The Role of Maternal Ideations on Breastfeeding Practices in Northwestern Nigeria: a Cross-sectional Analysis

Abstract Background Early initiation of breastfeeding (EIBF) within the first hour of birth and exclusive breastfeeding (EBF) for the first six months of life are beneficial for child survival and long-term health. Yet breastfeeding rates remain sub-optimal in Northwestern Nigeria, and such practices are often influenced by complex psychosocial factors at cognitive, social and emotional levels. To understand these influences, we developed a set of breastfeeding-related ideational factors and quantitatively examined their relationship with EIBF and EBF practices. Methods A cross‐sectional population‐based survey was conducted in Kebbi, Sokoto, and Zamfara states from September through October 2019. A random sample of over 3000 women with at least one child under 2 years was obtained. Respondents were asked about their health behaviors including breastfeeding practices for their youngest child under 2 years. Breastfeeding-related ideations were developed using the Ideation Model of Strategic Communication and Behavior Change. Mixed-effects logistic regression models were used to derive predicted probabilities for EIBF and EBF while adjusting for ideations and socio-demographic variables. Results Among 3039 women with a child under 2 years of age, 42.1% (95% CI: 35.1% - 49.4%) practiced EIBF, while 37.5% (95% CI: 29.8% - 46.0%) out of 721 infants aged 0-5 months were exclusively breastfed. Women who knew that EIBF was protective on the health of the newborn had 7.9 and 7.0 percentage points (pp) higher likelihood of EIBF and EBF practices respectively. Women who believed colostrum was harmful both had 8.4 pp lower likelihood of EIBF and EBF practices. We found a higher likelihood of practicing EIBF (5.1 pp) and EBF (13.3 pp) among women who knew at least one benefit of breastfeeding. Knowledge of the appropriate time to introduce complementary feeding and having self-efficacy to practice EBF were positively associated with 11.2 pp and 13.1 pp increased likelihood of practicing EBF alone. Household wealth, maternal occupation and attending ANC4+ times were associated with EIBF, while health provider’s influence was associated with EBF. Conclusion Social and Behavior Change (SBC) programs should focus on improving women’s knowledge about breastfeeding and its benefits, dispelling myths around colostrum as bad milk, building women’s confidence to exclusively breastfeed, and improving antenatal care uptake to support breastfeeding promotion.

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Socioeconomic Inequality in Exclusive Breastfeeding Behavior and Ideation Factors for Social Behavioral Change in Three North-western Nigerian States: a Cross-sectional Study.

10.21203/rs.3.rs-287956/v1 ◽

2021 ◽

Author(s):

Dele Abegunde ◽

Paul Hutchinson ◽

Udochisom Anaba ◽

Foyeke Oyedokun Adebagbo ◽

Emily White Johansson ◽

...

Keyword(s):

