Sensitivity of the Breastfeeding MotivationalMeasurement Scale: A Known Group Analysis of FirstTime Mothers

Doreen Stockdale, Marlene Sinclair, WG KERNOHAN, Evie McCrum-Gardner, John Keller

Research output: Contribution to journalArticle

Abstract

Breastfeeding has immense public health value for mothers, babies, and society. But there is an undesirably large gapbetween the number of new mothers who undertake and persist in breastfeeding compared to what would be a preferredlevel of accomplishment. This gap is a reflection of the many obstacles, both physical and psychological, that confront newmothers. Previous research has illuminated many of these concerns, but research on this problem is limited in part by theunavailability of a research instrument that can measure the key differences between first-time mothers and experiencedmothers, with regard to the challenges they face when breastfeeding and the instructional advice they require. Aninstrument was designed to measure motivational complexity associated with sustained breast feeding behaviour; theBreastfeeding Motivational Measurement Scale. It contains 51 self-report items (7 point Likert scale) that cluster into fourcategories related to perceived value of breast-feeding, confidence to succeed, factors that influence success or failure, andstrength of intentions, or goal. However, this scale has not been validated in terms of its sensitivity to profile the motivationof new mothers and experienced mothers. This issue was investigated by having 202 breastfeeding mothers (100 first timemothers) fill out the scale. The analysis reported in this paper is a three factor solution consisting of value, midwife support,and expectancies for success that explained the characteristics of first time mothers as a known group. These resultssupport the validity of the BMM scale as a diagnostic tool for research on first time mothers who are learning to breastfeed.Further research studies are required to further test the validity of the scale in additional subgroups.
LanguageEnglish
JournalPLoS ONE
Volume8
Issue number12
DOIs
Publication statusPublished - Dec 2013

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midwife
baby
Values
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confidence
learning

