Background
Methods
Study settings and data collection
Participant characteristics and validation items
Exclusive breastfeeding self-efficacy item generation and adaptation
Data analysis
Descriptive analysis
Item reduction and functionality
Extraction of factors
Test of dimensionality
Model modification
Reliability of exclusive breastfeeding self-efficacy scale
Validity of exclusive breastfeeding self-efficacy scale
Results
Participant characteristics
Socio-demographic characteristics (range or %) | N/ (%) | Mean (SD) |
---|---|
Maternal age (16–42) | 25.2 (5.3) |
Number of children (0–8) | 1.6 (1.5) |
Household size (1–13) | 4.6 (2.2) |
Primiparous (%) | 55 (23.0) |
HIV positive status (%) | 88 (36.8) |
Gravidity (1–10) | 2.9 (1.8) |
Maternal Education (%) | |
Less than Primary | 131 (55.7) |
Wealth (%) | |
Poorer | 82 (34.1) |
Middle | 80 (33.5) |
General Social Support (GSS) (10–30) | 19.1 (4.2) |
CESD1-Depression scale (0–53) | 18.5 (10.9) |
Breastfeeding characteristics at 1 month postpartum | |
Correct breastfeeding knowledge2 (%) | 139 (58.2) |
Exclusive Breastfeeding (EBF) (%) | 151 (63.9) |
Instrumental EBFSS3 (3–9) | 4.8 (1.7) |
Emotional EBFSS (8–24) | 13.2 (3.7) |
Informational EBFSS (5–15) | 7.4 (2.3) |
BSES-EBF Scores | |
Cognitive subscale4 (1 month) (4–20) | 13.5 (4.1) |
Functional subscale (1 month) (5–25) | 17.2 (4.3) |
Cognitive subscale (3 month) (4–20) | 13.6 (4.1) |
Functional subscale (3 months) (5–25) | 17.7 (4.3) |
Item reduction and functionality
Variable | Response Percentages | Correlation Matrix | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mean | Variance | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | |
Enough Milk | 3.65 | 1.78 | 12.55 | 6.69 | 17.15 | 30.13 | 33.47 | 1.00 | ||||||||||
Challenging Tasks | 3.16 | 1.20 | 8.37 | 19.67 | 27.62 | 35.98 | 8.37 | 0.32 | 1.00 | |||||||||
EBF Milk | 3.31 | 1.76 | 16.74 | 9.21 | 17.57 | 38.91 | 17.57 | 0.30 | 0.36 | 1.00 | ||||||||
Manage BF | 3.72 | 1.10 | 5.44 | 7.95 | 15.90 | 50.12 | 20.50 | 0.13 | 0.24 | 0.19 | 1.00 | |||||||
Continue EBF | 3.40 | 1.29 | 10.04 | 8.79 | 25.94 | 41.84 | 13.39 | 0.11 | 0.31 | 0.53 | 0.33 | 1.00 | ||||||
Satisfy BF | 3.22 | 1.53 | 10.88 | 22.59 | 12.97 | 41.00 | 12.55 | 0.43 | 0.22 | 0.29 | 0.13 | 0.16 | 1.00 | |||||
Deal BF | 3.73 | 1.51 | 7.95 | 9.62 | 16.32 | 33.89 | 32.22 | 0.38 | 0.23 | 0.29 | 0.17 | 0.11 | 0.47 | 1.00 | ||||
BF Every feeding | 3.09 | 1.05 | 10.88 | 12.13 | 37.66 | 35.56 | 3.77 | 0.34 | 0.31 | 0.51 | 0.19 | 0.41 | 0.35 | 0.31 | 1.00 | |||
Keep BF demands | 3.47 | 1.33 | 10.04 | 8.79 | 20.08 | 46.03 | 15.06 | 0.43 | 0.34 | 0.51 | 0.23 | 0.38 | 0.55 | 0.46 | 0.86 | 1.00 | ||
EBF Liquid | 3.23 | 1.84 | 19.25 | 7.95 | 20.92 | 34.31 | 17.57 | 0.26 | 0.29 | 0.80 | 0.17 | 0.52 | 0.30 | 0.26 | 0.49 | 0.51 | 1.00 | |
Stop Other foods | 3.55 | 1.51 | 10.46 | 8.37 | 20.08 | 37.66 | 23.43 | 0.22 | 0.26 | 0.53 | 0.19 | 0.36 | 0.22 | 0.27 | 0.36 | 0.30 | 0.66 | 1.00 |
