Health literacy of pregnant women and duration of breastfeeding maintenance: A feasibility study

Aims Research the association between health literacy (HL) and exclusive breastfeeding at 4‐months postpartum. Background Despite the benefits of breastfeeding (BF), its rates are low worldwide. Among the reasons for abandonment is the level of maternal education. Maternal education has been associa...

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Veröffentlicht in:Journal of advanced nursing 2021-02, Vol.77 (2), p.703-714
Hauptverfasser: Vila‐Candel, Rafa, Soriano‐Vidal, Francisco Javier, Mena‐Tudela, Desirée, Quesada, José Antonio, Castro‐Sánchez, Enrique
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container_end_page 714
container_issue 2
container_start_page 703
container_title Journal of advanced nursing
container_volume 77
creator Vila‐Candel, Rafa
Soriano‐Vidal, Francisco Javier
Mena‐Tudela, Desirée
Quesada, José Antonio
Castro‐Sánchez, Enrique
description Aims Research the association between health literacy (HL) and exclusive breastfeeding at 4‐months postpartum. Background Despite the benefits of breastfeeding (BF), its rates are low worldwide. Among the reasons for abandonment is the level of maternal education. Maternal education has been associated with HL, but evidence between HL and BF maintenance is limited. Design A cross‐sectional study. Methods The sample compromised 229 nursing mothers recruited from January 2018 to the end of December 2018 at Spain by systematic sampling method. Women were interviewed postpartum on parameters associated with the start and continuation of BF up to 4 months postpartum. Multivariate logistic regression models to explain exposure variables and exclusive BF cessation at 4 months. Results Approximately 10% of the participants had inadequate HL. Factors associated with early cessation of exclusive BF at 4 months in the multivariate model adjusted using a stepwise variable selection process based on a likelihood ratio test were civil status, risk of pregnancy, type of delivery, limited or inadequate level of HL, and LATCH score at discharge, with an 85.6% area under the ROC curve. Conclusions Our study offers preliminary evidence regarding the hitherto inconsistent relation between HL and early cessation exclusive BF at 4 months, supporting the conduct of further studies with larger sample sizes and greater statistical power. Such studies are warranted before endorsing HL‐based interventions aiming to mitigate early cessation exclusive BF. Impact Low or inadequate HL is linked to multiple poor health and clinical outcomes. We investigated the prevalence of exclusive BF at 4 months postpartum, and the impact of HL in maintaining optimal exclusive BF practices. Limited or inadequate HL was one of the factors associated with early cessation of exclusive BF in the multivariate regression model, although further research is needed. 目的 研究健康知能(HL)和产后4个月纯母乳喂养之间的关系。 背景 尽管母乳喂养(BF)有着诸多好处,但其在全球的普及率仍较低。放弃母乳喂养的原因之一与母亲教育水平有关。母亲的教育水平与健康知能有关,但能够证明健康知能和母乳喂养关系的证据十分有限。 设计 横向研究。 方法 通过系统采样的方法,从2018年1月至2018年12月底,本研究招募了229位哺乳母亲。对产后女性进行了采访,对有关开始和持续母乳喂养直到产后4个月相关的参数进行分析。其中,采用了多变量逻辑回归模型,以解释暴露变量和4个月时停止纯母乳喂养的行为。 结果 大约10%的参与者健康知能匮乏。根据可能比例、怀孕风险、分娩类型、有限或匮乏的健康知能等级以及出院时的LATCH评分,使用逐步变量选择流程,调整多变量模型中有关早期(4个月时)停止纯母乳喂养相关的因素。其中,85.6%区域低于ROC曲线。 结论 截至目前,我们的研究为健康知能和早期(4个月时)停止纯母乳喂养行为之间的不一致关系提供了初步的证据,并为采用更大的样本量和更多的统计数据进行进一步研究提供支持。在认同基于健康知能干扰以减少早期停止纯母乳喂养行为之前,该研究非常有必要。 影响 健康知能低或不足与多种不良健康状态和临床结果有关。我们研究了产后4个月纯母乳喂养的患病率
doi_str_mv 10.1111/jan.14625