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@article{bb8d45c80648409fb71a9ba76783b710,
title = "Sensitivity of the Breastfeeding MotivationalMeasurement Scale: A Known Group Analysis of FirstTime Mothers",
abstract = "Breastfeeding has immense public health value for mothers, babies, and society. But there is an undesirably large gapbetween the number of new mothers who undertake and persist in breastfeeding compared to what would be a preferredlevel of accomplishment. This gap is a reflection of the many obstacles, both physical and psychological, that confront newmothers. Previous research has illuminated many of these concerns, but research on this problem is limited in part by theunavailability of a research instrument that can measure the key differences between first-time mothers and experiencedmothers, with regard to the challenges they face when breastfeeding and the instructional advice they require. Aninstrument was designed to measure motivational complexity associated with sustained breast feeding behaviour; theBreastfeeding Motivational Measurement Scale. It contains 51 self-report items (7 point Likert scale) that cluster into fourcategories related to perceived value of breast-feeding, confidence to succeed, factors that influence success or failure, andstrength of intentions, or goal. However, this scale has not been validated in terms of its sensitivity to profile the motivationof new mothers and experienced mothers. This issue was investigated by having 202 breastfeeding mothers (100 first timemothers) fill out the scale. The analysis reported in this paper is a three factor solution consisting of value, midwife support,and expectancies for success that explained the characteristics of first time mothers as a known group. These resultssupport the validity of the BMM scale as a diagnostic tool for research on first time mothers who are learning to breastfeed.Further research studies are required to further test the validity of the scale in additional subgroups.",
author = "Doreen Stockdale and Marlene Sinclair and WG KERNOHAN and Evie McCrum-Gardner and John Keller",
note = "Reference text: 1. McAndrew F, Thompson J, Fellows L, Large A, Speed M, et al. (2012) Infant Feeding Survey 2012: Summary. Available at: https://catalogue.ic.nhs.uk/ publications/public-health/surveys/infant-feed-surv-2010/ifs-uk-2010-sum.pdf Accessed online 4th Jan 2012 2. Begley C, Gallagher L, Clarke M, Carroll M, Millar S (2008). The National Infant Feeding Survey. Health Service Executive Ireland. Available www.hse.ie. Accessed 2nd September 2012. 3. Centre for Disease Control and Prevention (CDC) Breastfeeding Report Card– United States 2010; Available: www.cdc.gov/breastfeeding/pdf/Breastfeeding ReportCard2010.pdf Accessed 1st August 2012 4. Wolf JB (2007) Is Breast Really Best? Risk and Total Motherhood in the National Breastfeeding Awareness Campaign. J Health Polit Policy Law 32(4), pp 595–636 5. Dennis CL (2003) Breastfeeding Self-efficacy Scale – psychometric assessment. JOGNN 32 (6): pp734–44 6. Wells KJ, Thompson NJ, Kloeblen-Tarver AS (2002) Intrinsic and Extrinsic Motivation and Intention to Breast-feed. Am J Health Behav 26(2): pp111–120 7. Wambach KA (1997) Breastfeeding Intention and Outcome: A Test of the Theory of Planned Behaviour. Res Nurs Health 20: pp51–59 8. Duckett L, Henly S, Avery M, Potter S, Hills-Bonczyk S, et al. (1998) A Theory of Planned Behavior-Based Structural Model for Breast-Feeding. Nursing Research 47(6): pp325–33 Validity of a Breastfeeding Motivation Scale PLOS ONE | www.plosone.org 6 December 2013 | Volume 8 | Issue 12 | e82976 9. Dick MJ, Evans ML, Arthurs JB, Barnes JK, Caldwell RS, et al. (2002) Predicting early breastfeeding attrition. J Hum Lact 18 (1): pp21–28 10. McMillan B, Conner M, Woolridge M, Dyson L, Green J, et al. (2008) Predicting breastfeeding in women living in areas of economic hardship: Explanatory role of the theory of planned behaviour. Psychology and Health 23 (7): pp767–788 11. Hoddinott P, Craig LCA, Britten J, McInnes RM (2012). A serial qualitative interview study of infant feeding experiences: idealism meets realism. BMJ Open 2012;2:e000504 doi:10.1136/bmjopen-2011-000504 12. Keller JM (1987) Development and Use of the ARCS Model of Instructional Design. Journal of Instructional Development (now Educ Technol Res Dev) 10(3): pp2–9 13. Ajzen I, Madden TJ (1986) Prediction of Goal Directed Behavior: Attitudes, intentions and perceived behavioral control. J Exp Soc Psychol, 22: pp453–474 14. Bandura A (1977) self-Efficacy: