Beliefs and Intentions of U.S. Registered Dietitians/Registered Dietitian Nutritionists Toward Providing Breastfeeding Support to Prenatal/Postpartum Mothers

Abstract

Background: Given the nutritional benefits and other advantages of breastfeeding, registered dietitian nutritionists (RDNs) must consider their role in supporting prenatal and postpartum mothers, as it pertains to breastfeeding. Methods: The online Breastfeeding Support Beliefs and Intentions Questionnaire (BSBIQ) was developed and tested to confirm psychometric properties before using it to investigate the beliefs and intentions of U.S. RDNs toward providing breastfeeding support to prenatal/postpartum mothers. A simple random sample of 5,030 RDNs, obtained from InfoGlobalData’s pool of approximately 12,000 of the nation’s 119,249 RDNs, received a hyperlink to the BSBIQ by email via the Qualtrics platform, as well as 471 RDNs employed by a foodservice company who were emailed directly from an email contact list. A priori power analysis determined that 383 cases were required to represent the population of 119,249 U.S. RDNs (95% confidence level; CI = 5), with 137 cases needed to perform structural equation modeling. Findings: The data analyses were conducted using IBM SPSS software and SPSS AMOS software. Confirmatory factor analysis (CFA) was performed to measure construct validity and determine the model fit. All 18 items of the TPB constructs displayed highly significant loadings (P < .001 for all) with each item demonstrating its the relationship with its latent constructs. The CFA determined that the model fit the data well. Structural equation modeling (SEM) was performed to assess the direct and indirect relationships of the exogenous and endogenous variables on the outcome variable, Intention. The final SEM demonstrated an improved model fit and indicated that Perceived Behavioral Control (PBC), Subject Norm (SubNorm), Level of Interest in completing continuing professional education related to breastfeeding (LevInt), and NotWhite (as compared to white) were all significantly predicting intention through direct effects (P < .001, P < .001, P < .001, P = .042, respectively). The TPB construct PBC was shown to be the best predictor for RDNs’ intentions toward providing breastfeeding support to prenatal and postpartum women. Conclusion: Results may inform interventions designed to increase the number of RDNs who provide breastfeeding support to prenatal/postpartum mothers, thus improving breastfeeding rates among the U.S. population.