Behavior Change ◽

Exclusive Breastfeeding ◽

Strategic Communication ◽

Household Wealth ◽

Socioeconomic Inequalities ◽

P Value ◽

Cross Sectional ◽

And Behavior ◽

The Impact ◽

North Western

Abstract BackgroundSocioeconomic inequalities could mitigate the impact of social and behavior change (SBC) interventions aimed at improving positive ideation towards the practice of exclusive breastfeeding. This study explores the empirical evidence of inequalities in the practice of exclusive breastfeeding (EBF) and associated ideational domains of the theory of Strategic Communication and Behavior Change in three north-western Nigeria states. MethodsWe used cross‐sectional data from 3,007 randomly selected women with under-two-year-old children; the convenient regression method was applied to estimate the concentration indexes of exclusive breastfeeding behavior, ranked by household wealth index. Inequality was decomposed to associated ideational factors and sociodemographic determinants. Avoidable inequalities and the proportion of linear redistribution to achieve zero inequality were estimated. ResultsWomen from wealthier households were more likely to practice exclusive breastfeeding (CIx = 0.1236, p-value = 0.00). Attendance of at least four antenatal clinic visits (ANC 4+) was the most significant contributor to the inequality, contributing CIx = 0.0307 (p-value = 0.00) to the estimated inequality in exclusive breastfeeding practice. The elasticity of exclusive breastfeeding behavior with respect to partners influencing decision to breastfeed and ANC4+, were 0.1484 (p-value = 0.00) and 0.0825 (p-value = 0.00) respectively. Inequality in the regular attendance at community meetings (CIx = 0.1887, p-value =0.00); ANC 4+) (CIx = 0.3722, p-value = 0.00); and maternal age (CIx = 0.0161, p-value = 0.00) were pro-rich. A 10.7% redistribution of exclusive breastfeeding behavior from the wealthier half to the poorer half of the population could eliminate the inequality (line of zero inequality). Inequalities were mainly in the cognitive and social norms domain and were all pro-poor.ConclusionSocioeconomic inequalities exist in exclusive breastfeeding behaviour: the associated ideations in the study states but are mostly avoidable. A 10.7% redistribution from wealthier to the poorer half of the population will achieve elimination. Messaging for SBC communication interventions to improve breastfeeding practices could be more effective by targeting the mitigation of these inequalities.

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Socioeconomic inequality in exclusive breastfeeding behavior and ideation factors for social behavioral change in three north-western Nigerian states: a cross-sectional study

International Journal for Equity in Health ◽

10.1186/s12939-021-01504-4 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Dele Abegunde ◽

Paul Hutchinson ◽

Udochisom Anaba ◽

Foyeke Oyedokun-Adebagbo ◽

Emily White Johansson ◽

...

Keyword(s):

Behavior Change ◽

Exclusive Breastfeeding ◽

Strategic Communication ◽

Household Wealth ◽

Socioeconomic Inequalities ◽

P Value ◽

Cross Sectional ◽

And Behavior ◽

The Impact ◽

North Western

Abstract Background Socioeconomic inequalities could mitigate the impact of social and behavior change (SBC) interventions aimed at improving positive ideation towards the practice of exclusive breastfeeding. This study explores the empirical evidence of inequalities in the practice of exclusive breastfeeding (EBF) and associated ideational dimensions and domains of the theory of Strategic Communication and Behavior Change in three north-western Nigeria states. Methods We used cross-sectional data from 3007 randomly selected women with under-two-year-old children; the convenient regression method was applied to estimate the concentration indexes (CIxs) of exclusive breastfeeding behavior, ranked by household wealth index. Inequality was decomposed to associated ideational factors and sociodemographic determinants. Avoidable inequalities and the proportion of linear redistribution to achieve zero inequality were estimated. Results Women from wealthier households were more likely to practice exclusive breastfeeding CIx = 0.1236, p-value = 0.00). Attendance of at least four antenatal clinic visits (ANC 4+) was the most significant contributor to the inequality, contributing CIx = 0.0307 (p-value = 0.00) to the estimated inequality in exclusive breastfeeding practice. The elasticity of exclusive breastfeeding behavior with respect to partners influencing decision to breastfeed and ANC4+, were 0.1484 (p-value = 0.00) and 0.0825 (p-value = 0.00) respectively. Inequality in the regular attendance at community meetings (CIx = 0.1887, p-value =0.00); ANC 4+) (CIx = 0.3722, p-value = 0.00); and maternal age (CIx = 0.0161, p-value = 0.00) were pro-rich. A 10.7% redistribution of exclusive breastfeeding behavior from the wealthier half to the poorer half of the population could eliminate the inequality (line of zero inequality). Inequalities were mainly in the cognitive and social norms dimension and were all pro-poor. Conclusion Socioeconomic inequalities exist in exclusive breastfeeding behaviors and in associated ideation factors in the three states but are mostly avoidable. A 10.7% redistribution from wealthier to the poorer half of the population will achieve elimination. Messaging for SBC communication interventions to improve breastfeeding practices could be more effective by targeting the mitigation of these inequalities.