Toward a Unifying Theory of Behavioral Change. Psychological Review 34 (2): pp191–215 15. Deci EL, Ryan RM (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum. 16. Janke JR (1994) Development of the Breast-Feeding Attrition Prediction Tool. Nursing Research, 43: pp100–104 17. Avery M, Duckett L, Dodgson J, Savik K, Henly SJ (1998) Factors Associated with Very Early Weaning Among Primparas Intending to Breastfeed. Matern Child Health J 2 (3): pp167–179 18. Stockdale J, Sinclair M, Kernohan WG, Dunwoody L, Cunningham JB, et al. (2008) Assessing the impact of midwives’ instruction: the breastfeeding motivational instructional measurement scale. Evidence Based Midwifery 6(1), pp27–34 19. Gorsuch RL (1983) Factor Analysis. Hillsdale, N.J. Lawrence Erlbaum (2nd Ed.) 20. Tabachnick BG, Fidell LS (2001) Using Multivariate Statistics 4th ed. By Allyn and Bacon: Pearson Education Company USA 21. Kaiser HF (1960) The application of electronic computers to factor analysis. Educ Psychol Meas, 20: pp141–151. 22. Cattell RB, Schuerger JM (1978) Personality Theory in Action. Champaign: IPAT 23. Goddard RL, Kirby A (1976) An introduction to factor analysis. Norwich. UK 24. Comrey A L, Lee HB (1992) A First Course in Factor Analysis. (2nd Ed) Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers. 25. Bulk-Bunschoten AMW, van Bodegom S, Reerink JD, Pasker-de Jong PCM, de Groot CJ (2001) Reluctance to continue breastfeeding in the Netherlands. Acta Paediatrica 90(9), pp1047–1053. 26. Kools EJ, Thijs C, De Vries H (2005) The Behavioral Determinants of Breast- Feeding in the Netherlands: Predictors for the Initiation of Breast-Feeding. Health Education and Behavior 32(6), pp809–824. 27. Renfrew M, McCormick F, Wade A, Quinn B, Dowswell T (2012) Support for Healthy Breastfeeding Mothers with Healthy Term Babies. Cochrane Library. DOI: 10.1002/14651858.CD001141.pub4 28. Costello AB, Osborne JW (2005) Best Practices in Exploratory Factor Analysis: Four Recommendations for Getting the Most from the Analysis. Practical Assessment, Research and Evaluation 10:7, pp1–9 29. Worell L (1956) The effect of goal value upon expectancy. J Abnorm Soc Psychol, Vol 53(1), 48–53. doi:10.1037/h0041704 30. Hauck YL, Irurtita VF (2003) Mothers dealt with incompatible expectations during breastfeeding and weaning. Evid Based Nurs 6: p92 31. Schmied V, Sheenan A, Barclay L (2001) Contemporary breast-feeding policy and practice: implications for midwives. Midwifery 17: pp44–54 32. Clifford TJ, Campbell MK, Speechley KN, Gorodzinsky F (2006) Factors influencing full breastfeeding in a south western Ontario community: assessments at 1 week and at 6 months postpartum. J Hum Lact 23: pp292–304. 33. Hegney D, Fallon T, O’Brien M (2008) Against all odds: a retrospective casecontrolled study of women who experience extraordinary breastfeeding problems. Journal of Clinical Nursing 17(9), pp1182–1192. 34. Martin LL, Tesser M (1996) Striving and Feeling: Interactions Among Goals, Affect and Self-Regulation. Lawrence Erlbaum Associates Inc. NJ. 35. Hong TM, Callister LC, Schwartz R (2003) First-time mothers’ view of breastfeeding support. MCN Am J Matern Child Nurs 28(1): pp10–15 36. Chezem J, Friesen C, Boettcher J (2003) Breastfeeding Knowledge, Breastfeeding Confidence, and Infant Feeding Plans: Effects on Actual Feeding Practices JOGNN. 32 (1): pp40–7 37. Cloherty M, Alexander J, Holloway I (2003) Supplementing breast-fed babies in the UK to protect their mothers from tiredness or distress. Midwifery 20: pp194– 204 38. Hanss K (2004) Confidence and breastfeeding: a view from the front-line. J Fam Health Care 14(1): pp21–24 39. Jacobs JE, Eccles JS (2000) Parents, task values, and real-life achievement-related choices. In: Sansone and Harackiewicz (2000) Intrinsic and Extrinsic Motivation, The Search for Optimal Motivation and Performance. Academic Press pp408–433 40. Deci EL, Ryan RM (2000). The ‘‘what’’ and ‘‘why’’ of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11, pp227– 268 41. Sansone C, Harackiewicz J (2000) Intrinsic and Extrinsic Motivation, The Search for Optimal Motivation and Performance. Academic Press 42. Keller JM (2010). Motivational Design for Learning and Performance: The ARCS Model Approach. Springer, New York. Validity of a Breastfeeding Motivation Scale PLOS",
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Sensitivity of the Breastfeeding MotivationalMeasurement Scale: A Known Group Analysis of FirstTime Mothers. / Stockdale, Doreen; Sinclair, Marlene; KERNOHAN, WG; McCrum-Gardner, Evie; Keller, John.

