Author and graduation date: Ryan Robert UNION, May, 1998

Committee members: Donna Beshgetoor (Chair), Kathy Lamaster, Dr. Price

Thesis title: Validation of a Questionnaire to Assess Attitudes Toward Breast Feeding Among WIC Participants

Breast-feeding is known to promote optimal nutrition for infants during early postnatal life. Although the promotion of breast-feeding is an integral part of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), breast-feeding initiation and duration rates for women enrolled in WIC fall far below national averages. While several studies have attempted to determine factors affecting mothers' infant feeding decisions, these studies have not utilized statistically reliable or validated instruments in the experimental design. This has imposed serious limitations in the interpretation of the studies results. Thus, the objective of this study was to validate a questionnaire designed to determine factors that favor or disfavor breast-feeding practices among WIC mothers. Three hundred and forty one women receiving WIC services from ten sites in San Diego County completed an attitudinal survey on breast-feeding. Completion of the survey was voluntary and all data were anonymously obtained. No individual benefits or risks were incurred by participating in the study. All attitudinal variables in the questionnaire were applied to a maximum likelihood factor analysis. Four factors were identified and labeled: perceived maternal benefits, enhancement of maternal-infant bond, perceived infant benefits, and perceived maternal barriers. The internal consistency (Cronbach's alpha) within each factor held to an acceptably high >0.7. The four factors correlated significantly (p = <0.01) with predictive questions in the predictive direction. Validation of this instrument will assist WIC personnel in developing more effective breast-feeding promotion programs which focus on the specific concerns of this population.

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