Feasibility of using the Breastfeeding Efficacy Beliefs Inventory for improving breastfeeding initiation rates in an urban population


Department of Obstetrics and Gynecology, Center for Urban Population Health, Department of Family Medicine, Aurora UW Medical Group

Presentation Notes

Presented at 2013 Aurora Scientific Day, Milwaukee, WI


Background/significance: Breastfeeding is the preferred method of infant nutrition. However, initiation rates of breastfeeding at Aurora Sinai are only 56% with a goal of 82% initiation per Healthy People 2020. Therefore confidence in breastfeeding in this population is important to find the barriers that must be overcome to reach this goal.

Purpose: To assess perceived breastfeeding confidence (BFC) and determine barriers in relationship to breastfeeding (BF) in an urban population.

Methods: Study Design: The Breastfeeding Personal Efficacy Beliefs Inventory (BPEBI) was used to determine perceived BFC. The survey was distributed to 272 obstetric patients during prenatal appointments. BF initiation rate at discharge was determined by medical chart review. Data Analysis: A principal component factor analysis with Varimax rotation was used to examine the structure of the BPEBI. The criterion for the determination of the number of factors was an Eigenvalue of greater than 1 and a loading factor of .30. Demographic data were summarized using descriptive statistics. Score variables were compared with the Mann-Whitney test. Univariate regression was used to determine association of predictor variables with individual inventory scores, and multivariate models were constructed with significant variables.

Results: Survey response rate was 88% (240/272). The mean age was 25.3±5.7, median age of 24; 64% of individuals had a high school diploma/GED. The overall BFC was 74%. In multivariate models, BFC increased with prior exposure to BF (p=0.03), exclusively BF (p=0.03), and length of BF (p=0.02). Factor analysis identified two constructs: Confidence to Manage Motivation and Confidence to Manage Technique/Environment. Within the motivation construct, BFC increased with prior exposure to BF (p=0.006) and exclusively BF (p=0.001), and within the technique/environment construct, BFC increased with exclusively BF (p=0.000). BF initiation rate at discharge was 56%.

Conclusion: These women rated themselves as confident with breastfeeding, in contrast to the BF initiation rate at discharge. The two main barriers to increased BFC were not having prior exposure to BF or not exclusively breastfeeding.

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