Dissertation/Thesis Abstract

Formative Research to Develop Breastfeeding Promotion Messages In Tijuana, Mexico
by Bueno-Gutierrez, Diana, Ph.D., University of California, Davis, 2014, 267; 3637802
Abstract (Summary)

Breastfeeding is a unique behavior maintained over millions of years of evolution that has endless advantages for children, mothers and communities. In Mexico, breastfeeding rates are one of the lowest of Latin America with 14.4% of exclusive breastfeeding (EBF) under six months. Most breastfeeding studies conducted in Mexico are based on the analysis of quantitative data from mothers. The objectives of this study were to evaluate the main obstacles to breastfeeding in low-income population in Tijuana, Mexico and to develop culturally appropriate messages to promote breastfeeding in low- income women from Tijuana, Mexico

We used qualitative methods to design messages based on a socio-ecological framework and social marketing principles. Our message development model had 4 phases: 1) Breastfeeding obstacles assessment: We selected four low-income communities with low accessibility to health care services in Tijuana to conduct focus groups and interviews with mothers, fathers and grandparents and interviews with key informants 2) Message content development: Messages were designed by a panel of public health professionals and lay women; 3) Message refining and tailoring: Message preferences for mothers were identified and segmentation of the target audience was conducted based on socio-demographic factors, perinatal factors and traditional or modern ideas; 4) Cognitive response testing for final messages.

The present work includes five chapters. The first is a literature review that examines breastfeeding benefits, prevalence and situation in Mexican population, as well as how formative research using the socio-ecological framework can guide us to design culturally-sensitive breastfeeding promotion messages that can be used in community-based interventions. Second, third and fourth chapters discuss findings from the individual, group and social factors that influence breastfeeding practices in this population. The last chapter describes the model to design and pre-test breastfeeding promotion messages based on our previous formative research.

A total of 169 participants were part of this study. We used the most relevant obstacles for mothers to develop 10 messages to promote breastfeeding in this population; 6 Individual: Enough milk, Pain, Aesthetics, Comfort, Baby behavior, Maintenance; 1 Group: Group Support (Family, Health Care Services, Worksite); and 3 Societal: Formula culture, Breastfeeding in Public and Cost. Obstacle ranking and message selection varied according to socio-demographic factors, perinatal experience and traditional or modern ideas. Migrant women recently arrived to Tijuana from the South ranked lack of breastfeeding support and culture as important obstacles to successful breastfeeding. Women with more traditional ideas, lower socio-economic status (SES) and education relied more on information from family members.

Individual, group and societal factors interacted with each other. For example, individual factors such as perception of inadequate milk or comfort are influenced by group and societal factors such as the Western constructs that view the female body as weak, defective and untrustworthy; a culture with no exposure to breastfeeding and inadequate medical practices and insensitive health care providers.

A comprehensive approach to breastfeeding recognizes that it is not merely an individual choice but that structural factors influence that choice, particularly for disadvantaged women. Awareness of the cultural, social and demographic influences on the population served provides a basis for the most appropriate advice to promote breastfeeding, based on the barriers faced.

The 10 messages designed in this study can be used to develop educational material and create a social campaign to promote breastfeeding culture in this population. The messages and qualitative findings have direct applications for public programs that provide nutrition education to mothers in Mexico. Target audience for these messages should not be limited to mothers and also include family, health care providers, work environment and society as a whole.

Indexing (document details)
Advisor: Chantry, Caroline J.
Commitee: Flores, Yvette G., Kaiser, Lucia L.
School: University of California, Davis
Department: Nutritional Biology
School Location: United States -- California
Source: DAI-B 76/02(E), Dissertation Abstracts International
Subjects: Medicine, Womens studies, Latin American Studies, Nutrition, Public health
Keywords: Breastfeeding, Formative research, Low-income women, Message development, Qualitative methods, Socio-ecological framework, Tijuana
Publication Number: 3637802
ISBN: 9781321210842
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