Mobile-based peer-led theoretically-designed intervention on continued breastfeeding among Iranian mothers

This study addresses the determination of educational intervention-based on the Theory of Planned Behavior (TPB)-effectiveness on continued breastfeeding among Iranian mothers attending health centers, considering low researchers' attention to the continued breastfeeding index despite its important impact on children's health.

The present study was conducted among 230 mothers with exclusively breastfed infant (115 in the intervention group and 115 in the control group). Sampling starts with randomly selecting 12 health centers among all health centers in Karaj, Alborz province, and allocating them randomly into two equal groups of intervention and control. A study-specific questionnaire, designed in alignment with TPB, was the primary data collection tool. The intervention group received peer education, and optional additional education through a social network. Data were collected in 4 stages, including before the intervention, immediately, 3 months, and 6 months after the intervention. Data were analyzed using SPSS-16 and Independent t-test, Chi-square RMANOVA, ANCOVA, Cochran and McNemar tests.

There was a significant increase in the mean scores of attitude, subjective norms and perceived behavioral control constructs in the intervention group and a significant decrease of those constructs was observed in the control group (p < 0.05). There was an improvement in the mean score of breastfeeding continuation behavior among intervention group mothers after intervention exposure but it was not significant (p > 0.05). There was also a significant decrease in breastfeeding and an increase in the usage of powdered milk in mothers of the control group (p < 0.05).

It was concluded that educational interventions based on TPB by using peer group and social network can promote the behavior of continued breastfeeding. This theoretical framework can act as a road map for future development of educational interventions targeting breastfeeding continuation.