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Background Despite the benefits of breastfeeding (BF), its rates are low worldwide. Among the reasons for abandonment is the level of maternal education. Maternal education has been associated with HL, but evidence between HL and BF maintenance is limited. Design A cross‐sectional study. Methods The sample compromised 229 nursing mothers recruited from January 2018 to the end of December 2018 at Spain by systematic sampling method. Women were interviewed postpartum on parameters associated with the start and continuation of BF up to 4 months postpartum. Multivariate logistic regression models to explain exposure variables and exclusive BF cessation at 4 months. Results Approximately 10% of the participants had inadequate HL. Factors associated with early cessation of exclusive BF at 4 months in the multivariate model adjusted using a stepwise variable selection process based on a likelihood ratio test were civil status, risk of pregnancy, type of delivery, limited or inadequate level of HL, and LATCH score at discharge, with an 85.6% area under the ROC curve. Conclusions Our study offers preliminary evidence regarding the hitherto inconsistent relation between HL and early cessation exclusive BF at 4 months, supporting the conduct of further studies with larger sample sizes and greater statistical power. Such studies are warranted before endorsing HL‐based interventions aiming to mitigate early cessation exclusive BF. Impact Low or inadequate HL is linked to multiple poor health and clinical outcomes. We investigated the prevalence of exclusive BF at 4 months postpartum, and the impact of HL in maintaining optimal exclusive BF practices. Limited or inadequate HL was one of the factors associated with early cessation of exclusive BF in the multivariate regression model, although further research is needed. 目的 研究健康知能(HL)和产后4个月纯母乳喂养之间的关系。 背景 尽管母乳喂养(BF)有着诸多好处,但其在全球的普及率仍较低。放弃母乳喂养的原因之一与母亲教育水平有关。母亲的教育水平与健康知能有关,但能够证明健康知能和母乳喂养关系的证据十分有限。 设计 横向研究。 方法 通过系统采样的方法,从2018年1月至2018年12月底,本研究招募了229位哺乳母亲。对产后女性进行了采访,对有关开始和持续母乳喂养直到产后4个月相关的参数进行分析。其中,采用了多变量逻辑回归模型,以解释暴露变量和4个月时停止纯母乳喂养的行为。 结果 大约10%的参与者健康知能匮乏。根据可能比例、怀孕风险、分娩类型、有限或匮乏的健康知能等级以及出院时的LATCH评分,使用逐步变量选择流程,调整多变量模型中有关早期(4个月时)停止纯母乳喂养相关的因素。其中,85.6%区域低于ROC曲线。 结论 截至目前,我们的研究为健康知能和早期(4个月时)停止纯母乳喂养行为之间的不一致关系提供了初步的证据,并为采用更大的样本量和更多的统计数据进行进一步研究提供支持。在认同基于健康知能干扰以减少早期停止纯母乳喂养行为之前,该研究非常有必要。 影响 健康知能低或不足与多种不良健康状态和临床结果有关。我们研究了产后4个月纯母乳喂养的患病率以及健康知能对维持最佳纯母乳喂养的影响。在多变量回归模型中,健康知能有限或匮乏是与早期停止纯母乳喂养有关的因素之一,尽管其还需进一步研究。</description><identifier>ISSN: 0309-2402</identifier><identifier>EISSN: 1365-2648</identifier><identifier>DOI: 10.1111/jan.14625</identifier><identifier>PMID: 33210369</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Breast Feeding ; breastfeeding ; Breastfeeding &amp; lactation ; breastfeeding abandonment ; breastfeeding duration ; Clinical outcomes ; Cross-Sectional Studies ; early cessation ; Early intervention ; exclusive breastfeeding ; Feasibility ; Feasibility Studies ; Female ; Health education ; Health Literacy ; Health status ; Humans ; Mothers ; Nursing ; Parent educational background ; Postpartum period ; Postpartum women ; Pregnancy ; Pregnant Women - psychology ; Spain ; Statistical power ; women ; Womens health</subject><ispartof>Journal of advanced nursing, 2021-02, Vol.77 (2), p.703-714</ispartof><rights>2020 John Wiley &amp; Sons Ltd</rights><rights>2020 John Wiley &amp; Sons Ltd.