Effectiveness of a Health Literacy-Based Breastfeeding Education Program

Nigde Omer Halisdemir University80 enrolled

Overview

This study aims to evaluate the effects of a comprehensive breastfeeding education program based on a health literacy development strategy on maternal and paternal breastfeeding self-efficacy, fathers' breastfeeding support, parental health literacy, and breastfeeding outcomes. The sustainability of breastfeeding depends not only on maternal knowledge and skills but also on social support mechanisms and parents' ability to access, understand, evaluate, and use health-related information. Fathers play a crucial role in supporting breastfeeding, yet studies incorporating both fathers and health literacy-based educational strategies remain limited. Therefore, this randomized controlled trial was designed to determine whether a structured breastfeeding education program delivered to both mothers and fathers, in addition to routine postpartum care, improves maternal and paternal breastfeeding self-efficacy, fathers' breastfeeding support, parental health literacy, and breastfeeding outcomes. This study sought to answer the following questions: 1. Does breastfeeding education based on a health literacy development strategy affect parents' breastfeeding self-efficacy? 2. Does breastfeeding education based on a health literacy development strategy affect fathers' breastfeeding support? 3. Does breastfeeding education based on a health literacy development strategy affect breastfeeding outcomes? If so, what is the nature of this effect? 4. Does breastfeeding education based on a health literacy development strategy affect the health literacy levels of mothers and fathers?

Based on this background, the present randomized controlled trial was designed to evaluate the effects of a structured, health literacy-oriented breastfeeding education program delivered to both mothers and fathers in addition to routine postpartum care. The study aimed to determine whether this comprehensive intervention improved maternal and paternal breastfeeding self-efficacy, increased fathers' breastfeeding support, enhanced parental health literacy, and positively influenced breastfeeding outcomes, including exclusive breastfeeding, bottle or teat use, breastfeeding frequency, breastfeeding duration, formula use, the frequency of breastfeeding problems, and breastfeeding success.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

Interventions

Routine postpartum breastfeeding careOTHER

Breastfeeding is initiated by nurses or midwives in the hospital within the first hour after birth at most. General information about breastfeeding and breastfeeding is given to the patient for approximately 10 minutes. Afterwards, care is provided in the form of answering the patient's questions, if any.

ExperimentalOTHER

In this study, a breastfeeding education program was prepared based on the "Integrated Health Literacy Model" that combines the processes of accessing, understanding, appraising, and applying health information. The intervention consisted of a 25-30 minute face-to-face education given by the researcher in the hospital within the first 24 hours after birth. At the end of the training, written material was presented and directions were provided to reliable online resources. In order to support the intervention, telephone counseling was provided in the first week after birth and the La Leche League Turkey article "Breastfeeding Myths" was shared via WhatsApp. On the 15th day, a telephone call was made again to evaluate current experiences and send short support messages. In the first month, information was provided about the TEMAS Association's article "Breastfeeding Volunteer, Mothers Have Something to Say" and the "Tuesday Swings" support activities.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Mothers and fathers aged 18-65 years * Parents of a healthy term infant * Parents able to read and speak Turkish * Mothers and fathers without hearing or visual impairment * Mother without a medical contraindication to breastfeeding * Parents with access to the internet * Parents willing to participate voluntarily * Parents living together * Parents able to receive postpartum education Exclusion Criteria: * Separation of the mother and infant due to admission to intensive care * Maternal use of medications contraindicating breastfeeding * Loss of internet access during the study period * Discontinuation of breastfeeding due to maternal or infant medical conditions * Inability to complete follow-up (e.g., relocation, death, or loss to follow-up)

Outcomes

Primary Outcomes

Health literacy level

Health literacy will be assessed using the Turkish version of the 12-item Short-Form Health Literacy Instrument (HLS-SF12). Scores are converted to an index ranging from 0 to 50, with higher scores indicating better health literacy.