Korean Journal of Community Nutrition

[English]
Examination of explicit and implicit emotions and relationship with the intention to support breastfeeding in public: a descriptive study: Katilin D. Overgaard, Lauren M. Dinour, Adrian L. Kerrihard, Yeon K. Bai; Korean J Community Nutr 2023;28(2):114-123. Published online April 30, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.2.114

Abstract PDF: Objectives
Current social norms in the United States do not favor breastfeeding in public. This study examined associations between college students’ explicit and implicit emotions of breastfeeding in public and their intention to support public breastfeeding.
Methods
Twenty-two student participants viewed images of a breastfeeding woman with a fully-covered, fully-exposed, or partially-exposed breast in a public setting. After viewing each image, participants’ explicit emotions (self-reported) of the image were measured using a questionnaire and their implicit emotions (facial expression) were measured using FaceReader technology. We examined if a relationship exists between both emotions [toward images] and intention to support breastfeeding in public using correlation techniques. We determined the relative influence of two emotions on the intention to support breastfeeding in public using regression analyses.
Results
The nursing images depicting a fully-covered breast (r = 0.425, P = 0.049 vs. r = 0.271, P = 0.222) and fully-exposed breast (r = 0.437, P = 0.042 vs. r = 0.317, P = 0.150) had stronger associations with explicit emotions and intention to support breastfeeding in public compared to implicit emotions and intention. Breastfeeding knowledge was associated with a positive explicit emotion for images with partial- (β = 0.60, P = 0.003) and full-breast exposure (β = 0.65, P = 0.002).
Conclusions
Explicit emotions appear to drive stated intentions to support public breastfeeding. Further research is needed to understand the disconnect between explicit and implicit emotions, the factors that influence these emotions, and whether stated intentions lead to consistent behavior.

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[English]
Effects of Educational Intervention about Breastfeeding on University Students' Knowledge and Attitudes toward Breastfeeding: Focusing on Gender Differences: Jo Yoon Lee; Korean J Community Nutr 2018;23(1):1-12. Published online February 28, 2018; DOI: https://doi.org/10.5720/kjcn.2018.23.1.1

Abstract PDF PubReader: OBJECTIVES
The purpose of this study was to examine the impact of a targeted, practical education intervention on university students' knowledge and attitudes toward breastfeeding.
METHODS
A university curricular intervention was designed for students to increase their knowledge and positive attitude toward breastfeeding issues. The participants attended a breastfeeding education lectures two hours of weekly for fifteen weeks in university; 61 students (female, n=31 and male, n=30) participated. The pre- and post-measurements included future breastfeeding intention, knowledge, attitude and perceived control beliefs scores based on the results of a questionnaire.
RESULTS
The statistical analysis results revealed a significant difference in the pretest and posttest scores (0.57 to 5.10 points, p < 0.001) in regard to the students' breastfeeding knowledge. For female students, significant differences were observed in the future breastfeeding intention (p < 0.05), knowledge (p < 0.001), and attitudes towards breastfeeding (p < 0.05) between the pretest and posttest scores. For male students, there were no significant differences in the future breastfeeding intention, attitudes towards breastfeeding, and perceived control beliefs scores after the breastfeeding education lecture.
CONCLUSIONS
This study showed that the implementation of practical breastfeeding educational interventions helped improve university students' knowledge and attitudes toward breastfeeding. In summary, despite the limitations, it is necessary to pay more attention to improving students' knowledge and attitudes towards breastfeeding through university curricula.