</rights><rights>2021 John Wiley &amp; Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3885-dd3552e23fd9781d94eedc784f317e9c9332047c5766e6207dcd34db87ff010b3</citedby><cites>FETCH-LOGICAL-c3885-dd3552e23fd9781d94eedc784f317e9c9332047c5766e6207dcd34db87ff010b3</cites><orcidid>0000-0003-1596-3064</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,1418,27926,27927,31001</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33210369$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vila‐Candel, Rafa</creatorcontrib><creatorcontrib>Soriano‐Vidal, Francisco Javier</creatorcontrib><creatorcontrib>Mena‐Tudela, Desirée</creatorcontrib><creatorcontrib>Quesada, José Antonio</creatorcontrib><creatorcontrib>Castro‐Sánchez, Enrique</creatorcontrib><title>Health literacy of pregnant women and duration of breastfeeding maintenance: A feasibility study</title><title>Journal of advanced nursing</title><addtitle>J Adv Nurs</addtitle><description>Aims Research the association between health literacy (HL) and exclusive breastfeeding at 4‐months postpartum. Background Despite the benefits of breastfeeding (BF), its rates are low worldwide. Among the reasons for abandonment is the level of maternal education. Maternal education has been associated with HL, but evidence between HL and BF maintenance is limited. Design A cross‐sectional study. Methods The sample compromised 229 nursing mothers recruited from January 2018 to the end of December 2018 at Spain by systematic sampling method. Women were interviewed postpartum on parameters associated with the start and continuation of BF up to 4 months postpartum. Multivariate logistic regression models to explain exposure variables and exclusive BF cessation at 4 months. Results Approximately 10% of the participants had inadequate HL. Factors associated with early cessation of exclusive BF at 4 months in the multivariate model adjusted using a stepwise variable selection process based on a likelihood ratio test were civil status, risk of pregnancy, type of delivery, limited or inadequate level of HL, and LATCH score at discharge, with an 85.6% area under the ROC curve. Conclusions Our study offers preliminary evidence regarding the hitherto inconsistent relation between HL and early cessation exclusive BF at 4 months, supporting the conduct of further studies with larger sample sizes and greater statistical power. Such studies are warranted before endorsing HL‐based interventions aiming to mitigate early cessation exclusive BF. Impact Low or inadequate HL is linked to multiple poor health and clinical outcomes. We investigated the prevalence of exclusive BF at 4 months postpartum, and the impact of HL in maintaining optimal exclusive BF practices. Limited or inadequate HL was one of the factors associated with early cessation of exclusive BF in the multivariate regression model, although further research is needed. 目的 研究健康知能(HL)和产后4个月纯母乳喂养之间的关系。 背景 尽管母乳喂养(BF)有着诸多好处,但其在全球的普及率仍较低。放弃母乳喂养的原因之一与母亲教育水平有关。母亲的教育水平与健康知能有关,但能够证明健康知能和母乳喂养关系的证据十分有限。 设计 横向研究。 方法 通过系统采样的方法,从2018年1月至2018年12月底,本研究招募了229位哺乳母亲。对产后女性进行了采访,对有关开始和持续母乳喂养直到产后4个月相关的参数进行分析。其中,采用了多变量逻辑回归模型,以解释暴露变量和4个月时停止纯母乳喂养的行为。 结果 大约10%的参与者健康知能匮乏。根据可能比例、怀孕风险、分娩类型、有限或匮乏的健康知能等级以及出院时的LATCH评分,使用逐步变量选择流程,调整多变量模型中有关早期(4个月时)停止纯母乳喂养相关的因素。其中,85.6%区域低于ROC曲线。 结论 截至目前,我们的研究为健康知能和早期(4个月时)停止纯母乳喂养行为之间的不一致关系提供了初步的证据,并为采用更大的样本量和更多的统计数据进行进一步研究提供支持。在认同基于健康知能干扰以减少早期停止纯母乳喂养行为之前,该研究非常有必要。 影响 健康知能低或不足与多种不良健康状态和临床结果有关。我们研究了产后4个月纯母乳喂养的患病率以及健康知能对维持最佳纯母乳喂养的影响。在多变量回归模型中,健康知能有限或匮乏是与早期停止纯母乳喂养有关的因素之一,尽管其还需进一步研究。