Using the Information-Motivation-Behavioral Framework to Promote Rational Medicine Use Among Breastfeeding Women: A
Ritah Nakijoba1, Lynn M Atuyambe2, Simon Peter Asiimwe1
1Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.
Background:
Rational medicine use during breastfeeding remains a challenge, especially in low- and middle-income countries. Self-medication, incomplete dosing, inappropriate drug selection, poor adherence, and adverse drug reactions contribute to antimicrobial resistance. Although the Information-Motivation-Behavioral Skills (IMB) model has successfully influenced health behaviors, its application to promoting safe medicine practices among breastfeeding women in urban settings is limited. This study assessed the association of an IMB-based educational intervention with knowledge, attitudes, and practices related to medication use.
Methods:
A quasi-experimental study with intervention and control groups was conducted among 184 breastfeeding women (≥18 years) with infants ≤12 months attending six urban clinics in Kampala, Uganda. Participants were recruited using systematic random sampling and allocated to intervention and control groups. The intervention comprised 12 weekly IMB-based health education sessions delivered through lectures, group discussions, videos, and printed materials. The control group received standard health education. Outcomes were measured at baseline and at 3 months using structured Likert-scale questionnaires. Changes over time and between groups were analyzed using repeated-measures analysis of variance and mixed-effects regression models.
Results:
Baseline characteristics were comparable between groups. At three months, greater improvements in knowledge were observed in the intervention group compared with the control group (89% versus 80%; Mean difference (MD) = 8.3; 95% confidence interval [CI]: 6.0-10.6), motivation (81% versus 70%; MD = 11.5; 95% CI: 8.6-14.4), and behavior (91% versus 81%; MD = 9.9; 95% CI: 7.3-12.5), all p < 0.001. Mixed-effects regression analyses showed that changes over time differed significantly between the intervention and control groups, with greater improvements in knowledge observed in the intervention group compared with the control group (β = 7.34; p < 0.001), motivation (β = 11.49; p < 0.001), and behavior (β = 5.67; p = 0.012).
Conclusion:
The IMB-based intervention improved women's knowledge, motivation, and practices, supporting the integration of such programs into routine health education.
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