Effects of social cognitive theory based health education intervention on exclusive breastfeeding practice among antenatal mothers: a study protocol

Introduction: Despite the numerous benefits of breastfeeding to mothers and infants, the rate of exclusive breastfeeding (EBF) in Nigeria is still low. Aim: This study aims to evaluate the effectiveness of health education intervention to improve EBF among antenatal mothers in the Imo State Specialist Hospital in Nigeria, using the social cognitive theory. Methods: This study is a two parallel arm single blinded randomised controlled trial (RCT) that will involve women who come for antenatal check-up in the Imo State Specialist Hospital in Owerri, Nigeria. The primary outcome is EBF practice while secondary outcome is breastfeeding knowledge, breastfeeding attitude, breastfeeding outcome expectancy, breastfeeding social support and breastfeeding self-efficacy. Participants were randomly assigned to either intervention (Health education intervention) or control group. The health education intervention will be developed based on the Social Cognitive Theory and the World Health Organisation guidelines on exclusive breastfeeding. The Social Cognitive Theory in breastfeeding education programme (SCT-BFEP) will be a six-month intervention programme delivered in phases, including a health education session (4 weeks), followed by weekly follow-up WhatsApp messages until eight weeks post-natal. Concealment was determined by using sequentially numbered sealed opaque envelopes. The sample size is 204. In brief, 102 mothers will receive health education alongside standard care for four weeks, while another 102 participants (control group) will receive only standard care. Discussion: Studies reported that health education interventions and behaviour change outlines provide an effective basis to increase EBF rates. A health education intervention programme is also a feasible and effective method that may contribute to the national strategy on infant and child feeding practices. This is done through the health education empowerment of mothers and the support of frontline healthcare providers and health programme managers to reinforce the importance and benefits of breastfeeding from early antenatal visits. Data collection will be done at baseline, at three months, and six months post-natal. Conclusion: The SCT-BFEP will be effective in positively affecting the outcome variables such as EBF practice, breastfeeding knowledge, attitude, intention, outcome expectancy, social support and self-efficacy.

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