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Public Awareness of Low-Risk Alcohol Use Guidelines

Health Promotion Practice ◽

10.1177/1524839918781527 ◽

2018 ◽

Vol 20 (6) ◽

pp. 905-913

Author(s):

Kelcy McNally ◽

Laura Lee Noonan ◽

Marguerite Cameron ◽

Karen Phillips ◽

Shamara Baidoobonso ◽

...

Keyword(s):

Behavior Change ◽

Public Awareness ◽

Heavy Drinking ◽

Public Health Education ◽

Population Based ◽

Low Risk ◽

Specific Knowledge ◽

Cross Sectional ◽

Education Campaign ◽

And Behavior

Objective. To evaluate the effectiveness of a population-based, public education campaign designed to increase awareness of the Canadian Low-Risk Alcohol Drinking Guidelines (LRDG). Method. A province-wide mass media campaign was introduced. To measure campaign effectiveness, we completed a cross-sectional study using pre- and postcampaign surveys. Measurements included awareness of the LRDG, specific knowledge of the LRDG, and beliefs toward drinking and behavior change. Results. Postsurvey respondents were more likely to be aware of the LRDG (19.2% vs. 25.8%). However, increased awareness was largely driven by females being significantly more aware of the guidelines after the campaign (odds ratio = 1.74; 95% confidence interval = [1.38, 2.19]). Men were not found to be more aware postcampaign. The results did not show a significant increase in specific knowledge of the LRDG or change in beliefs toward drinking and behavior change after the campaign. Independent of the survey cycle, males and those aged 19 to 25 years were less likely to be aware of the LRDG, select the correct drink limit or less, and believe that consuming alcohol in excess has short- and long-term health consequences when compared to females and those aged 56 to 70 years. Conclusions. A provincial public health education campaign was effective at increasing awareness of the LRDG, though uptake was lowest among those at highest risk for heavy drinking.

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The relationship between socioeconomic position and health literacy among urban and rural adults in regional China

BMC Public Health ◽

10.1186/s12889-021-10600-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wei Chen ◽

Hongfu Ren ◽

Na Wang ◽

Yaqing Xiong ◽

Fei Xu

Keyword(s):

Health Literacy ◽

Educational Attainment ◽

Socioeconomic Position ◽

Population Based ◽

Outcome Variable ◽

Average Income ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Logistic Regression Models ◽

Rural Adults

Abstract Background To examine associations of socioeconomic position (SEP), separately indicated by education, monthly family average income (FAI) and occupation, with health literacy (HL) among adults in regional China. Methods A cross-sectional survey was conducted among urban and rural adults (aged 25–69 years) who were randomly selected, using the probability proportionate to size sampling approach, from Nanjing municipality of China during October and December of 2016. HL, the outcome variable, was assessed using the Chinese Resident Health Literacy Scale. SEP, our independent variable, was separately measured with educational attainment, monthly family average income and occupation. Logistic regression models were introduced to examine SEP-HL association with odds ratio (OR) and 95% confidence interval (CI). Results Totally, 8698 participants completed the survey. The proportion of participants with unweighted and weighted adequate HL was 18.0% (95%CI = 17.2, 18.8%) and 19.9% (95%CI = 16.6, 23.6%), respectively, in this study. After adjustment for possible confounding factors, each SEP indicator was in significantly positive relation to both unweighted and weight HL level. Participants who obtained 13+ and 10–12 years educational attainment, respectively, had 2.41 (95%CI = 1.60, 3.64) and 1.68 (95%CI = 1.23, 2.29) times odds to record weighted adequate HL compared to their counterparts who were with 0–9 years education. Subjects within upper (OR = 1.92, 95%CI = 1.24, 2.98) and middle FAI tertile (OR = 1.59, 95%CI = 1.19, 2.13), respectively, were more likely to report weighted adequate HL relative to those who were within lower FAI tertile. White collars were more likely to have weighted adequate HL (OR = 1.33, 95%CI = 1.09, 1.61) than blue collars. Conclusions Each of education, FAI and occupation was positively associated with health literacy among urban and rural adults in China. The findings have important implications that different SEP indicators can be used to identify vulnerable residents in population-based health literacy promotion campaigns.

