title: Impact of intervention on breastfeeding outcomes and determinants based on theory of planned behavior.
abstract: BACKGROUND
  Breastfeeding knowledge, attitude, subjective norm, and perceived control are significant determinants of breastfeeding, according to the theory of planned behavior (TPB). However, evidence concerning the effectiveness of the TPB-based intervention in breastfeeding promotion is sparse. Meanwhile, the changes of these determinants with time have not been examined in previous studies.
  
  
  OBJECTIVE
  To investigate the effectiveness of the TPB-based intervention program in improving exclusive breastfeeding, and the interaction of time and intervention on these determinants of breastfeeding.
  
  
  METHODS
  285 primiparous mothers were included, with 157 mothers in the experimental group and 128 mothers in the control group. The experimental group received the TPB-based intervention program delivered during 6 weeks postpartum, while both the experimental and control groups received the standard obstetric care.
  
  
  RESULTS
  Scores of breastfeeding knowledge, attitude and breastfeeding control increased with time from baseline to 6 weeks postpartum, while breastfeeding subjective norm decreased at 6 weeks both in the experimental and the control groups. Besides, scores of the four determinants were significantly higher in the experimental group than these in the control group at 3days and 6 weeks, except for breastfeeding control at 6 weeks, which resulted in the higher exclusive breastfeeding rates at 3days and 6 weeks in the experimental group than the control group.
  
  
  CONCLUSIONS
  The TPB-based intervention was effective in promoting exclusive breastfeeding during 6 weeks postpartum. Future interventions are recommended to adjust intervention strategies with time, and give more focus on providing continued breastfeeding support after discharge.
authors: Department of Nursing, Shanghai Proton and Heavy Ion Center, Kangxin Road, Pudong, Shanghai 201321, China.
authors: Yu
authors: Y
authors: Zhu
authors: Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200040, China.
authors: Zhihong
authors: Z
authors: Zhang
authors: Department of Human Resource, Shanghai Proton and Heavy Ion Center, Kangxin Road, Pudong, Shanghai 201321, China.
authors: Yun
authors: Y
authors: Ling
authors: Department of Nursing, Shanghai Proton and Heavy Ion Center, Kangxin Road, Pudong, Shanghai 201321, China. Electronic address: Hong_whw@aliyun.com.
authors: Hongwei
authors: H
authors: Wan
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology*; D003376:Counseling / Q000458:organization & administration*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009035:Mothers / Q000193:education* / Q000523:psychology*; D011181:Postnatal Care / Q000458:organization & administration*; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy
keywords: Attitude; Behavior control; Exclusive breastfeeding; Knowledge; Subjective norm