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[English]
A Study on Knowledge and Control Beliefs Regarding Breastfeeding of University Students by Their General Characteristics and Experienced Education in Breastfeeding: Jo Yoon Lee, Kang Wook Lee, Wha Jin Hyun; Korean J Community Nutr 2013;18(5):457-466. Published online October 31, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.5.457

This study was conducted to investigate the effect of breastfeeding education experience on knowledge, control beliefs, and future intention toward breastfeeding to consider the needs of breastfeeding education program of university students. The breastfeeding knowledge, control beliefs and related habits of 445 male and female college students were evaluated between September 1, 2011 to April 30, 2012. Data were collected from self-administered questionnaires and analyzed using SPSS for Window V.17.0. chi2-test, t-test and ANOVA were used for the calculation of differences between groups. The percentage of students who intended to breastfeed their baby was 80.7% (male: 73.6%, female: 84.2%). Only 21.6% of students experienced breastfeeding education. Students planned to get information related to breastfeeding from their mothers (32.4%), breastfeeding experts (23.8%) and Medical doctors & nurses (10.6%). breastfeeding education group showed higher knowledge level (14.46 vs 10.56) and control beliefs (3.48 vs 3.16) to breastfeeding than non-education group (p < 0.001). General attitude toward breastfeeding was similar between groups; the specific intention to breastfeed for 6 months was higher in the education group (83.3% vs 58.2%) (p < 0.01). Percentage of students who gave correct answers to knowledge questions related to breastfeeding was also higher in the breastfeeding education group than non-education group (72.3% vs 52.8%). Among 20 questions, only 2 questions showed no significant differences between the groups. These findings suggested that breastfeeding education was effective in encouraging or improving breastfeeding practices.

Citations

Citations to this article as recorded by

Effects of Educational Intervention about Breastfeeding on University Students' Knowledge and Attitudes toward Breastfeeding: Focusing on Gender Differences
Jo-Yoon Lee
Korean Journal of Community Nutrition.2018; 23(1): 1. CrossRef
Belief factors associated with breastfeeding intentions of single women: Based on the theory of planned behavior
Min Kyung Jang, Seung-Min Lee, Jin Mo Khil
Journal of Nutrition and Health.2017; 50(3): 284. CrossRef

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2 Crossref

[English]
A Study on Actual Conditions and Needs of Breastfeeding Education for Pregnant Women in Health Centers: Joung Won Lee; Korean J Community Nutr 2008;13(6):818-828. Published online December 31, 2008

Abstract PDF: This study was conducted to investigate actual conditions and needs on breastfeeding education for pregnant women in health centers for the development of a breastfeeding educational program. The questionnaires were mailed to 245 health centers and 148 (60.4%) questionnaires were returned. 91% of the health centers had breastfeeding education for pregnant women. 66% of them operated breastfeeding education as one part of other health programs. About 76% of supervisors and 64% of educators were the nurses. The teaching methods frequently used were lectures (30.5%), giving out booklets and leaflets (22.6%), demonstration and practice (21.5%), personal counseling (13.3%), and others. The teaching materials used were materials of outside speakers (39.7%), materials of development oneself (19.0%), materials of academic association or institute (14.8%), and others. The subjects which educators taught were the benefits of breastfeeding (16.7%), breastfeeding techniques (15.8%), caring for breasts before and after delivery (15.1%), nutritional management for lactating women (14.2%), coping strategies for the difficult situation of breastfeeding (13.3%), and others. Those were different from each other according to the educators' general characteristics. Success factors of education were increased motivation for breastfeeding (52.8%), practice (22.6%), professional's lecture (11.3%) and others. The failure factors of education were the ineffectiveness of the lecture method (69.2%), lack of education for supporters (15.4%) and lack of standardized education (15.4%). The most important barrier of education was the lack of a standardized breastfeeding educational programs (43.9%). The most effective teaching methods that educators thought were demonstration and practice (24.0%). The educators thought they need the tools and space for practice (28.2%), a standardized breastfeeding educational program (26.9%), and the human resources (24.4%) for effective education. Subjects that educators thought important for education were the breastfeeding techniques, benefits of breastfeeding, caring for breasts before and after delivery, nutritional management for lactating women, coping strategies for the difficult situation of breastfeeding, rooming system after delivery, ways to assess mother's milk quantity, introducing successful cases of breastfeeding in rank order. To promote the effectiveness of breastfeeding education, standardized breastfeeding educational programs, diverse teaching materials, space and tools, and human resources are needed.