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Support for cigarette filter waste policies among US adults

Tobacco Control ◽

10.1136/tobaccocontrol-2020-056451 ◽

2021 ◽

pp. tobaccocontrol-2020-056451

Author(s):

Minal Patel ◽

Alison F Cuccia ◽

Shanell Folger ◽

Adam F Benson ◽

Donna Vallone ◽

...

Keyword(s):

Smoking Status ◽

Population Based ◽

Tobacco Product ◽

Cross Sectional ◽

Cigarette Filter ◽

Logistic Regression Models ◽

Knowledge And Beliefs ◽

Cigarette Butts ◽

Using Data ◽

The Impact

IntroductionLittle is known on whether cigarette filter-related knowledge or beliefs are associated with support for policies to reduce their environmental impact.MethodsA cross-sectional, population-based sample of US adults aged 18–64 years (n=2979) was used to evaluate filter-related knowledge and beliefs by smoking status using data collected between 24 October 2018 and 17 December 2018. Multivariate logistic regression models explored whether these knowledge and belief items were associated with support for two policies, a US$0.75 litter fee and a ban on sales of filtered cigarettes, controlling for demographic characteristics and smoking status.ResultsRegardless of smoking status, 71% did not know plastic was a cigarette filter component and 20% believed filters were biodegradable. Overall, 23% believed filters reduce health harms and 60% believed filters make it easier to smoke; 90% believed cigarette butts are harmful to the environment. Individuals believing cigarette butts harmed the environment were more likely to support a litter fee (adjusted OR (aOR)=2.33, 95% CI: 1.71 to 3.17). Individuals believing that filters are not biodegradable had higher odds of supporting a litter fee (OR=1.47, 95% CI: 1.15 to 1.88). Respondents believing that filters do not make cigarettes less harmful were more likely to support a litter fee (aOR=1.50, 95% CI: 1.20 to 1.88) and filter ban (aOR=2.03, 95% CI: 1.64 to 2.50). Belief that filters make it easier to smoke was associated with decreased support for a filter ban (aOR=0.69, 95% CI: 0.58 to 0.83).ConclusionsComprehensive efforts are needed to educate the public about the impact of cigarette filters in order to build support for effective tobacco product waste policy.

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Women’s Autonomy and Support for Wife Beating: Findings From a Population-Based Survey in Jordan

Violence and Victims ◽

10.1891/0886-6708.25.3.409 ◽

2010 ◽

Vol 25 (3) ◽

pp. 409-419 ◽

Cited By ~ 25

Author(s):

Natalia Linos ◽

Marwan Khawaja ◽

Mohannad Al-Nsour

Keyword(s):

Regression Models ◽

Binary Logistic Regression ◽

Population Based ◽

Married Women ◽

Wife Beating ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Logistic Regression Models ◽

Hypothetical Scenario ◽

Population Based Survey

The aim of this study is to examine attitudes among married women toward wife beating and to investigate the hypothesis that female individual empowerment is associated with such attitudes within a broader context of societal patriarchy in Jordan. The study uses data from a cross-sectional survey of a representative sample of married women (n = 5,390) conducted in 2002. Associations between acceptance of wife beating and several women’s empowerment variables, including decision-making power, as well as other risk factors were assessed, using odds ratios from binary logistic regression models. The key finding is that the vast majority (87.5%) of Jordanian women believe that wife beating is justified in at least one hypothetical scenario, and justification is negatively associated with empowerment variables and some demographic, geographic, and socioeconomic factors.

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Association between Eating Away from Home and Hyperuricemia: A Population-Based Nationwide Cross-Sectional Study in China

BioMed Research International ◽

10.1155/2019/2792681 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Zifeng Liu ◽

Xiaoting Su ◽

Mianli Xiao ◽

Peien Zhou ◽

Jianwei Guo ◽

...

