Innovative Use of Influential Prenatal Counseling May Improve Breastfeeding Initiation Rates Among WIC Participants

• Published in: Journal of nutrition education and behavior 2014-11, Vol.46 (6), p.458-466
• Main Authors: Hildebrand, Deana A., PhD, RD, LD, McCarthy, Pam, MS, RD, Tipton, Debi, MS, RD, LD, Merriman, Connie, MS, Schrank, Melody, MS, RD, LD, Newport, Melinda, MS, RD, LD
• Format: Article
• Language: English
• Subjects: Behavior Change; Behavior Modification; Breast Feeding - ethnology; breastfeeding; Breastfeeding & lactation; Caregivers - education; Chickasaw Nation; Child Nutrition Sciences - education; Culturally Competent Care - ethnology; Data Analysis; decision theory; Demonstration Programs; Epistemology; Female; Females; Food Assistance; Gastroenterology and Hepatology; Health Knowledge, Attitudes, Practice - ethnology; Humans; Indians, North American; Infant; Infant, Newborn; Internal Medicine; Intervention; low-income population; Male; Nutrition; Nutrition Policy; Oklahoma; Parents & parenting; Parents - education; Patient Compliance - ethnology; Perceptions; Poverty Areas; Prenatal Education; Quasiexperimental Design; Regression analysis; Research Design; Social Theory; Young Children
• ISSN: 1499-4046; 1878-2620; 1708-8259
• DOI: 10.1016/j.jneb.2014.05.005

Abstract Objective To determine whether integrating influence strategies (reciprocation, consistency, consensus, feeling liked, authority, and scarcity) throughout Chickasaw Nation Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics (1) changed participants' perception of the WIC experience and (2) affected breastfeeding initiation rates. Methods Two-part, quasi-experimental design. Setting Four WIC clinics. Participants Parents and caregivers of children birth to 3 years. Intervention Behavior change intervention based on Social Cognitive Theory using Caildini's Principles of Influence. Traditional-model groups (control) received services prior to the intervention; influence-model groups (experimental) received services after initiation of the intervention. Main Outcomes The preliminary demonstration project surveyed 2 groups to measure changes in their perceptions of the WIC environment. Secondary data analysis measured changes in breastfeeding initiation in 2 groups of postpartum women. Analyses Frequency analysis, independent sample t tests, chi-square for independence, step-wise logistic regression. Results The demonstration project resulted in 5 improved influence measures ( P < .02), aligning with the influence principle of “feeling liked.” The model had a small effect (φ = 0.10) in distinguishing breastfeeding initiation; women in the influence model were 1.5 times more likely (95% CI, 1.19–1.86; P < .05) to initiate breastfeeding compared with women in the traditional model, controlling for parity, mother's age, and race. Conclusions and Implications Consistent with Social Cognitive Theory, changing the WIC environment by integrating influence principles may positively affect women's infant feeding decisions and behaviors, specifically breastfeeding initiation rates.