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[English]
A Survey of Female College Students' Knowledge and Attitudes Toward Breastfeeding: Hyun Kyo Lee, Yong Song, Nam Mi Kang; Korean J Community Nutr 2008;13(3):367-373. Published online June 30, 2008

Abstract PDF: Breastfeeding is an ideal approach for physical and emotional development of babies, as well as recovery of mothers. A breastfeeding education for female students seems to be an effective intervention to increase the Korean women breastfeeding rate. The purpose of this study was to evaluate their knowledge, attitudes, and other related breastfeeding variables for developing a design for a pre-parental breastfeeding educational information for Korean female students of childbearing age. The sample consisted of 205 Korean female college students, ranging in age from 20 to 25 years old. In this study, a self-administered questionnaire included 6 pages with close-ended multiple-choice questions, and included a cover page with 15 questions on demographic characteristics and personal experiences related to breastfeeding. Data analysis was done utilizing inferential statistics using SPSS 12.0 computer program. The findings indicated that breastfeeding education programs should focus on the practical aspect of attitudes toward breastfeeding, and that educational information design should focus on the practical aspects of breastfeeding for all levels of students' education by nurses. Therefore, education for female college students seems to be an effective intervention to increase breastfeeding rate. This study is useful for descriptions of educational activities to help female students develop positive attitudes to breastfeed, to help these students have confidence toward breast-feeding in future by providing correct information and practical techniques on breastfeeding.

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[English]
Perception and Service Needs about Nutrition Education of Pregnant and Lactating: To Compare with Pregnant and Lactating Women, Health Specialist and College Women: Hong Seok Ahn, Youngmee Lee, Yu Jin Oh; Korean J Community Nutr 2006;11(3):327-337. Published online June 30, 2006

Abstract PDF: The major purpose of this study was to develop the nutrition education contents and material through the basic data from the service provider and the consumer. And also, to find out the differences of attitude and needs between the service provider (SP, breastfeeding specialist), present consumer (PC, pregnant or lactating women) and future consumer (FC, college women). There were types of questionnaires, which consisted of needs and attitudes toward child and maternal nutrition, as well as the personal characteristics of the study subjects. The subjects consisted of 113 breastfeeding specialists who served at medical related institutions, 197 pregnant or lactating women and 309 college women. The self-administered questionnaires from subjects were collected from October to November 2005 in Seoul and Kyunggi Province. The data was analysed by SPSS Win 12.0, ANOVA and Kruskal-Wallis test. The results of this study were as following: 1) The most important determining factors on breastfeeding was 'medical specialist's support' (3.51) and the next one was 'knowledge of maternity care practice' (3.39). And the importance score of determinating factors on breastfeeding was significantly different between each group (p<0.001). The groups of consumer (3.50 at PC and 3.59 at FC) considered the service provider (3.32) more important. The service providers considered a more effective determining factor to be "husband and family support" and "peer support" than the others (p<0.001). 2) To compare the effective factors of breastfeeding practices between the three groups, the service providers were more significantly considered than the others such as "attendance of intervention program" (p<0.001). But the PC group considered the most effective factors was "mother's job after delivery". 3) The self-evaluated score of the breastfeeding knowledge was the most high in SP; the score was significantly different between groups. The knowledge score of nutritional aspects in human milk was most highly evaluated. But maternity care practice and public acceptance marked the lower evaluation score than other issues. 4) The desirable types of educational material was mass media, and the next was printed matter such as booklets. Two kinds of consumers preferred DVD or VCR tapes than and the service provider group (p<0.001). 5) The priority contents of nutrition service PC group wanted the information about infant care more than maternal care (p<0.05), but FC group's priority was significantly different compared with PC group (p<0.001). The priority of SP group pointed out the information of practical child care methods. The results showed the needs of nutrition service, education channels, and perception toward effective factors on consumer behavior changes were significantly different between each group. Thus the result of this study may suggest that consumer oriented nutrition service programs must be developed.

