Predicting infant feeding intention and intensity in Oman using a path analysis approach.

Background: Low breastfeeding rates are a global concern, and few studies have examined breastfeeding in Oman. Aims: We examined the associations of mothers' sociodemographic characteristics, breastfeeding knowledge, attitudes, subjective norms, perceived control, previous breastfeeding experience, and early breastfeeding support with infant feeding intention at birth and breastfeeding intensity at 8 weeks postpartum. Methods: We used a descriptive, prospective cohort design. Data collection was in 2016. We administered a structured questionnaire to mothers at postpartum discharge from 2 hospitals in Oman and followed up once via a 24-hour dietary recall at 8 weeks. We used a path analysis model (n = 427) using SPSS, version 24.0, and Amos, version 22. Results: During the postpartum hospitalization, 33.3% of mothers reported that their babies received formula milk. At the 8-week follow-up, 27.3% of mothers were exclusively breastfeeding. Subjective norms (measured by social and professional support) were the strongest predictors. Infant feeding intention significantly predicted breastfeeding intensity. Returning to work/school was the only sociodemographic variable to significantly correlate with breastfeeding intensity (r = -0.17; P < 0.001); mothers who planned to return to work/school had significantly lower intensity. Knowledge significantly predicted positive and negative attitudes, subjective norms and perceived control. Early breastfeeding support negatively correlated with breastfeeding intensity (r= -0.15; P < 0.001). Conclusion: Infant feeding intention positively predicted breastfeeding intensity with subjective norms or social and professional support and had the strongest correlation with mothers' intentions.

CROSS-CULTURAL ADAPTATION AND LINGUISTIC VALIDATION OF THE TRANSLATED ARABIC REVISED BREASTFEEDING ATTRITION PREDICTION TOOL.

Background and Purpose: The diversity of populations across the globe and the need to better compare research findings make it imperative to validate research instruments across cultures. The purpose is to systematically describe the translation and the cross-cultural validation of the Revised-Breastfeeding Attrition Prediction Tool from English to Arabic. Methods: The process of cross-cultural validation included (a) translation and linguistic validation: forward- and back-translations; (b) expert evaluation using content validity index (CVI); (c) cognitive interviews (CIs), and (d) pilot testing with postpartum mothers. Results: The item-CVI scores ranged from .8 to 1.00 and the scale-CVI was .95. The CIs identified items that required modification. The reliability coefficient of the pilot-test was .83 and subscale reliabilities ranged from .31 to .93. Discussion: The translation process provided confirmation for the appropriateness of the translated tool to Arabic.

Using the Theory of Planned Behaviour to assess nursing and allied health students' knowledge and intention to care for patients with COVID-19.

AIMS AND OBJECTIVES: To assess nursing and allied health students' demographics, knowledge and intentions to care for patients with an infectious disease, COVID-19. BACKGROUND: COVID-19 has caused a public health crisis and worldwide panic. Little is known about students' knowledge levels and intentions to care for infected patients during pandemics. DESIGN: A quantitative, cross-sectional study. METHOD: A cross-sectional study with a convenience sample (N = 480) of nursing and allied health students was analysed using the Mann-Whitney and Spearman's correlation tests. RESULTS: At least 60% of the participants attained high scores for 16 of the 22 items on the knowledge scale. Knowledge was positively associated with attitude (rs  = .19, p < .01) and perceived behavioural control (rs  = .38, p < .01) and negatively associated with subjective norms (rs  = -.11, p < .05). Senior students had higher scores (p = .024) in knowledge. Intention was negatively correlated with knowledge (rs  = -.24, p < .01) and perceived behavioural control (rs  = -.16, p < .01). Male students (p = .031) and younger students had higher scores in intention (p = .040). Males had higher scores in subjective norms (p < .001), and older and senior students had higher scores in perceived behavioural control (p < .001). CONCLUSIONS: Despite the current knowledge on COVID-19 available through multimedia-communication channels, students had negative perceived behavioural controls and intentions to care for COVID-19 patients. Formal education and training are required to enhance students' intentions to care for patients with infectious diseases. Additionally, demographics and belief variables influence students' intentions to care, and further in-depth analysis is required. Relevance to Clinical Practice This study suggests the importance of updating and contextualizing nursing and allied health curricula to meet global infectious disease guidelines and, ultimately, to support the healthcare system with efficient practitioners in future pandemics.

A Mixed-Methods, Randomized Clinical Trial to Examine Feasibility of a Mindfulness-Based Stress Management and Diabetes Risk Reduction Intervention for African Americans with Prediabetes.

African Americans have disproportionately high rates of stress-related conditions, including diabetes and diabetes-related morbidity. Psychological stress may negatively influence engagement in risk-reducing lifestyle changes (physical activity and healthy eating) and stress-related physiology that increase diabetes risk. This study examined the feasibility of conducting a randomized trial comparing a novel mindfulness-based stress management program combined with diabetes risk-reduction education versus a conventional diabetes risk-reduction education program among African American adults with prediabetes and self-reported life stress. Participants were recruited in collaboration with community partners and randomized to the mindfulness-based diabetes risk-reduction education program for prediabetes (MPD; n = 38) or the conventional diabetes risk-reduction education program for prediabetes (CPD; n = 30). The mindfulness components were adapted from the Mindfulness-based Stress Reduction Program. The diabetes risk-reduction components were adapted from the Power to Prevent Program and the Diabetes Prevention Program. Groups met for eight weeks for 2.5 hours, with a half-day retreat and six-monthly boosters. Mixed-methods strategies were used to assess feasibility. Psychological, behavioral, and metabolic data were collected before the intervention and at three and six months postintervention to examine within-group change and feasibility of collecting such data in future clinical efficacy research. Participants reported acceptability, credibility, and cultural relevance of the intervention components. Enrollment of eligible participants (79%), intervention session attendance (76.5%), retention (90%), and postintervention data collection attendance (83%, 82%, and 78%, respectively) demonstrated feasibility, and qualitative data provided information to further enhance feasibility in future studies. Both groups exhibited an A1C reduction. MPD participants had reductions in perceived stress, BMI, calorie, carbohydrate and fat intake, and increases in spiritual well-being. Considering the high prevalence of diabetes and diabetes-related complications in African Americans, these novel findings provide promising guidance to develop a larger trial powered to examine efficacy of a mindfulness-based stress management and diabetes risk-reduction education program for African Americans with prediabetes.