In: PLoS ONE, Vol. 8, No. 12, 12.2013.

Research output: Contribution to journalArticle

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T1 - Sensitivity of the Breastfeeding MotivationalMeasurement Scale: A Known Group Analysis of FirstTime Mothers

AU - Stockdale, Doreen

AU - Sinclair, Marlene

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AU - McCrum-Gardner, Evie

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N1 - Reference text: 1. McAndrew F, Thompson J, Fellows L, Large A, Speed M, et al. (2012) Infant Feeding Survey 2012: Summary. Available at: https://catalogue.ic.nhs.uk/ publications/public-health/surveys/infant-feed-surv-2010/ifs-uk-2010-sum.pdf Accessed online 4th Jan 2012 2. Begley C, Gallagher L, Clarke M, Carroll M, Millar S (2008). The National Infant Feeding Survey. Health Service Executive Ireland. Available www.hse.ie. Accessed 2nd September 2012. 3. Centre for Disease Control and Prevention (CDC) Breastfeeding Report Card– United States 2010; Available: www.cdc.gov/breastfeeding/pdf/Breastfeeding ReportCard2010.pdf Accessed 1st August 2012 4. Wolf JB (2007) Is Breast Really Best? Risk and Total Motherhood in the National Breastfeeding Awareness Campaign. J Health Polit Policy Law 32(4), pp 595–636 5. Dennis CL (2003) Breastfeeding Self-efficacy Scale – psychometric assessment. JOGNN 32 (6): pp734–44 6. Wells KJ, Thompson NJ, Kloeblen-Tarver AS (2002) Intrinsic and Extrinsic Motivation and Intention to Breast-feed. Am J Health Behav 26(2): pp111–120 7. Wambach KA (1997) Breastfeeding Intention and Outcome: A Test of the Theory of Planned Behaviour. Res Nurs Health 20: pp51–59 8. Duckett L, Henly S, Avery M, Potter S, Hills-Bonczyk S, et al. (1998) A Theory of Planned Behavior-Based Structural Model for Breast-Feeding. Nursing Research 47(6): pp325–33 Validity of a Breastfeeding Motivation Scale PLOS ONE | www.plosone.org 6 December 2013 | Volume 8 | Issue 12 | e82976 9. Dick MJ, Evans ML, Arthurs JB, Barnes JK, Caldwell RS, et al. (2002) Predicting early breastfeeding attrition. J Hum Lact 18 (1): pp21–28 10. McMillan B, Conner M, Woolridge M, Dyson L, Green J, et al. (2008) Predicting breastfeeding in women living in areas of economic hardship: Explanatory role of the theory of planned behaviour. Psychology and Health 23 (7): pp767–788 11. Hoddinott P, Craig LCA, Britten J, McInnes RM (2012). A serial qualitative interview study of infant feeding experiences: idealism meets realism. BMJ Open 2012;2:e000504 doi:10.1136/bmjopen-2011-000504 12. Keller JM (1987) Development and Use of the ARCS Model of Instructional Design. Journal of Instructional Development (now Educ Technol Res Dev) 10(3): pp2–9 13. Ajzen I, Madden TJ (1986) Prediction of Goal Directed Behavior: Attitudes, intentions and perceived behavioral control. J Exp Soc Psychol, 22: pp453–474 14. Bandura A (1977) self-Efficacy: Toward a Unifying Theory of Behavioral Change. Psychological Review 34 (2): pp191–215 15. Deci EL, Ryan RM (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum. 16. Janke JR (1994) Development of the Breast-Feeding Attrition Prediction Tool. Nursing Research, 43: pp100–104 17. Avery M, Duckett L, Dodgson J, Savik K, Henly SJ (1998) Factors Associated with Very Early Weaning Among Primparas Intending to Breastfeed. Matern Child Health J 2 (3): pp167–179 18. Stockdale J, Sinclair M, Kernohan WG, Dunwoody L, Cunningham JB, et al. (2008) Assessing the impact of midwives’ instruction: the breastfeeding motivational instructional measurement scale. Evidence Based Midwifery 6(1), pp27–34 19. Gorsuch RL (1983) Factor Analysis. Hillsdale, N.J. Lawrence Erlbaum (2nd Ed.) 20. Tabachnick BG, Fidell LS (2001) Using Multivariate Statistics 4th ed. By Allyn and Bacon: Pearson Education Company USA 21. Kaiser HF (1960) The application of electronic computers to factor analysis. Educ Psychol Meas, 20: pp141–151. 22. Cattell RB, Schuerger JM (1978) Personality Theory in Action. Champaign: IPAT 23. Goddard RL, Kirby A (1976) An introduction to factor analysis. Norwich. UK 24. Comrey A L, Lee HB (1992) A First Course in Factor Analysis. (2nd Ed) Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers. 25. Bulk-Bunschoten AMW, van Bodegom S, Reerink JD, Pasker-de Jong PCM, de Groot CJ (2001) Reluctance to continue breastfeeding in the Netherlands. Acta Paediatrica 90(9), pp1047–1053. 26. Kools EJ, Thijs C, De Vries H (2005) The Behavioral Determinants of Breast- Feeding in the Netherlands: Predictors for the Initiation of Breast-Feeding. Health Education and Behavior 32(6), pp809–824. 27. Renfrew M, McCormick F, Wade A, Quinn B, Dowswell T (2012) Support for Healthy Breastfeeding Mothers with Healthy Term Babies. Cochrane Library. DOI: 10.1002/14651858.CD001141.pub4 28. Costello AB, Osborne JW (2005) Best Practices in Exploratory Factor Analysis: Four Recommendations for Getting the Most from the Analysis. Practical Assessment, Research and Evaluation 10:7, pp1–9 29. Worell L (1956) The effect of goal value upon expectancy. J Abnorm Soc Psychol, Vol 53(1), 48–53. doi:10.1037/h0041704 30. Hauck YL, Irurtita VF (2003) Mothers dealt with incompatible expectations during breastfeeding and weaning. Evid Based Nurs 6: p92 31. Schmied V, Sheenan A, Barclay L (2001) Contemporary breast-feeding policy and practice: implications for midwives. Midwifery 17: pp44–54 32. Clifford TJ, Campbell MK, Speechley KN, Gorodzinsky F (2006) Factors influencing full breastfeeding in a south western Ontario community: assessments at 1 week and at 6 months postpartum. J Hum Lact 23: pp292–304. 33. Hegney D, Fallon T, O’Brien M (2008) Against all odds: a retrospective casecontrolled study of women who experience extraordinary breastfeeding problems. Journal of Clinical Nursing 17(9), pp1182–1192. 34. Martin LL, Tesser M (1996) Striving and Feeling: Interactions Among Goals, Affect and Self-Regulation. Lawrence Erlbaum Associates Inc. NJ. 35. Hong TM, Callister LC, Schwartz R (2003) First-time mothers’ view of breastfeeding support. MCN Am J Matern Child Nurs 28(1): pp10–15 36. Chezem J, Friesen C, Boettcher J (2003) Breastfeeding Knowledge, Breastfeeding Confidence, and Infant Feeding Plans: Effects on Actual Feeding Practices JOGNN. 32 (1): pp40–7 37. Cloherty M, Alexander J, Holloway I (2003) Supplementing breast-fed babies in the UK to protect their mothers from tiredness or distress. Midwifery 20: pp194– 204 38. Hanss K (2004) Confidence and breastfeeding: a view from the front-line. J Fam Health Care 14(1): pp21–24 39. Jacobs JE, Eccles JS (2000) Parents, task values, and real-life achievement-related choices. In: Sansone and Harackiewicz (2000) Intrinsic and Extrinsic Motivation, The Search for Optimal Motivation and Performance. Academic Press pp408–433 40. Deci EL, Ryan RM (2000). The ‘‘what’’ and ‘‘why’’ of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11, pp227– 268 41. Sansone C, Harackiewicz J (2000) Intrinsic and Extrinsic Motivation, The Search for Optimal Motivation and Performance. Academic Press 42. Keller JM (2010). Motivational Design for Learning and Performance: The ARCS Model Approach. Springer, New York. Validity of a Breastfeeding Motivation Scale PLOS

