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Infant Feeding Knowledge, Attitudes, Exposure, and Intentions

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Infant Feeding Knowledge, Attitudes, Exposure, and Intentions INFANT FEEDING KNOWLEDGE, ATTITUDES, EXPOSURE, AND INTENTIONS AMONG NON-PREGNANT ADOLESCENTS A Research Grant Proposal Presented to the faculty of the School of Nursing California State University, San Marcos Submitted in partial satisfaction of the requirements for the degree of MASTER OF SCIENCE in Nursing (Family Nurse Practitioner) by Natalie Alonzo SPRING 2016 © 2016 Natalie Alonzo ALL RIGHTS RESERVED ii ACKNOWLEDGEMENTS I would like to take the opportunity to acknowledge the network of faculty, family, and mentors that provided support and guidance through the progression of this grant proposal. Dr. Denise Boren, Dr. JoAnn Daugherty, Dr. Linea Axman, and Dr. Amy Carney guided the early development of this proposal and introduced a true appreciation for research and statistics. My committee chair Dr. Patricia Hinchberger and committee member Dr. Deborah Bennett have nurtured my proposal step-by-step through this process with their patience and passion for education. My family and mentors supported me through the necessary sacrifices to make this proposal successful. Life, health, and distance may have complicated this process from time to time, but my family and friends are truly what kept me going. They have taught me the importance of achieving my goals, never giving up, prayer is powerful, and following my heart. I am blessed to have had this opportunity to grow and develop a new appreciation for those currently in my life and those whom this journey has brought into my life. My sincere gratitude extends to all who have made this possible. vi PREFACE Specific Aim The purpose of this study is to assess the benefits of a school-based infant feeding education session in order to determine perceived breastfeeding knowledge, attitudes, exposure, and intentions among non-pregnant 10th, 11th, and 12th grade students, ages 15 to 19. Four measurement tools will be used to compare pre-test and post-test results with the use of a control group to enrich the quality of this study, and they include: Infant Feeding Knowledge Test Form- A (knowledge), Iowa Infant Feeding Attitude Scale (Attitudes), Breastfeeding Exposure Questions (Exposure), Breastfeeding Behavior Questionnaire (intention), and demographic information. Research confirms school-based health education curriculum often lacks content that educates adolescents on infant feeding options and the health benefits of breastfeeding. Considering the reality of pregnancy in adolescents and the lack of breastfeeding curriculum in schools it is necessary to equip adolescents with the knowledge, positive attitudes, and exposure in order to create a breastfeeding culture. It is important to introduce adolescents to these concepts with the intent to promote future breastfeeding practice. Learning the basic physiology of breastfeeding, hazards of formula feeding, family and community support, and establishing breastfeeding role models through media will initiate a socio-cultural shift. If these changes are addressed, breastfeeding initiation and retention statistics should reflect an increase overall with a decrease in health-related conditions that result from not breastfeeding. vii Specific Objective To test the given hypothesis that “ Participation in a school-based infant feeding education session will deduce perceived knowledge, attitudes, exposure, and intention in 10th , 11th, and 12th grade students, age 15-19 year-olds. viii Table of Contents ACKNOWLEDGEMENTS ........................................................................................................... vi PREFACE ..................................................................................................................................... vii Specific Aim ............................................................................................................................. vii Specific Objective ................................................................................................................... viii INTRODUCTION ........................................................................................................................... 1 Significance ................................................................................................................................. 1 The Problem ................................................................................................................................ 2 Nursing Implications ................................................................................................................... 2 Innovation: Research Hypothesis & Variables ............................................................................ 3 REVIEW OF LITERATURE .......................................................................................................... 5 Introduction ................................................................................................................................. 5 Gaps ........................................................................................................................................... 17 Adolescent Psychosocial and Cognitive Development ............................................................. 17 Applying a Theory ..................................................................................................................... 19 Summary .................................................................................................................................... 20 METHODOLOGY ........................................................................................................................ 21 Introduction ............................................................................................................................... 21 Hypothesis ................................................................................................................................. 21 Research Variables .................................................................................................................... 21 Design ........................................................................................................................................ 21 Intervention ................................................................................................................................ 22 Sample & Sampling ................................................................................................................... 23 Inclusion/Exclusion Criteria ...................................................................................................... 23 Data Collection .......................................................................................................................... 23 Measurement Tools ................................................................................................................... 24 Data Management ...................................................................................................................... 25 Data Coding ............................................................................................................................... 25 Data Analysis ............................................................................................................................. 26 Research Bias ............................................................................................................................ 26 Protection of Human Subjects/Ethical considerations .............................................................. 27 Summary .................................................................................................................................... 27 GRANT ELEMENTS ................................................................................................................... 32 Potential Grants & Feasibility ................................................................................................... 32 Budget ........................................................................................................................................ 33 Timeline ..................................................................................................................................... 35 REFERENCES .............................................................................................................................. 36 Appendix A: Instruments ......................................................................................................... 36 Appendix B: Demographic Survey Form ................................................................................. 40 Appendix C: Informed Consent ................................................................................................. 42 Appendix D: IRB Application ................................................................................................... 45 ix 1 INTRODUCTION Significance In the world of maternal-child health there has been an ongoing socio-cultural shift that began in 1991 as a result of the United Nations International Children's Emergency Fund (UNICEF) and World Health Organization (WHO) Baby Friendly Hospital-Initiative based on the “10-steps to Successful Breastfeeding” (UNICEF, 1991). The primary shift resulted from research that identified health benefits to both mother and baby with a direct correlation to breast milk and breastfeeding. It was determined that properties contained in breast milk decreased the risk of chronic diseases like asthma, atopic
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