Perceptions of Public Breastfeeding Images and Their Association With Breastfeeding Knowledge and Attitudes Among an Internet Panel of Men Ages 21-44 in the United States.

BACKGROUND: Men's attitudes toward public breastfeeding may influence a woman's decisions about breastfeeding and her perceived comfort with public breastfeeding. Research aim: This study aimed to evaluate factors associated with men's visual perception of images of public breastfeeding. METHODS: A 95-item online survey was administered to 502 U.S. men ages 21 to 44. Respondents were presented with four images of women breastfeeding and asked to evaluate agreement with 15 adjectives describing each image. Based on factor analysis, 13 of these adjectives were combined to create the Breastfeeding Images Scale for each image. An 8-item Situational Statements Scale and the 17-item Iowa Infant Feeding Attitude Scale (IIFAS) were used to assess breastfeeding knowledge and attitudes. Multiple regression was used to evaluate the association between breastfeeding attitudes and knowledge and the Breastfeeding Images Scale. RESULTS: The image depicting a woman breastfeeding privately at home had the highest mean score of 71.95, 95% confidence interval (CI) [70.69, 73.22], on the Breastfeeding Images Scale, compared with 61.93, 95% CI [60.51, 63.36], for the image of a woman breastfeeding in a public setting. The overall mean scale score for the IIFAS was 56.99, 95% CI [56.27, 57.70], and for the Situational Statements Scale was 28.80, 95% CI [27.92, 29.69]. For all images, increasing breastfeeding knowledge and attitudes measured by the IIFAS and the Situational Statements Scale were associated with a more positive perception of the image. CONCLUSION: Images of public breastfeeding are viewed less favorably by men in the sample than are images of private breastfeeding. Knowledge and attitudes toward breastfeeding are positively associated with perception of breastfeeding images.

Attitudes Toward Breastfeeding Among an Internet Panel of U.S. Males Aged 21-44.

Lack of familial support, particularly from fathers or partners, has been identified by the U.S. Surgeon General as a barrier to breastfeeding. Although partners have been identified as an important source of breastfeeding support, research on U.S. men's knowledge about and attitudes towards breastfeeding is limited. An internet panel survey of 502 U.S. males aged 21-44 years was conducted. It included the 17-item Iowa Infant Feeding Attitude Scale (IIFAS), a series of questions assessing prior exposure to breastfeeding and demographic questions. Frequencies, proportions and means were calculated and analysis of variance used to test differences in the mean IIFAS scale score across demographic groups. A multiple linear regression model was used to identify predictors of IIFAS score. The sample was largely white, non-Hispanic (65.7%), college educated (44.4%) and married (47%). The mean IIFAS score was 57 (SD = 8.13; range 25-84). In the adjusted regression model, being white, non-Hispanic, having a college education, having siblings who were breastfed and observing ten or more different women breastfeeding were significantly associated with higher IIFAS scores. In a sample of U.S. men of reproductive age, breastfeeding knowledge and attitudes as measured by the IIFAS are neutral. Race, education, and exposure to breastfeeding are important predictors of breastfeeding attitudes in males as measured by the IIFAS.

Apps of steel: are exercise apps providing consumers with realistic expectations?: a content analysis of exercise apps for presence of behavior change theory.

OBJECTIVE: To quantify the presence of health behavior theory constructs in iPhone apps targeting physical activity. METHODS: This study used a content analysis of 127 apps from Apple's (App Store) Health & Fitness category. Coders downloaded the apps and then used an established theory-based instrument to rate each app's inclusion of theoretical constructs from prominent behavior change theories. Five common items were used to measure 20 theoretical constructs, for a total of 100 items. A theory score was calculated for each app. Multiple regression analysis was used to identify factors associated with higher theory scores. RESULTS: Apps were generally observed to be lacking in theoretical content. Theory scores ranged from 1 to 28 on a 100-point scale. The health belief model was the most prevalent theory, accounting for 32% of all constructs. Regression analyses indicated that higher priced apps and apps that addressed a broader activity spectrum were associated with higher total theory scores. CONCLUSION: It is not unexpected that apps contained only minimal theoretical content, given that app developers come from a variety of backgrounds and many are not trained in the application of health behavior theory. The relationship between price and theory score corroborates research indicating that higher quality apps are more expensive. There is an opportunity for health and behavior change experts to partner with app developers to incorporate behavior change theories into the development of apps. These future collaborations between health behavior change experts and app developers could foster apps superior in both theory and programming possibly resulting in better health outcomes.

Use of social media in health promotion: purposes, key performance indicators, and evaluation metrics.

Despite the expanding use of social media, little has been published about its appropriate role in health promotion, and even less has been written about evaluation. The purpose of this article is threefold: (a) outline purposes for social media in health promotion, (b) identify potential key performance indicators associated with these purposes, and (c) propose evaluation metrics for social media related to the key performance indicators. Process evaluation is presented in this article as an overarching evaluation strategy for social media.