Keyword(s):

Regression Models ◽

Population Based ◽

Cross Sectional Study ◽

Noncommunicable Diseases ◽

Sectional Study ◽

Nutrition Survey ◽

Cross Sectional ◽

Logistic Regression Models ◽

Health And Nutrition ◽

Home Food

Hyperuricemia (HU) is a risk factor for different kinds of chronic noncommunicable diseases, and eating away from home (EAFH) may play an important role in their development, which has been ignored greatly so far. This study aimed to investigate the association between EAFH and HU in different models. A cross-sectional study involving 8,322 participants of the China Health and Nutrition Survey (CHNS) was conducted. Logistic regression models were used to analyze the data. We found that participants who consumed more away-from-home food had a higher risk for HU, and the adjusted odds ratio (aOR) and 95% confidence interval (CI) (for each increment in grades of EAFH) were 1.11 (1.02, 1.20) in a multiadjusted model (adjusted for age, gender, province, net individual income, body mass index, smoking, leisure-time physical activities, energy intake, and sleep duration). As for stratified analyses, the aOR (95% CI) of EAFH was 1.12 (1.01, 1.24) for men and 1.06 (0.92, 1.21) for women. Similar results can be found in the middle-aged and obese population, with aOR (95% CI) of EAFH as 1.17 (1.05, 1.30) and 1.15 (1.03, 1.29), respectively. In conclusion, EAFH is positively associated with the prevalence of HU.

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Suicidal ideation in relation to disordered eating, body size and weight perception: a cross-sectional study of a Norwegian adolescent population: the HUNT Study

BMJ Open ◽

10.1136/bmjopen-2019-029809 ◽

2019 ◽

Vol 9 (7) ◽

pp. e029809 ◽

Cited By ~ 2

Author(s):

Farzaneh Saeedzadeh Sardahaee ◽

Turid Lingaas Holmen ◽

Nadia Micali ◽

Erik R Sund ◽

Ottar Bjerkeset ◽

...

Keyword(s):

Body Size ◽

Suicidal Ideation ◽

Disordered Eating ◽

Weight Perception ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Logistic Regression Models ◽

Norwegian Population ◽

Hunt Study

ObjectiveWe conducted a population-based study on a sample of more than 7000 adolescents where we examined the associations between suicidal ideation (SI) and disordered eating (DE) and its related traits.DesignCross-sectional.SettingsData were derived from two Norwegian population-based cohorts, the Young-HUNT1 (1995–1997) and Young-HUNT3 (2006–2008) from the county of Nord-Trøndelag, Norway.ParticipantsA total of 7268 adolescents (15–19 years) who had completed self-reported questionnaires including items on SI, DE, body size and weight perception were included.Primary outcome measuresORs for SI given DE, body size or weight perception. Analyses were performed in multivariate logistic regression models.ResultsThe prevalence of SI was 23.1% in total population. Both girls and boys who reported DE, evaluated their body size asnot‘about the same as others’ or were ‘unhappy about their weight’ had between twofold to fivefold increase in odds for SI; these incremental risks were observed independent of sex, age, body mass index and socioeconomic status. We observed higher odds for SI among boys.ConclusionsOur findings suggest a clear association between SI and DE and its associated traits, in both genders but especially in males. Special attention should be paid on early detection of DE traits among adolescents.

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Understanding Family Planning Outcomes in Northwestern Nigeria: Analysis and Modeling of Social and Behavior Change Factors

10.21203/rs.3.rs-113046/v1 ◽

2020 ◽

Author(s):

Paul Hutchinson ◽

Udochisom Anaba ◽

Dele Abegunde ◽

Mathew Okoh ◽

Paul Hewett ◽

...

