Toward A Taxonomy of Behavior Change Techniques for Exclusive Breastfeeding Interventions Open Access

Abstract

Background:Exclusive breastfeeding prevents disease and saves lives. Yet the uptake and duration of this recommended behavior remains far below global targets, especially in developing countries where it has the potential for the greatest impacts. Shifting individual behaviors and social norms to support exclusive breastfeeding is challenging, and sub-optimal progress may be due to lack of consideration for theory-based intervention design. To create effective interventions, program designers need to identify barriers and influencers in their given context, and understand the behavioral mechanisms that guide their population's behavior. Currently there are no guidelines for designing and implementing effective exclusive breastfeeding interventions.

Objective: This project aimed to understand what aspects of effective exclusive breastfeeding interventions work in developing country contexts by evaluating the use of theory-based behavior change techniques present in exclusive breastfeeding interventions.

Methods:A systematic review was conducted and interventions (n = 41) were mapped on to a 93-item taxonomy of behavior change techniques.

Results: The process revealed a dearth of detailed reporting, limiting mapping capacity and study reproducibility, and the taxonomy did not account for some attributes of breastfeeding behavior. Many interventions did employ important behavioral mechanisms for exclusive breastfeeding, such as social support and problem solving, but it was unclear whether this was intentional or coincidental due to reporting insufficiencies.

Conclusion:Intervention reporting needs to be detailed and standardized. Also, the current taxonomy should be tested and applied to infant and young child feeding behaviors, including exclusive breastfeeding, and appropriate changes made for greater applicability.

Table of Contents

INTRODUCTION ................................................................................1

LITERATURE REVIEW ........................................................................6

METHODS ........................................................................................27

RESULTS ..........................................................................................30

DISCUSSION .....................................................................................39

RECOMMENDATIONS .......................................................................43

TABLES, FIGURES, & APPENDICES:

TABLE 1............................................................................................13

TABLE 2 ...........................................................................................24

TABLE 3 ...........................................................................................25

TABLE 4 ...........................................................................................26

TABLE 5 ...........................................................................................32

FIGURE 1 .........................................................................................46

APPENDIX 1 ....................................................................................47

REFERENCES ...................................................................................57

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Nutrition Health Sciences, Public Health Psychology, Behavioral
Keyword	Intervention Behavior Change Techniques Exclusive Breastfeeding Taxonomy
Committee Chair / Thesis Advisor	Girard, Amy Webb, Emory University
Committee Members	Golding, Lenette C., Emory University

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