</description><subject>Breast Feeding</subject><subject>breastfeeding</subject><subject>Breastfeeding &amp; lactation</subject><subject>breastfeeding abandonment</subject><subject>breastfeeding duration</subject><subject>Clinical outcomes</subject><subject>Cross-Sectional Studies</subject><subject>early cessation</subject><subject>Early intervention</subject><subject>exclusive breastfeeding</subject><subject>Feasibility</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Health education</subject><subject>Health Literacy</subject><subject>Health status</subject><subject>Humans</subject><subject>Mothers</subject><subject>Nursing</subject><subject>Parent educational background</subject><subject>Postpartum period</subject><subject>Postpartum women</subject><subject>Pregnancy</subject><subject>Pregnant Women - psychology</subject><subject>Spain</subject><subject>Statistical power</subject><subject>women</subject><subject>Womens health</subject><issn>0309-2402</issn><issn>1365-2648</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp1kLlOxDAQQC0EguUo-AFkiQaKgK8cplshTiFooA6OPQavEmexE6H8PYYFCiTcTDFPz6OH0D4lJzS904XyJ1QULF9DM8qLPGOFqNbRjHAiMyYI20LbMS4IoZwxtom2OGeU8ELO0PM1qHZ4xa0bICg94d7iZYAXr_yA3_sOPFbeYDMGNbjef66bACoOFsA4_4I75fwACddwhufYpp1rXNJNOA6jmXbRhlVthL3vuYOeLi8ez6-zu4erm_P5XaZ5VeWZMTzPGTBujSwraqRIfl1WwnJagtQynUxEqfOyKKBgpDTacGGaqrSWUNLwHXS08i5D_zZCHOrORQ1tqzz0Y6xZ6iNSJFkl9PAPuujH4NN1iSqlFOkjnqjjFaVDH2MAWy-D61SYakrqz-x1yl5_ZU_swbdxbDowv-RP5wScroB318L0v6m-nd-vlB-mrYt-</recordid><startdate>202102</startdate><enddate>202102</enddate><creator>Vila‐Candel, Rafa</creator><creator>Soriano‐Vidal, Francisco Javier</creator><creator>Mena‐Tudela, Desirée</creator><creator>Quesada, José Antonio</creator><creator>Castro‐Sánchez, Enrique</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1596-3064</orcidid></search><sort><creationdate>202102</creationdate><title>Health literacy of pregnant women and duration of breastfeeding maintenance: A feasibility study</title><author>Vila‐Candel, Rafa ; Soriano‐Vidal, Francisco Javier ; Mena‐Tudela, Desirée ; Quesada, José Antonio ; Castro‐Sánchez, Enrique</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3885-dd3552e23fd9781d94eedc784f317e9c9332047c5766e6207dcd34db87ff010b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Breast Feeding</topic><topic>breastfeeding</topic><topic>Breastfeeding &amp; lactation</topic><topic>breastfeeding abandonment</topic><topic>breastfeeding duration</topic><topic>Clinical outcomes</topic><topic>Cross-Sectional Studies</topic><topic>early cessation</topic><topic>Early intervention</topic><topic>exclusive breastfeeding</topic><topic>Feasibility</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Health education</topic><topic>Health Literacy</topic><topic>Health status</topic><topic>Humans</topic><topic>Mothers</topic><topic>Nursing</topic><topic>Parent educational background</topic><topic>Postpartum period</topic><topic>Postpartum women</topic><topic>Pregnancy</topic><topic>Pregnant Women - psychology</topic><topic>Spain</topic><topic>Statistical power</topic><topic>women</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vila‐Candel, Rafa</creatorcontrib><creatorcontrib>Soriano‐Vidal, Francisco Javier</creatorcontrib><creatorcontrib>Mena‐Tudela, Desirée</creatorcontrib><creatorcontrib>Quesada, José Antonio</creatorcontrib><creatorcontrib>Castro‐Sánchez, Enrique</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index &amp; Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of advanced nursing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vila‐Candel, Rafa</au><au>Soriano‐Vidal, Francisco Javier</au><au>Mena‐Tudela, Desirée</au><au>Quesada, José Antonio</au><au>Castro‐Sánchez, Enrique</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Health literacy of pregnant women and duration of breastfeeding maintenance: A feasibility study</atitle><jtitle>Journal of advanced nursing</jtitle><addtitle>J Adv Nurs</addtitle><date>2021-02</date><risdate>2021</risdate><volume>77</volume><issue>2</issue><spage>703</spage><epage>714</epage><pages>703-714</pages><issn>0309-2402</issn><eissn>1365-2648</eissn><abstract>Aims Research the association between