Exposure to mass media and interpersonal counseling has additive effects on exclusive breastfeeding and its psychosocial determinants among Vietnamese mothers

Abstract

The pathways through which behavior change interventions impact breastfeeding practices have not been well studied. This study aimed to examine: (1) the effects of exposure to mass media and interpersonal counseling on exclusive breastfeeding (EBF) and hypothesized psychosocial determinants (i.e. knowledge, intention, beliefs, social norms, and self‐efficacy); and (2) the pathways through which exposure to mass media and interpersonal counseling are associated with EBF. We used survey data from mothers with children < 2 year (n = 2045) from the 2013 process evaluation of Alive & Thrive's program in Viet Nam. Multiple linear regression analyses and structural equation modeling were used to estimate effects. Exposure to mass media only, interpersonal counseling only, both or neither was 51%, 5%, 19% and 25%, respectively. Exposure to both mass media and interpersonal counseling had additive effects on EBF as well as on related psychosocial factors, compared with no exposure. For example, EBF prevalence was 26.1 percentage points (pp) higher in the group that received interpersonal counseling only, 3.9 pp higher in the mass media group and 31.8 pp higher in the group that received both interventions. As hypothesized, more than 90% of the total effect of the two interventions on EBF was explained by the psychosocial factors measured. Our findings suggest that combining different behavior change interventions leads to greater changes in psychosocial factors, which in turn positively affects breastfeeding behaviors.

Factors influencing the uptake of a mass media intervention to improve child feeding in Bangladesh

“…Direct narrative messaging appeared to lead to better comprehension than indirect narrative forms in our context, and messaging was most effective when it is combined with complementary activities such as home visits by FHWs to deliver similar messages. Although metaphors are commonly used in persuasive message design, our findings concur with those from other mass media interventions, suggesting simple well‐developed messages for target audiences (Snyder, ) and implementation with combined behaviour change strategies contribute to successful interventions (Nguyen et al, ; Sinha et al, ).…”

“…Even with high believability and identification with the situation or characters, the barriers to feasibility such as sociocultural issues and economic constraints continue to present obstacles to implementing behaviours and may undermine the uptake of messages into practice. Thus, for behaviours highly embedded in sociocultural contexts such as child feeding practices, mass media interventions that reach caregivers as well as other family members and the broader community play an important role in combination with other strategies in promoting IYCF practices (Menon et al, ; P. H. Nguyen, Kim, et al, ), and more evidence such as our study is needed in support of refining these interventions for social and behaviour change. In our study, we examined the various factors (Salmon & Atkin, ), with the assumption that these elements work together to influence behaviour.…”

“…Thus, for behaviours highly embedded in sociocultural contexts such as child feeding practices, mass media interventions that reach caregivers as well as other family members and the broader community play an important role in combination with other strategies in promoting IYCF practices P. H. Nguyen, Kim, et al, 2016), and more evidence such as our study is needed in support of refining these interventions for social and behaviour change.…”

It takes a village: An empirical analysis of how husbands, mothers‐in‐law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India

“…For ease of interpretation, these scores were then divided into tertiles (as low‐, medium‐, or high‐knowledge levels) for multivariable analyses. Belief and self‐efficacy were measured on a 5‐point Likert scale by asking women the extent to which they agreed or disagreed with statements related to adopting recommended practices for breastfeeding (Nguyen et al, ). A scale representing maternal beliefs and self‐efficacy favouring EIBF or EBF was created for examination in the multivariable models (Supplemental Table 2).…”

Women's bargaining power and child feeding in Nepal: Linkages through nutrition information

“…For example, cognitive aspects of social capital such as trust, perceived support and/or reciprocity could be examined along with the structural aspects of participation and size of the network to understand the relative contribution of each aspect to influence IYCF practices. Mechanisms linking bargaining power to knowledge or intention of IYCF practices could be assessed to provide evidence of relationship between bargaining and cognitive processes such as knowledge and intention, which are shown to be associated with practices (Nguyen et al, ). Combining nutrition messaging with social participation can help maximize women's use of social resources and time to build social capital, offer opportunities to economically contribute to the household and improve nutrition knowledge and related‐self efficacy.…”