Determinants of Infant Feeding Practice Among HIV-Postitive Mothers in Ethiopia

描述(由申请人提供)：与其他高流行国家相比，埃塞俄比亚近年来艾滋病毒发病率显著下降。然而，联邦卫生部认识到，对艾滋病毒母婴传播的预防不足，往往是通过次优的婴儿喂养做法，阻碍了这一努力。虽然已经确定了一些与一种关键但未得到充分利用的积极喂养做法--纯母乳喂养(EBF)--的相关性，但可能阐明因果关系的中介因素在很大程度上仍不清楚。本研究将运用计划行为理论来考察影响母亲婴儿喂养决策和行为的因素，以便设计和实施有效的健康干预措施。本研究的目的是：1)开发和验证基于TPB的文化相关调查问卷，重点关注亚的斯亚贝巴HIV阳性母亲的EBF；2)评估TPB解释EBF行为意图和出生时和产后3个月实际行为的能力；3)确定影响EBF行为意图强度和稳定性的变量。目标人群是亚的斯亚贝巴的艾滋病毒阳性孕妇和产后妇女，那里的艾滋病毒流行率在埃塞俄比亚最高。采用有目的的抽样方法，将从亚的斯亚贝巴的4家医院招募168名患者。第一个目标将通过进行定性访谈来解决，以在目标人群中引发与EBF实践相关的显著行为、规范和控制信念。结果将被用来开发和验证与文化相关的调查问卷，该问卷将允许对 随时间推移TPB结构之间的因果关系。第二和第三个目标将通过在出生时和产后3个月对艾滋病毒阳性妇女的预期队列进行这一定量调查来实现。该调查将收集有关人口统计和社会经济特征的数据，利用利克特量表(基于形成性研究)来衡量态度、社会规范、感知的行为控制和行为意图，并确定实际的婴儿喂养行为。数据将使用结构方程建模(SEM)进行分析，这是一种类似于回归建模的技术，允许同时分析多个自变量和因变量。

DESCRIPTION (provided by applicant): Compared to other high-prevalence countries, Ethiopia has achieved a remarkable reduction in HIV incidence in recent years. However, the Federal Ministry of Health recognizes that inadequate prevention of mother-to- child transmission of HIV, often through suboptimal infant feeding practices, has hindered this effort. While some correlates of a key but underutilized positive feeding practice, exclusive breastfeeding (EBF), have been identified, the mediating factors that might elucidate causal relationships remain largely unknown. This study will use the Theory of Planned Behavior to examine the factors that underlie women's infant feeding decision- making and behavior, so that effective health interventions can be designed and implemented. The aims of this study are: 1) to develop and validate a culturally relevant survey questionnaire, based on the TPB, focusing on EBF among HIV-positive mothers in Addis Ababa; 2) to assess the ability of the TPB to explain EBF behavioral intention and actual behavior at time of birth and three months postpartum; and 3) to identify variables that modify the strength and stability of EBF behavioral intention. The target population is HIV-positive pregnant and postpartum women in Addis Ababa, where HIV prevalence is highest in Ethiopia. Using a purposive sampling methodology, 168 patients will be recruited from 4 hospitals in Addis Ababa. The first aim will be addressed by conducting qualitative interviews to elicit salient behavioral, normative, and control beliefs related to EBF practice among the target population. Results will be used to develop and validate a culturally relevant survey questionnaire that will allow for quantitative measurement of causal relationships between TPB constructs over time. The second and third aim will be addressed by administering this quantitative survey to a prospective cohort of HIV positive women at time of birth and 3 months postpartum. The survey will collect data on demographic and socioeconomic character, utilize Likert scales (based on formative research) to measure attitudes, social norms, perceived behavioral control, and behavioral intention, and determine actual infant feeding behavior. Data will be analyzed using Structural Equation Modeling (SEM), a technique similar to regression modeling that allows multiple independent and dependent variables to be analyzed simultaneously.