Keyword(s):

Family Planning ◽

Behavior Change ◽

Large Scale ◽

Contraceptive Use ◽

Gender Inequalities ◽

High Fertility ◽

Partner Communication ◽

Cross Sectional ◽

Modern Contraception ◽

And Behavior

Abstract Background: Northwestern Nigeria faces a situation of high fertility and low contraceptive use, driven in large part by high-fertility norms, pro-natal cultural and religious beliefs, misconceptions about contraceptive methods, and gender inequalities. Social and behavior change (SBC) programs often try to shift drivers of high fertility through multiple channels including mass and social media, community-level group and interpersonal activities. This study seeks to assist SBC programs to better tailor their efforts by assessing the effects of intermediate determinants of contraceptive use/uptake and by demonstrating their potential impacts on contraceptive use, interpersonal communication with partners, and contraceptive approval.Methods: Data for this study come from a cross-sectional household survey, conducted in the states of Kebbi, Sokoto and Zamfara in northwestern Nigeria in September 2019, involving 3,000 women aged 15 to 49 years with a child under 2 years. Using an ideational framework of behavior that highlights psychosocial influences, multivariate regression analyses assess associations between ideational factors and family planning outcomes, and post-estimation simulations with regression coefficients model the magnitude of effects for these intermediate determinants.Results: Knowledge, approval of family planning, and social influences, particularly from husbands, were all associated with improved family planning outcomes. Approval of family planning was critical – women who personally approve of family planning were nearly three times more likely to be currently using modern contraception and nearly six times more likely to intend to start use in the next six months. Husband’s influence was also critical. Women who had ever talked about family planning with their husbands were three times more likely both to be currently using modern contraception and to intend to start in the next six months. Conclusion: SBC programs interested in improving family planning outcomes could potentially achieve large gains in contraceptive use—even without large-scale changes in socio-economic and health services factors—by designing and implementing effective SBC interventions that improve knowledge, encourage spousal/partner communication, and work towards increasing personal approval of family planning. Uncertainty about the time-order of influencers and outcomes however precludes inferences about the existence of causal relationships and the potential for impact from interventions.

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Fermentable Oligo-, Di-, and Mono-Saccharides and Polyols (FODMAPs) Consumption and Irritable Bowel Syndrome in the French NutriNet-Santé Cohort

Nutrients ◽

10.3390/nu13124513 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4513

Author(s):

Elodie Schneider ◽

Jean-Marc Sabaté ◽

Michel Bouchoucha ◽

Serge Hercberg ◽

Mathilde Touvier ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Daily Intake ◽

Population Based ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Logistic Regression Models ◽

The Mean ◽

Irritable Bowel ◽

Composition Table

(1) Background: Specific foods, and more particularly, fermentable oligo-, di-, and mono-saccharides and polyols (FODMAPs) are often considered as triggers of digestive symptoms in Irritable Bowel Syndrome (IBS). Our aim was to study FODMAP consumption in controls and IBS participants in a large French population-based cohort; (2) Methods: Participants from the NutriNet-Santé cohort study completed the Rome IV and IBS-SSS questionnaire in a cross sectional study. Among them, 27,949 eligible participants had previously completed three 24-h recalls as well as anthropometrics, socio-demographical and lifestyle data. Total FODMAP intake (in g/day) was computed using a specific composition table. The association between FODMAPs and IBS was estimated through multivariable logistic regression models; (3) Results: Included participants were mainly women (75.4%) and the mean age was 43.4 ± 14.1 years. FODMAPs accounted for a mean daily intake of 19.4 ± 9.5 g/day. Overall 1295 participants (4.6%) were identified with an IBS. After adjusting for confounding factors, IBS participants had lower intakes in FODMAPs than non-IBS ones (aOR: 0.88, 95% CI: 0.82–0.95, p-value: 0.001). IBS severity was associated with more frequent low FODMAP intakes (<9 g/day); (4) Conclusions: Participants tended to consume 19 g of FODMAPs per day, but slightly less for IBS participants than for controls. In IBS participants, higher severity was associated with lower intakes.

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