Comparison of breastfeeding knowledge, attitudes, and beliefs before and after educational intervention for northeast Tennessee high school students

Breastfeeding rates in Northeast Tennessee are much lower than national rates and the Healthy People 2020 targets. Literature review and interviews with regional stakeholders informed development of an educational intervention for high school students aimed to increase the breastfeeding rates in this southern Appalachian region. A jeopardy style game was developed based on the Theory of Planned Behavior (TPB) that provided information about breastfeeding. Two regional high school health science classes participated. Prior to the game, the students were given a pre-survey to assess knowledge, attitudes, subjective norms, perceived behavioral control, and intentions, the tenets of the TPB. A post-survey was given two weeks later and compared to the pre-test results using t-tests to assess changes in these measures of the TPB tenets. Surveys were completed by 107 students (75% female, 68% freshman/sophomores). At baseline, future breastfeeding intention was 47.6% with a post-survey intention of 66.3%. Knowledge, attitudes, and perceptions of subjective norms related to breastfeeding were all significantly improved as well after the intervention. Breastfeeding education is not common among middle and high schools with limited research in this type of education. This study provides evidence that including breastfeeding education in the curriculum can positively influence student's future breastfeeding behavior. Limitations include only having one session of education and a short follow-up of only two weeks. While this study did not assess the impact of the intervention on breastfeeding rates, the changes observed suggest that it may have the potential to increase the breastfeeding rates in the future.