The impact of knowledge and social influences on adolescents' breast-feeding beliefs and intentions

Abstract

Objectives Many health promotion educational interventions assume that increasing knowledge directly influences beliefs, intentions and behaviour, whereas research suggests that knowledge alone is insufficient for behavioural change. Social cognition frameworks such as the Theory of Reasoned Action (TRA) propose a central role for beliefs and social normative influences. This Scottish study evaluates the role of knowledge and social influences (subjective norms, exposure to breastfeeding; social barriers) on beliefs and future intentions to breastfeed or bottle-feed. Social influences from family and peers are investigated. Design A cross-sectional between-subjects observational design was used. A questionnaire was administered to a sample of 229 (46%) male and 267 (54%) female adolescents aged 11-18. Setting Participants completed questionnaires during lessons at 3 secondary schools in Central Scotland. Results Knowledge about health benefits of breastfeeding was generally poor. Analyses found that perceived social barriers to breastfeeding moderated the relationship between knowledge and beliefs. More knowledge, positive beliefs and supportive subjective norms also predicted future intentions to breastfeed. Parental norms exerted greater influence than peer norms on adolescents’ breastfeeding beliefs. Conclusions Knowledge and social influences are important predictors of positive breastfeeding beliefs, and future intentions to breastfeed in adolescents. This has important implications for breastfeeding health promotion interventions in young people.