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Measuring exclusive breastfeeding social support: Scale development and validation in Uganda
Godfred O Boateng1, Stephanie L Martin2, Shalean M Collins1
1Department of Anthropology and Global Health, Northwestern University, Evanston, Illinois, USA.
Maternal & Child Nutrition
|January 23, 2018
Summary
A new scale measures exclusive breastfeeding social support (EBFSS) in low-income settings. This validated tool assesses instrumental, emotional, and informational support to improve infant feeding practices.
Area of Science:
- Public Health
- Maternal and Child Health
- Health Services Research
Background:
- The World Health Organization recommends exclusive breastfeeding (EBF) for six months.
- Social support significantly influences breastfeeding practices, but existing tools are inadequate for measuring exclusive breastfeeding social support (EBFSS) in low-income settings.
Purpose of the Study:
- To develop and validate a tool to measure exclusive breastfeeding social support (EBFSS) specifically for low-income settings.
- To adapt and refine the Hughes' Breastfeeding Social Support Scale for EBFSS measurement.
Main Methods:
- Modified the Hughes' Breastfeeding Social Support Scale with expert input.
- Implemented the scale in an observational cohort in Gulu, Uganda (n=238 at 1 month, n=237 at 3 months).
- Utilized exploratory and confirmatory factor analysis, alongside validity and reliability testing.
Main Results:
- Developed a 16-item Exclusive Breastfeeding Social Support (EBFSS) scale with three dimensions: Instrumental, Emotional, and Informational.
- Achieved high reliability for the dimensions (alpha coefficients: 0.79, 0.85, 0.83).
- Demonstrated supported predictive, convergent, and discriminant validity against EBF, self-efficacy, general social support, and depression.
Conclusions:
- The EBFSS scale is a valid and reliable instrument for assessing exclusive breastfeeding social support in northern Uganda.
- This tool has potential utility in other low-income settings to evaluate factors influencing exclusive breastfeeding.
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