Breastfeeding Self-Efficacy Theory-Based Education and Counseling in Pregnant Adolescents

NCT07025265 | Completed

• 1 other identifier: THESIS-2025-001
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Adolescence is the period between the ages of 10 and 19, during which individuals undergo physiological, biological, psychological, and social development, transitioning from childhood to adulthood. Pregnancies occurring during this period are defined as adolescent pregnancies. In developing countries, approximately 21 million adolescent pregnancies occur annually among individuals aged 15-19, resulting in around 12 million births. According to national demographic data, a certain percentage of adolescent women have already started childbearing. Pregnancies occurring during this stage, when physical and psychosocial development is still incomplete, bring various medical and social challenges. Adolescent pregnancies are associated with increased maternal and fetal mortality and morbidity risks and are classified as high-risk pregnancies. Therefore, adolescent mothers require close follow-up during both the antenatal and postpartum periods. However, studies indicate that adolescent mothers often fail to attend regular antenatal check-ups, receive inadequate education on breastfeeding, and consequently feel unprepared for motherhood. They tend to have low breastfeeding self-efficacy and develop negative attitudes toward breastfeeding. In the postpartum period, they also experience difficulties in initiating and maintaining breastfeeding. Research highlights the need for education and counseling for adolescent mothers during the antenatal and postpartum periods. Providing education on breastfeeding is particularly important for improving maternal and infant health outcomes. Current approaches to breastfeeding counseling involve face-to-face training provided by healthcare professionals in medical institutions, as well as various alternative methods such as home visits, online/web-based education portals, theory-based training, text messages, emails, and phone consultations. In breastfeeding counseling, it is essential to not only provide education but also ensure continuous follow-up. Monitoring the process is expected to increase adolescent mothers' breastfeeding self-efficacy, foster positive attitudes toward breastfeeding, and extend the duration of breastfeeding. This study aims to assess the effects of antenatal education based on the Breastfeeding Self-Efficacy Theory and postpartum follow-up counseling on adolescent mothers' breastfeeding attitudes and self-efficacy. By enhancing their breastfeeding self-efficacy and attitudes, this study is expected to contribute to resolving challenges related to early initiation and continuation of breastfeeding in the postpartum period.

Conditions

Adolescent Pregnancy; Breastfeeding; Self-Efficacy

Keywords

Adolescent Mothers; Breastfeeding Counseling; Prenatal Education; Postpartum Follow-Up; Lactation

Outcome Measures

Primary Outcomes (1)

• Change in Breastfeeding Self-Efficacy Score

  Breastfeeding self-efficacy was assessed using the 14-item Breastfeeding Self-Efficacy Scale-Short Form. The antenatal version was administered at baseline, and the postnatal version was administered at postpartum week 6. Each item is rated from 1 to 5. Total scores range from 14 (minimum) to 70 (maximum). Higher scores indicate a better outcome, reflecting greater breastfeeding self-efficacy. The outcome was defined as the change in the total score from baseline to postpartum week 6.

  Baseline and postpartum week 6

Secondary Outcomes (3)

• Intervention Group Satisfaction With Breastfeeding Support

  Postpartum Week 6

• Change From Baseline in Breastfeeding Knowledge Score

  Baseline and postpartum week 6

• Change From Baseline in Breastfeeding Attitude Score

  Baseline and postpartum week 6

Study Arms (2)

Intervention Group: Breastfeeding Self-Efficacy Theory-Based Education and Counseling

EXPERIMENTAL

Participants assigned to this arm received two individual, face-to-face antenatal breastfeeding education sessions based on Breastfeeding Self-Efficacy Theory. Following the education, weekly supportive text messages were sent until childbirth. Postpartum support included one home visit during the first postpartum week and five weekly telephone counseling sessions during postpartum weeks 2-6. Posttest data were collected at postpartum week 6.

Behavioral: reastfeeding Self-Efficacy Theory-Based Antenatal Education and Postpartum Follow-Up Counseling

Control Group: Routine Antenatal and Postpartum Care

NO INTERVENTION

Participants assigned to this arm received routine antenatal and postpartum care provided by healthcare professionals at the family health centers. No additional breastfeeding education, text-message support, home visit, or telephone counseling was provided by the research team during the study. Telephone contact was limited to confirming childbirth information and collecting posttest data at postpartum week 6. After posttest data collection was completed, breastfeeding education was offered to control-group participants who requested it.

Interventions

reastfeeding Self-Efficacy Theory-Based Antenatal Education and Postpartum Follow-Up Counseling BEHAVIORAL

The intervention was developed based on Breastfeeding Self-Efficacy Theory and included antenatal education, supportive text messages, a postpartum home visit, and telephone counseling. The antenatal education consisted of two consecutive individual, face-to-face sessions, each lasting approximately 55 minutes, with a 10-minute break between sessions. The education addressed the importance of breastfeeding, breast anatomy and lactation physiology, maternal nutrition, breastfeeding techniques, infant hunger and satiety cues, breast care, common breastfeeding problems, expression and storage of breast milk, and the emotional aspects of breastfeeding. Verbal instruction, question-and-answer, demonstration, and hands-on practice were used with a flipchart, an infant model, and a breast model. Weekly supportive text messages were sent from completion of the antenatal education until childbirth. During the first postpartum week, a 45-60-minute home visit was conducted. Five telephone counsel

Intervention Group: Breastfeeding Self-Efficacy Theory-Based Education and Counseling

Eligibility Criteria

• Age: 16 Years - 19 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Adolescent pregnant women aged 16-19 years
• Gestational age of 32 weeks or more at enrollment
• A healthy pregnancy without a known maternal or fetal complication that would interfere with participation in the study
• No known maternal or fetal condition contraindicating breastfeeding
• Able to communicate with the researcher and complete the study procedures
• Access to a reachable telephone
• Provision of written informed consent
• Singleton pregnancy
• Planning to breastfeed postpartum
• No previous breast surgery
• No psychiatric disorder
• No planned relocation

You may not qualify if:

• A maternal or fetal complication identified before enrollment that could lead to pregnancy loss or prevent participation in the study
• A known maternal condition contraindicating breastfeeding
• A communication barrier that would prevent completion of the education, counseling, or study assessments

Sponsors & Collaborators

• Saglik Bilimleri Universitesi: lead

Study Sites (1)

Family Health Centers Affiliated With the Eyyübiye District Health Directorate

Sanliurfa, Şanlıurfa, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Breast Feeding

Condition Hierarchy (Ancestors)

Feeding Behavior; Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Due to the nature of the intervention, participants, the intervention provider, and the outcomes assessor were not blinded to group allocation. The intervention and posttest data collection were conducted by the same researcher. Statistical analyses were performed by an independent statistician who was blinded to the group codes.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD Candidate in Obstetrics and Gynecology Nursing

Model Details: This was a two-arm, parallel-group randomized controlled trial. Adolescent pregnant women were assigned in a 1:1 ratio to either the intervention group or the control group. The intervention group received two sessions of theory-based antenatal breastfeeding education, weekly text-message support until birth, one home visit during the first postpartum week, and five weekly telephone counseling sessions during postpartum weeks 2-6. The control group received routine antenatal and postpartum care. Outcomes were assessed at baseline and at postpartum week 6.

Study Record Dates

• First Submitted: June 9, 2025
• First Posted: June 17, 2025
• Study Start: March 17, 2025
• Primary Completion: October 31, 2025
• Study Completion: October 31, 2025
• Last Updated: August 5, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)