstract: One risk factor for infant and childhood morbidity is not exclusive breastfeeding (EBF) during the first six months of life. Entertainment Education (EE) is a communication strategy consisting of placing educational information into television, movies, and radio programs. In developing countries this form of behavioral change communication has proven effective in addressing health-related issues; however, no research has determined if EE is effective in promoting EBF. The objective of this research was to develop an EE audio program and discussion guide and to determine if a series of four 15-minute episodes and post-listening discussion improved knowledge, perceived benefits, self-efficacy, and intention and decreased misconceptions and perceived barriers toward EBF in the Kumbo West Health District, Cameroon. Pregnant women and their partners were assigned to either the control group (N = 116; 74 women, 42 partners) or intervention group (N = 148; 99 women, 49 partners) based on expected date of delivery. All control and intervention group participants completed a questionnaire prior to listening to the first and after the last episode. Pre- and post-listening questionnaires were used to determine changes in the EBF knowledge, misconceptions, perceived barriers, self-efficacy, and intention variables as a result of exposure to the audio program. The Wilcoxon Sign Rank test showed significant improvement in all of the variables, except perceived barriers, within the intervention group (p < 0.05) and the Mann-Whitney test indicated significant differences between the control and intervention group in all of the variables (p < 0.05), indicating that using an audio program and discussion guide based on the EE model is an effective tool for promoting EBF in this setting. The strength of this approach is that it goes beyond simply telling women about what constitutes EBF, but addresses misconceptions and perceived barriers that may prevent women from practicing EBF for six months.
authors.affiliation: School of Health Sciences, Liberty University, USA Cameroon Baptist Convention Health Services, Cameroon kreinsma@liberty.edu.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Reinsma
authors.affiliation: National Coordinator for Health Education and Development Consultancy Services, Bamenda, Cameroon.
authors.forename: Nancy
authors.initials: N
authors.lastname: Bolima
authors.affiliation: Department of Biomedical Sciences, University of Dschang, Cameroon.
authors.forename: Florence
authors.initials: F
authors.lastname: Fonteh
authors.affiliation: Northwest Special Fund for Health, Bamenda, Cameroon.
authors.forename: Patrick
authors.initials: P
authors.lastname: Okwen
authors.affiliation: Nutrition Department, School of Public Health, Loma Linda University, USA.
authors.forename: Gina
authors.initials: G
authors.lastname: Siapco
authors.affiliation: Kumbo West Health District Medical Officer, Cameroon.
authors.forename: Daniel
authors.initials: D
authors.lastname: Yota
authors.affiliation: Behavioral Health Institute, Loma Linda University, USA.
authors.forename: Susanne
authors.initials: S
authors.lastname: Montgomery
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D002163:Cameroon; D005260:Female; D058015:Health Communication / Q000379:methods*; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000193:education*; D037841:Pregnant People; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Entertainment Education; exclusive breastfeeding; health behavior; health promotion; maternal