Sociodemographic and Personal Predictors of Exclusive Breastfeeding in Pregnant Mexican Women Using Public Health Services.

Exclusive breastfeeding (EBF) is a cost-effective healthy behavior for the mother-child dyad. Globally, rates of EBF are low. Little research has been conducted on the joint role of modifiable and nonmodifiable variables in pregnant women's decision-making. The aim was to develop and test a model that used personal and sociodemographic factors to predict whether pregnant women who use public healthcare services plan to breastfeed. In a nonprobabilistic sample of 728 pregnant Mexican women, self-efficacy, the planned behavior theory constructs, and the intention to breastfeed (BFI) were measured. A total 60% of the sample was randomly chosen to develop a predictive multivariate logistic regression model. The model was validated in the remaining 40%. Women in the highest tertiles of attitudes and self-efficacy had fourfold increased chances of having a high BFI (OR 4.2, 95% CI [2.4, 7.4]). Working was associated with a decreased intention to exclusively breastfeed (OR 0.61, 95% CI [0.37, 0.98]). The model predicted BFI with a sensitivity of 38.3% and specificity of 82.2%. While personal variables predict the BFI, working decreases women's chances of breastfeeding. The results can be utilized to develop primary prevention strategies to help mothers who use public health services to breastfeed.

Intención de Lactar exclusivamente con Leche Materna: Un Estudio Basado en la Teoría de la Conducta Planeada / Intention to breastfeed exclusively: A study based on the Theory of Planned Behavior

La lactancia materna exclusiva (LME) aporta diversos beneficios a la salud del niño y de la madre. La Teoría de la Conducta Planeada (TCP) es un modelo enfocado en la predicción de algunas conductas relacionadas con la salud, como la LME. El objetivo de este estudio fue identificar la relación de las variables de la TCP con la intención de dar LME. Se llevó a cabo un estudio transversal con 442 mujeres embarazadas de la Ciudad de México. Las variables de la TCP se midieron con instrumentos previamente validados. Un análisis de regresión logística múltiple, ajustado por paridad y edad materna, identificó asociaciones significativas entre la intención de amamantar y la norma subjetiva, OR = 1.07 (IC 95% [1.01, 1.14]), y el control conductual percibido, OR = 1.05 (IC 95% [1.01, 1.11]), con la intención. Como conclusión, en esta muestra se asociaron dos constructos de la TCP con la intención de lactar de forma exclusiva

Breastfeeding provides health benefits to children and mothers. WHO recommends it be exclusive until 6 months of age. The Theory of Planned Behavior (TPB) focus on the prediction of health-related behaviors, such as breastfeeding. The objective of this study was to identify the relationship of attitudes, subjective norm, and perceived behavioral control with the intention of exclusively breastfeeding in a sample of Mexican pregnant women. A cross-sectional study was carried out with 442 pregnant women from Mexico City. Psychosocial variables were measured with a set of scales previously validated. A multiple logistic regression analysis, adjusted for the number of previous children and maternal age, identified significant associations between intention to breastfeed and one dimension of the subjective norm (participants' mothers opinions), OR = 1.07 (IC 95% [1.01, 1.14]), as well as perceived behavioral control, OR = 1.05 (IC 95% [1.01, 1.11]). In the case of this sample, TCP constructs associated to the intention to exclusively breastfeed

Diseño y validación de un instrumento para medir la autoeficacia para lactar de mujeres embarazadas mexicanas / Design and validation of a scale to measure breastfeeding self-efficacy in Mexican pregnant women

Resumen La lactancia materna exclusiva (LME) es una de las conductas saludables con mayor valor protector para la salud del niño y de la madre. La autoeficacia es un predictor de diferentes conductas saludables. El objetivo de esta investigación fue diseñar y validar un instrumento para medir la autoeficacia para lactar en mujeres embarazadas. Se realizó un estudio instrumental con usuarias de dos centros de salud de primer nivel de atención, seleccionadas a través de un muestreo no probabilístico. Se excluyeron aquellas mujeres que fueran analfabetas o tuvieran alguna condición médica que contraindicara la LME. Se utilizaron análisis descriptivos, bivariados y multivariados para obtener las propiedades psicométricas del instrumento. Participaron 369 mujeres. A través de un análisis factorial exploratorio se obtuvo una estructura unidimensional de 15 reactivos que explicó el 83% de la varianza total del instrumento (alfa de Cronbach = .93). Además, la autoeficacia para lactar se asoció (p <.05) con la intención para lactar, la edad y la escolaridad. El instrumento de autoeficacia para lactar obtenido mostró propiedades psicométricas adecuadas por lo que puede ser útil para identificar a las mujeres que están en riesgo de no iniciar la LME desde el nacimiento de su hijo, además, parece ser el primer instrumento de autoeficacia para lactar en México.

Abstract Exclusive breastfeeding (EB) is a health behavior with a greatest health protective value for children and mothers. Self-efficacy is a predictor of different health behaviors. The objective of this research was to design and validate an instrument to measure self-efficacy to breastfeed in pregnant women. An instrumental study was conducted with users of two primary health care centers, selected through a non-probabilistic sampling. Those women who were illiterate or had a medical condition that contraindicated EB were excluded. Descriptive, bivariate and multivariate analysis were used to obtain the psychometric properties of the instrument. 369 women participated. An exploratory factorial analysis resulted in a 15 items unidimensional structure that explained 83% of the total variance of the scale (Cronbach's alpha = .93). In addition, self-efficacy for breastfeeding was associated (p<.05) with intention to breastfeed, age and scholarship. The breastfeeding self-efficacy scale obtained showed adequate psychometric properties. So, it can be useful to identify women who may be at risk of not initiate breastfeeding from birth, as well as, it seems to be the first breastfeeding self-efficacy scale in Mexico.

Asociación del índice de masa corporal y el autocontrol con la calidad de vida relacionada con la salud en personas con sobrepeso/obesidad / Association of body mass index and self-control with healthrelated quality of life in overweight/obese people

El propósito de este trabajo fue identificar la asociación del autocontrol con la calidad de vida relacionada con la salud y el papel que en ella pudiera tener el Índice de Masa Corporal (imc). Se realizó un estudio transversal predictivo. Participaron 273 adultos, usuarios de un centro de primer nivel de atención a la salud de la Ciudad de México, entre 18 y 65 años de edad, con un imc mayor a 25 unidades. Se aplicó el SF12 v1 y la escala de autocontrol de Tangney, Baumeister y Boone. Se identificó una asociación significativa entre el autocontrol y la calidad de vida física y mental; el imc se asoció con la calidad de vida física, pero no con la calidad de vida mental, ni con el autocontrol. No se identificó un efecto mediador del imc en la relación del autocontrol con la calidad de vida. Los resultados sugieren que una persona con sobrepeso u obesidad con mayor autocontrol, tiene mejor percepción de bienestar en aspectos físicos y emocionales, independientemente del imc.

The aim of this study was to identify the association of self-control with health-related quality of life and the possible mediation of the Body Mass Index (BMI). A predictive cross-sectional study was conducted. Participated 273 adults, users of a primary health care center in Mexico City, aged 18 to 65 years, with a BMI greater than 25. The SF-12 V1 and the Tangney, Baumeister and Boone's Self-Control Scale were applied. The results showed a significant association between self-control to physical and mental health quality of life; BMI was associated with physical quality of life. No associations were found between BMI to mental quality of life and self-control. There were no evidence of a mediation effect of BMI on the relationship between self-control and health-related quality of life. The results suggest that an overweight or obese person with greater self-control has better perception of physical and emotional well-being, independently of BMI.