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[English]
A Study on the Future Plans for Infant Feeding Practice and Its Associated Factors among University Students: Kyung Suk Choi; Korean J Community Nutr 2003;8(2):240-249. Published online April 30, 2003

Abstract PDF: This study was carried out to investigate the future plan for infant feeding practice and its associated factors among university students so as to develop focus for nutritional education program for the promotion of breastfeeding. The subjects were 301 students (males 130, females 171). The results obtained were as follows. In this survey, the subjects had a basic knowledge of breastfeeding and lactation, especially of the ingredient of breastmilk. However they were not well informed about the physiology and method of breastfeeding and benefits of breastfeeding for mothers. The average scores for attitude toward breastfeeding and lactation were 3.09 points on a 4 point scale, which indicated a slightly positive attitudes toward breastfeeding. However the participants had a negative attitude toward its emotional and practical aspects. Their future plan for infant feeding was breastfeeding 40.3%, formula feeding 3.0% and mixed feeding 56.7%. A concern was that the students showed a high rate with regard to a mixed feeding plan, and they decided this based on an incorrect knowledge of breastfeeding. The group who planned to breastfeed in the future (BF) showed higher scores with respect to knowledge and attitudes than those who planned to formula feed or mixed feed (FF + MF). Therefore, to encourage mothers to breastfeed and support breastfeeding, breastfeeding nutritional education is urgently needed among university students. In addition, nutrition education programs should promote the benefits of breastfeeding for mothers and the physiology and practical method of breastfeeding. Also a practical and culturally sensitive course about food and nutrition is recommended to inform participants about breastfeeding.

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[English]
The Economic Benefits of Breastfeeding: Taisun Hyun, Ki Nam Kim, Nammi Kang, Eun Young Lim; Korean J Community Nutr 2002;7(6):863-871. Published online December 31, 2002

Abstract PDF: To compare the costs incurred by infant feeding between mothers who breastfed their infants and those who fed them infant formula, a questionnaire survey was carried out to 136 mothers living in Seoul, Cheongju and Chungju who breastfed and 199 mothers who formula-fed their infants. The cost of formula-feeding was estimated based on the expenditures for formula and feeding apparatus, and the time needed to wash bottles and prepare formula. The cost of breastfeeding was estimated based on the expenditures for food for the additional nutritional intake of these mothers. The mean cost of formula-feeding was 1,870,125won during the first year of the baby's life. The food cost for the additional nutritional intake of the breastfeeding mothers was 203,004 won per year. The extra medical cost for respiratory illnesses in the formula-fed group compared to the breastfed group was 62,920 won because the formula-fed infants required medical attention for respiratory illnesses more often than the breast-fed infants. Therefore, breastfeeding could save 1,730,041 won during the first year of an infant's life. We may have underestimated the cost savings from breastfeeding because we did not take into account the potentially decreased costs of fertility control and the health benefits for mothers, as well as the decreased usage of water and gas. Analyses showed that breastfeeding is not only nutritionally advantageous, but also economically advantageous for families and society.

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[English]
A Survey on the Feeding Practices of Women for the Development of a Breastfeeding Education Program: Breastfeeding Knowledge and Breastfeeding Rates: Ki Nam Kim, Taisun Hyun, Nam Mi Kang; Korean J Community Nutr 2002;7(3):345-353. Published online June 30, 2002

Abstract PDF: A survey was carried out to investigate the breastfeeding knowledge, breastfeeding rates and related factors among women in Seoul and the Chungbuk area, in order to obtain baseline data for the development of an education program on breastfeeding. Subjects included 671 lactating mothers who visited public health or pediatric centers, between December, 1999 and February, 2000 and were interviewed using a questionnaire. The results are as follows: In the breastfeeding knowledge, most of the subjects (93.4%) knew correctly that 'breastfeeding is better for a baby's emotional development than formula feeding,' whereas only half of the subjects (51.7%) answered correctly the question on whether 'formula is more nutritious than breastmilk.' The breastfeeding rates were about 57%, 40%, 33% and 12%, respectively for baby's aged 1, 3, 6, and 12 months. These results showed that the breastfeeding rate rapidly decreased with the baby's age. Lower breastfeeding rates were associated with high educational level (college graduate and above), high income, mothers' employment, no experience of attending breastfeeding education programs, and no planning on breastfeeding prior to pregnancy. There was a significant relationship between the level of knowledge and breastfeeding practice; the higher the knowledge score, the higher the breastfeeding rate. In conclusion, an education program should be developed and offered for each low breastfeeding rate group, in order to promote breastfeeding.