PY - 2013/12

Y1 - 2013/12

N2 - Breastfeeding has immense public health value for mothers, babies, and society. But there is an undesirably large gapbetween the number of new mothers who undertake and persist in breastfeeding compared to what would be a preferredlevel of accomplishment. This gap is a reflection of the many obstacles, both physical and psychological, that confront newmothers. Previous research has illuminated many of these concerns, but research on this problem is limited in part by theunavailability of a research instrument that can measure the key differences between first-time mothers and experiencedmothers, with regard to the challenges they face when breastfeeding and the instructional advice they require. Aninstrument was designed to measure motivational complexity associated with sustained breast feeding behaviour; theBreastfeeding Motivational Measurement Scale. It contains 51 self-report items (7 point Likert scale) that cluster into fourcategories related to perceived value of breast-feeding, confidence to succeed, factors that influence success or failure, andstrength of intentions, or goal. However, this scale has not been validated in terms of its sensitivity to profile the motivationof new mothers and experienced mothers. This issue was investigated by having 202 breastfeeding mothers (100 first timemothers) fill out the scale. The analysis reported in this paper is a three factor solution consisting of value, midwife support,and expectancies for success that explained the characteristics of first time mothers as a known group. These resultssupport the validity of the BMM scale as a diagnostic tool for research on first time mothers who are learning to breastfeed.Further research studies are required to further test the validity of the scale in additional subgroups.

AB - Breastfeeding has immense public health value for mothers, babies, and society. But there is an undesirably large gapbetween the number of new mothers who undertake and persist in breastfeeding compared to what would be a preferredlevel of accomplishment. This gap is a reflection of the many obstacles, both physical and psychological, that confront newmothers. Previous research has illuminated many of these concerns, but research on this problem is limited in part by theunavailability of a research instrument that can measure the key differences between first-time mothers and experiencedmothers, with regard to the challenges they face when breastfeeding and the instructional advice they require. Aninstrument was designed to measure motivational complexity associated with sustained breast feeding behaviour; theBreastfeeding Motivational Measurement Scale. It contains 51 self-report items (7 point Likert scale) that cluster into fourcategories related to perceived value of breast-feeding, confidence to succeed, factors that influence success or failure, andstrength of intentions, or goal. However, this scale has not been validated in terms of its sensitivity to profile the motivationof new mothers and experienced mothers. This issue was investigated by having 202 breastfeeding mothers (100 first timemothers) fill out the scale. The analysis reported in this paper is a three factor solution consisting of value, midwife support,and expectancies for success that explained the characteristics of first time mothers as a known group. These resultssupport the validity of the BMM scale as a diagnostic tool for research on first time mothers who are learning to breastfeed.Further research studies are required to further test the validity of the scale in additional subgroups.

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