Breastfeeding and Blogging: Exploring the Utility of Blogs to Promote Breastfeeding

Background: People are increasingly using the Internet and social networking sites for behavior support. Almost no literature exists exploring the utility of these sites for supporting breastfeeding behavior. Purpose: The purpose of this study was to determine the extent to which blogs are currently being used to support breastfeeding behavior. Methods: Data for this study came from a sample of 32 active blogs, resulting in 354 posts and 881 comments for analysis. Evidence of intent to support behavior was determined by the presence of theoretical behavior support constructs from the Integrated Behavioral Model. Results: In posts, attitudes (28.5%), behavioral cues (23.8%), and consciousness-raising (25.3%) appeared frequently. Praise (43.3%), behavioral cues (37.4%), and attitudes (30.4%) were the most prominent constructs in comments. More behavior support appeared on industry-affiliated blogs than on private blogs. Posts that presented mostly information only were least effective at eliciting behavior support. Discussion: Blogs are being used to support breastfeeding behavior, and blogs with industry affiliation appear to offer more support. Translation to Health Education Practice: Health educators wishing to support breastfeeding may use blogs and may want to partner with industry. Such efforts might also focus on functional content knowledge aimed at supporting breastfeeding behavior. West J, Hanson C, Thackeray R, Barnes M, Neiger, McIntyre E. Breastfeeding and blogging: exploring the utility of blogs to promote breastfeeding. Am J Health Educ. 2011;42(2):106-115. This paper was submitted to the Journal on September 27, 2010, revised and accepted for publication on December 16, 2010. Joshua West is an assistant professor in the Department of Health Science, Brigham Young University, 229-L Richards Building, Provo, UT 84602; E-mail: josh.west@byu. edu. P. Cougar Hall is an assistant professor in the Department of Health Science, Brigham Young University, 229-E Richards Building, Provo, UT 84602. Carl Hanson is an associate professor in the Department of Health Science, Brigham Young University, 213-A Richards Building, Provo, UT 84602. Rosemary Thackeray is an associate professor in the Research Article Department of Health Science, Brigham Young University, 229-H Richards Building, Provo, UT 84602. Michael Barnes is a professor in the Department of Health Science, Brigham Young University, 221-F Richards Building, Provo, UT 84602. Brad Neiger is a professor in the Department of Health Science, Brigham Young University, 221-G Richards Building, Provo, UT 84602. Emily McIntyre is an assistant professor in the Department of Health Science, Brigham Young University, 229-B Richards Building, Provo, UT 84602. Joshua West, P. Cougar Hall, Carl Hanson, Rosemary Thackeray, Michael Barnes, et al. American Journal of Health Education — March/April 2011, Volume 42, No. 2 107 postings and comments. 4 Papacharissi showed that most content on personal blogs was intended to be read by friends and family, groups that already share social connections. blogs are also capable of bringing groups together to both forge and strengthen new social network bonds. 7, 8 This happens when individuals participate in a blog that revolves around a common theme (e.g., cancer survivorship), but where the individuals have little or no previous contact or awareness of each other. Either way, one commonality among blogs is that they tend to feature a strong sense of community. Several different types of blogs exist: (1) personal blogs, representing a lay person’s blog on any topic of personal interest; (2) topic or industry blogs, representing authoritative and influential bloggers on a subject area or industry; (3) publicationbased blogs, typically editors or reporters who stimulate discussion of a certain topic; and (4) corporate blogs, representing corporate executives or board members who blog about a single company. Topic or industry blogs “function nearly like an ongoing white paper or keynote speech as if to impart sage wisdom to others who, for example, need or want to know what the state of the subject is, where it’s going, and what stands to be gained or lost with or without proper action.” 35) Breastfeeding and Behavior Support breastfeeding is a health behavior with many documented benefits for both mother and child. In most cases, breastfeeding is optimal for the child’s growth. Exclusive breastfeeding for the first six months of a child’s life is the best and most cost-effective intervention to provide newborns with much needed nutrients and to improve infant and children survival rates. Additionally, mothers that breastfeed decrease their risk for breast cancer. Despite the empirical support for breastfeeding, rates remain low. Frequently cited psychosocial determinants of breastfeeding include such things as attitudes, beliefs about the benefits of breastfeeding, self-efficacy, social support, 21, 22 and normative beliefs of family members, 23, 24 friends and society. 18, 19, 25 Whereas traditional counseling techniques have not been effective at overcoming many psychosocial barriers, behavior support delivered via blogs may be an effective strategy for tailoring approaches aimed at addressing common psychosocial determinants. Providing new mothers with adequate behavior support for breastfeeding holds promise in overcoming breastfeeding difficulty. both informal (family, friends) and professional (health care professionals) social networks aimed at providing social support for breastfeeding have been identified as effective tools for breastfeeding promotion. Indeed, practitioners such as physicians, nurses, midwives and lactation specialists are well positioned to provide meaningful breastfeeding behavior support. Consistent with these findings, Dennis recommended a telephone peer support program to match new mothers with experienced breastfeeding mothers in the same community. The experienced mother can then provide the necessary behavior support through positive role modeling and verbal persuasion needed to help the new mother overcome breastfeeding difficulties. Utilizing online social networking mediums may provide a new and more efficient strategy, as well as increased accessibility, for providing this type of breastfeeding behavior support. Social support is a generic term for behavior support from social sources. Constructs prominent in health behavior change theories can be used to operationally define social support in useful terms for health educators. The current study draws heavily upon constructs adapted from the Integrated behavioral Model. This model defines behavior support as efforts to influence behavioral intentions through attitudes, social norms, and self-efficacy, which are commonly cited psychosocial determinants of breastfeeding. These constructs are influenced by an individual’s perceptions regarding such things as the benefits from engaging in the behavior or possible barriers. The model’s value for this study rests in its integration of constructs from numerous influential theories. Therefore, its robustness enhances its applicability to women from diverse cultures and ideologies that wish to breastfeed.