title: Efficacy of the theory of planned behavior in predicting breastfeeding: Meta-analysis and structural equation modeling.
abstract: OBJECTIVE
  This study assessed the applicability and efficacy of the theory of planned behavior (TPB) in predicting breastfeeding.
  
  
  BACKGROUND
  The TPB assumes a rational approach for engaging in various behaviors, and has been used extensively for explaining health behavior. However, most studies have tested the effectiveness of TPB constructs in predicting how people perform actions for their own benefit rather than performing behaviors that are beneficial to others, such as breastfeeding infants. A meta-analysis approach could help clarify the breastfeeding practice to promote breastfeeding.
  
  
  METHODS
  This study used meta-analytic procedures. We searched for studies to include in our analysis, examining those published between January 1, 1990 and December 31, 2013 in PubMed, Medline, CINAHL, ProQuest, and Mosby's Index. We also reviewed journals with a history of publishing breastfeeding studies and searched reference lists for potential articles to include.
  
  
  RESULTS
  Ten studies comprising a total of 2694 participants were selected for analysis. These studies yielded 10 effect sizes from the TPB, which ranged from 0.20 to 0.59. Structural equation model analysis using the pooled correlation matrix enabled us to determine the relative coefficients among TPB constructs. Attitude, subjective norms, and perceived behavioral control were all significant predictors of breastfeeding intention, whereas intention was a strong predictor of breastfeeding behavior. Perceived behavioral control reached a borderline level of significance to breastfeeding behavior. Theoretical and empirical implications are discussed from the perspective of evidence-based practice.
authors: Department of Health Promotion and Health Education, University of National Taiwan Normal University, Taipei, Taiwan. Electronic address: jonglong@ntnu.edu.tw.
authors: J L
authors: JL
authors: Guo
authors: School of Nursing, National Yang-Ming University, Taipei, Taiwan. Electronic address: fang@ym.edu.tw.
authors: T F
authors: TF
authors: Wang
authors: Department of Health Promotion and Health Education, University of National Taiwan Normal University, Taipei, Taiwan. Electronic address: libertyvalley18@gmail.com.
authors: J Y
authors: JY
authors: Liao
authors: School of Nursing, National Yang-Ming University, Taipei, Taiwan. Electronic address: cmhuang@ym.edu.tw.
authors: C M
authors: CM
authors: Huang
mesh_terms: D001942:Breast Feeding / Q000523:psychology; D005260:Female; D005544:Forecasting; D006801:Humans; D033182:Intention; D008962:Models, Theoretical; D011594:Psychometrics
keywords: Breastfeeding; Meta-analysis; Structural equation modeling (SEM); Theory of planned behavior (TPB)