dissertation defense 2012
DESCRIPTION
breastfeeding empowerment program, preventative care for post-partum depressionTRANSCRIPT
Michelle Irvin-GrajedaDissertation Defesnse
January 11, 2012
Breastfeeding
Empowerment
Postpartum Depression
•PPD affects 13-19.2% of women who deliver babies (O’Hara & Swain, 1996; Gavin, et al., 2005)
•Following first PPD episode risk increases to 30-50% (American Psychiatric Association, 2000)
•PPD is not always diagnosed
Parenting Efficacy
•Parent feels competent•Increases well being•Minimizes stress•parent-child relationships•child development outcomes
(de Montigny & Lacharite, 2005;Hudson et al.,2001; Gilmore & Cuskelly, 2008; Jones & Prinz, 2005)
BreastfeedingBenefits
• motor development• infant disease• Infant’s immune system • cognitive abilities
(Evidence, 2005)
PPD and Breastfeeding
• Desire to BF decreases• Mother-child relationship
(Hoddinott et al., 2009)
Empowerment
• Focuses on health• Builds on strengths• Builds confidence
Social Support for New Mothers
•Many sources of social support•More important for 1st time mothers•Linked to successful breastfeeding
(Hoddinnott & Phil, 1999; Bosnjak, et al, 2009)
Breastfeeding Support Groups
•United States has low breastfeeding prevalence•Recommended to new mothers•Research is limited
(Ekstrom, et al., 2006; Bosnjak, 2009; Hoddinnott, et al., 2006; Kang, et al., 2007)
Current Study
•Examined whether and how attending BF support groups impacts new mothers•Whether programs that promote the initiation and maintenance of BF prevent symptoms of: • PPD • enhance self-efficacy
Limited research Diverse Sample Larger sample size Examined the association of attendance &
DVs
What it adds
Mothers who attend BF groups longer ◦ higher levels of wellbeing, PSOC, SS and BF
empowerment◦ decrease in depressive sxs
Determine whether empowerment and social support mediate the effect of attendance on DV
Hypotheses
Participants: ◦ 90 participants ◦ Breastfeeding support groups◦ Community resource center
Breastfeeding support group: ◦ Facilitated by professional◦ Process group◦ Additional services available◦ Open membership
Method
Sample◦ Ages, 16-37, 20% were 29◦ Education, 32.2% BA, Some 27.8%, MA 20%◦ Income, 35.6% 50-59k, 15.6% 70-79k, 13.3% 40-
49k◦ Marital status, 36.7% single/never married,
married 62.2%◦ Ethnicity, 52.2% white, 27.8% Hispanic
Method
Measures:◦ The Edinburgh Postnatal Depression Scale
Cronbachs alpha 0.856◦ Parenting Sense of Competency
0.965◦ Psychological General Well Being Index
0.915
Method
Hypothesized Mediators◦ Breastfeeding Empowerment
0.971◦ Breastfeeding Will
0.885◦ Scales of Perceived Social Support
0.963
Method
Attendance Identify number of sessions attended birth date and date first attended
Method
Series of correlation between attendance◦ PPD◦ Self-efficacy◦ Well being◦ Empowerment◦ Social Support (not correlated)
Mediation◦ Baron & Kenny, 1986◦ Control for the effect of attendance
Analyses
Possible confounds tested Attendance and Experience as a mother
◦ In order to rule out, regression equations were conducted
◦ Age of child in months and attendance as predictors for each DV
Analyses
Attendance Attendance controlling for age of child1
PPD -.299** -.302**
BF Empowerment .638** .717**
PSOC .751** .753**
Wellbeing .465** .463**
Zero order correlations and standardized regression coefficients of attendance and outcome variables
1Note. Regression analysis was run entering both days old and attendance ** p < .01
•Attendance was statistically significant predictor of each even when controlling for experience as mothers
Additional confounds tested:◦ Individual characteristics commonly associated
with better functioning. Education Income Marriage Ethnicity
◦ Findings suggest attendance not greater for white, married, more wealthy, and more educated mothers
Results
Mediator
YX
Results: Mediation
a b
c’
A series of steps with 3 regressions were carried out for each mediator and DV pair
Regression analysis was conducted to determine whether attendance had stat sig effect on DV. ◦ Tests total effect (c) of X on Y
Steps for mediation
YX
2nd step, R.A. conducted ◦ To determine whether the intervention has
statistically sig effect on hypothesized mediator, path a.
3rd, R.A. to determine whether hypothesized mediator was statistically sig predictor of DV’s ◦ while controlling for the effect of the attendance,
path b.
Steps for mediation
Mediator
YX
Results: Mediation
a b
c’
4th, if mediator completely mediates the effect of X on Y ◦ the effect controlling for the mediator (path c’)
should become zero When a partial mediation may exist If conditions were met:
◦ at least for partial mediation…◦ sobel test is conducted using an interactive
calculation tool developed by Preacher and Leonardelli
Results: Mediation
Breastfeeding Empowerment
PSOCAttendence
.638**
.751** (.629**)
..191*
Results: Mediation
•BF Empowerment was a significant predictor of PSOC while controlling for attendance
Breastfeeding Will
PPDAttendence
.682**
.299** (-.205)
.402*
Results: Mediation
•BF Will was a significant predictor of PPD while controlling for attendance
Breastfeeding Will
PSOCAttendence
.682**
.751** (.507**)
.358**
Results: Mediation
•BF Will was a significant predictor of PPD while controlling for attendance
Breastfeeding Will
WellbeingAttendence
.682**
.465** (.238)
.333**
Results: Mediation
•BF Will was a significant predictor of Wellbeing while controlling for attendance
Attendance associated with positive outcomes◦ Greater attendance in BSG associated with increase in
parental self-efficacy Social support
◦ Attendance appeared to have no effect on social support in the current study
BF empowerment mediated the effect of attendance on:◦ parental self efficacy ◦ PPD symptoms ◦ parental self-efficacy ◦ well-being
Discussion
◦ Past research only focused on providing information to mothers little on the interaction of mothers.
interactions continue to build on strengths encouraging self help Teach new skills education about infants and their needs
Discussion
Limits in the ability to draw causal inferences
Examine the predictors of BF Will
Limitations/future directions
Thanks
for listeni
ng!