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[English]
Prenatal Breastfeeding Education and Infant Feeding Practices in Public Health Centers and Baby-Friendly Hospitals: Taisum Hyun, Eun Young Lim, Nammi Kang, Ki Nam Kim; Korean J Community Nutr 2001;6(4):678-685. Published online October 31, 2001

Abstract PDF: Although breastfeeding is recognized to be vital to the health and well-being of children and women, the rate of breastsfeeding among Korean women has continuously decreased. One barrier to breastfeeding has been identified to be associated with health care providers. Health care professionals do not give sufficient advice and encouragement, next do hospitals provide supportive environments for breastfeeding by separating infants from mothers or providing formula. The purpose of this study was to investigate prenatal breastfeeding education and infant feeding practices in public health centers and baby-friendly hospitals. A telephone survey was carried out on 57 public health centers located in the Seoul and Chungcheong areas and 13 baby-freindly hospitals from February to April in 2000. Among the public health centers, 43.8% offered periodic prenatal education for pregnant women who visited the centers. Most of them used leaflets or pamphlets developed by the Ministry of Health and Welfare or UNICEF. Twenty six percent of the public health centers developed their own educational materials. All of the 13 baby-friendly hospitals gave additional fluids to infants, did not allow mothers and infants to stay together 24 hours a day, and did not foster the establishment of breatfeeding support groups among the mothers. Most of the baby-friendly hospitals gave artificial teats, did not help mothers initiate breastfeeding within a half-hour of birth. Findings indicate that current practices even in the baby-friendly hospitals are not consistent with the '10 steps to success breastfeeding'. Therefore, deliberate efforts should be made to incorporate adequate breastfeeding education into prenatal program in both public health centers and hospitals, and create environments to support breastfeeding in hospitals, even in baby-friendly hospitals.

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[English]
A Study on Predicting Behavioral Intention of Breastfeeding among Primigravida: Jie Eun Kim, Dong Yean Park; Korean J Community Nutr 2001;6(3):331-339. Published online August 31, 2001

Abstract PDF: This study was conducted to examine the predicting factors for the intention of breastfeeding with The Theory of Planned Behavior. The questionnaires were distributed to 131 primigravidas who were in their third trimester of pregnancy in Seoul, Kyonggido, Kyongsangbukdo, and Kyongsnagnamdo. Descriptive statistics, Pearsons Correlation and Multiple Regression were used to analyse the data. The subjects showed strong intention of breastfeeding. The subjects showed favorable attitudes toward breastfeeding. This fact showed significant correlation with the belief that their breastfeeding intention was due to the advantage of breast milk for the infant with regard to allergy prevention, disease protection, contribution to intellectual development, psychological closeness between mother and infant, convenience, cost, and the reduction of breast cancer risk and weight of the mother. No item of outcome evaluation did showed significant correlation with behavioral intension. The subjects were influenced about breastfeeding by their referents such as siblings and friends with breastfeeding experience, their mothers and husbands, and mothers-in-law. Most items of the control beliefs had a significant influence on the intention of breastfeeding. The subjects felt they could not control the situation ie. "when I have to breastfeed in public". However they felt they could control the situation ie. "when I suffer from mastitis", "when I have to cut down on coffee, alcohol, and smoking", "when I have Caesarean section", "when I need to maintain breast condition", and "when the infant hates to suck my nipple". Regression analysis revealed that control beliefs and attitudes toward breastfeeding could predict the behavioral intention of breastfeeding. Control beliefs were the most important factor in predicting behavioral intention. Therefore, nutrition education is needed to enhance the ability to cope with difficult situations while breastfeeding and increase faborable attitudes toward breastfeeding.

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