Item-total correlation | 0.56 | 0.52 | 0.79 | 0.40 | 0.60 | 0.59 | 0.56 | 0.72 | 0.79 | 0.78 | 0.63 | |||||||
Adjusted item-total correlation | 0.43 | 0.41 | 0.70 | 0.28 | 0.49 | 0.47 | 0.43 | 0.65 | 0.72 | 0.69 | 0.52 |
Extraction of factors
One-factor model | Two-factor model | ||
---|---|---|---|
1 | 1 | 2 | |
Enough Milk | 0.40 |
0.30
| |
Challenging Tasks | 0.39 | 0.24 | |
EBF Milk | 0.74 |
0.85
| |
Manage BF | 0.30 | ||
Continue EBF | 0.54 |
0.51
| |
Satisfy BF | 0.47 |
0.47
| |
Deal BF | 0.41 |
0.36
| |
BF Every feeding | 0.78 |
0.74
| |
Keep BF demands | 0.80 |
1.02
| |
EBF Liquid | 0.74 |
0.90
| |
Stop Other foods | 0.53 |
0.68
|
Factor Extraction (n = 239) | |||||||||
---|---|---|---|---|---|---|---|---|---|
Rotation | Analytical Technique | AIC1 | BIC2 | χ23 |
df
4
| RMSEA5 | CFI6 | TLI7 | SRMR8 |
Geomin Oblique Rotation |
EFA
9
(11 items)
| ||||||||
Eigenvalues |
4.29, 1.40, 1.01
| ||||||||
One-factor model
| 7747.46 | 7862.18 | 344.64 | 44 | 0.17 | 0.70 | 0.62 | 0.08 | |
Two-factor model
|
7521.89
|
7671.38
| 99.07 | 34 |
0.09
|
0.93
|
0.89
|
0.06
| |
Test of Dimensionality (n = 238) |
AIC
|
BIC
|
χ2
|
df
|
RMSEA
|
CFI
|
TLI
|
WRMR
10
| |
Geomin Oblique Rotation (Initial CFA test) |
CFA
11
(2 factors)
|
5837.01
|
5934.11
| 90.62 | 26 |
0.10
|
0.94
|
0.91
|
0.61
|
After re-specification (Geomin Oblique Rotation) |
CFA (2 factors)
|
5808.44
|
5912.48
| 58.05 | 24 |
0.08
|
0.97
|
0.95
|
0.60
|
Test of dimensionality
Model modification
Tell me how you would rank your confidence on a scale of 1 to 5 for each statement: | ||
---|---|---|
Domain | Item Label | Items |
Cognitive | EBF Milk | I can always give my baby only breast milk without using animal milk, formula, or other liquids or foods as a supplement |
Continue EBF | I can continue exclusively breastfeeding for as long as I want | |
EBF Liquid | I can always exclusively breastfeed without my baby receiving even a drop of water or any other liquid | |
Stop Other Foods | I can always stop someone from trying to feed my baby liquids or foods other than breast milk, including purchased baby foods (e.g. infant formula, milk, porridge, juice, tea [whatever is commonly given]), before 6 months of age | |
Functional | Enough Milk | … determine that my baby is getting enough milk* |
Satisfy BF | … be satisfied with my breastfeeding experience* | |
Deal BF | … deal with the fact that breastfeeding can be time consuming* | |
BF Every Feeding | … continue to breastfeed my baby for every feeding* | |
Keep Bf Demands | … manage to keep up with my baby’s breastfeeding demands* |
Reliability of the BSES-EBF scale
EBFSS Subscales | Average Inter-item covariance (1 month) | Average Inter-item covariance (3 months) | Cronbach’s Alpha Coefficient (1 month) | Cronbach’s Alpha Coefficient (3 months) | Coefficient of Stability |
---|---|---|---|---|---|
Cognitive (4 items) | 0.8598 | 0.894 | 0.8219 | 0.8523 | 0.54 (95% CI: 0.44, 0.62; p < 0.001) |
Functional (5 items) | 0.5758 | 0.5743 | 0.7677 | 0.7903 | 0.22 (95% CI: 0.09, 0.34; p < 0.001) |