health literacy (HL) and exclusive breastfeeding at 4‐months postpartum. Background Despite the benefits of breastfeeding (BF), its rates are low worldwide. Among the reasons for abandonment is the level of maternal education. Maternal education has been associated with HL, but evidence between HL and BF maintenance is limited. Design A cross‐sectional study. Methods The sample compromised 229 nursing mothers recruited from January 2018 to the end of December 2018 at Spain by systematic sampling method. Women were interviewed postpartum on parameters associated with the start and continuation of BF up to 4 months postpartum. Multivariate logistic regression models to explain exposure variables and exclusive BF cessation at 4 months. Results Approximately 10% of the participants had inadequate HL. Factors associated with early cessation of exclusive BF at 4 months in the multivariate model adjusted using a stepwise variable selection process based on a likelihood ratio test were civil status, risk of pregnancy, type of delivery, limited or inadequate level of HL, and LATCH score at discharge, with an 85.6% area under the ROC curve. Conclusions Our study offers preliminary evidence regarding the hitherto inconsistent relation between HL and early cessation exclusive BF at 4 months, supporting the conduct of further studies with larger sample sizes and greater statistical power. Such studies are warranted before endorsing HL‐based interventions aiming to mitigate early cessation exclusive BF. Impact Low or inadequate HL is linked to multiple poor health and clinical outcomes. We investigated the prevalence of exclusive BF at 4 months postpartum, and the impact of HL in maintaining optimal exclusive BF practices. Limited or inadequate HL was one of the factors associated with early cessation of exclusive BF in the multivariate regression model, although further research is needed. 目的 研究健康知能(HL)和产后4个月纯母乳喂养之间的关系。 背景 尽管母乳喂养(BF)有着诸多好处,但其在全球的普及率仍较低。放弃母乳喂养的原因之一与母亲教育水平有关。母亲的教育水平与健康知能有关,但能够证明健康知能和母乳喂养关系的证据十分有限。 设计 横向研究。 方法 通过系统采样的方法,从2018年1月至2018年12月底,本研究招募了229位哺乳母亲。对产后女性进行了采访,对有关开始和持续母乳喂养直到产后4个月相关的参数进行分析。其中,采用了多变量逻辑回归模型,以解释暴露变量和4个月时停止纯母乳喂养的行为。 结果 大约10%的参与者健康知能匮乏。根据可能比例、怀孕风险、分娩类型、有限或匮乏的健康知能等级以及出院时的LATCH评分,使用逐步变量选择流程,调整多变量模型中有关早期(4个月时)停止纯母乳喂养相关的因素。其中,85.6%区域低于ROC曲线。 结论 截至目前,我们的研究为健康知能和早期(4个月时)停止纯母乳喂养行为之间的不一致关系提供了初步的证据,并为采用更大的样本量和更多的统计数据进行进一步研究提供支持。在认同基于健康知能干扰以减少早期停止纯母乳喂养行为之前,该研究非常有必要。 影响 健康知能低或不足与多种不良健康状态和临床结果有关。我们研究了产后4个月纯母乳喂养的患病率以及健康知能对维持最佳纯母乳喂养的影响。在多变量回归模型中,健康知能有限或匮乏是与早期停止纯母乳喂养有关的因素之一,尽管其还需进一步研究。</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33210369</pmid><doi>10.1111/jan.14625</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-1596-3064</orcidid><oa>free_for_read</oa></addata></record>
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ispartof Journal of advanced nursing, 2021-02, Vol.77 (2), p.703-714
issn 0309-2402
1365-2648
language eng
recordid cdi_proquest_miscellaneous_2462414698
source MEDLINE; Access via Wiley Online Library; Applied Social Sciences Index & Abstracts (ASSIA)
subjects Breast Feeding
breastfeeding
Breastfeeding & lactation
breastfeeding abandonment
breastfeeding duration
Clinical outcomes
Cross-Sectional Studies
early cessation
Early intervention
exclusive breastfeeding
Feasibility
Feasibility Studies
Female
Health education
Health Literacy
Health status
Humans
Mothers
Nursing
Parent educational background
Postpartum period
Postpartum women
Pregnancy
Pregnant Women - psychology
Spain
Statistical power
women
Womens health
title Health literacy of pregnant women and duration of breastfeeding maintenance: A feasibility study
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