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

埃塞俄比亚艾滋病毒阳性母亲婴儿喂养方式的决定因素

• 批准号: 8732349
• 负责人: Meridith Mikulich
• 金额: $ 4.27万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8732349
• 关键词: Accounting; Address; Anti-Retroviral Agents; Attitude; Behavior; Behavior Control; Behavioral; Belief; Birth; Cessation of life; Characteristics; Child; Childhood; Counseling; Country; Data; Decision Making; Developing Countries; Diffusion; Disclosure; Dose; Equation; Ethiopia; Exclusive Breastfeeding; Expectancy; Feeding behaviors; Gold; HIV; HIV Infections; HIV Seropositivity; Happiness; Health; Health Care Costs; Health Care Seeking Behavior; High Prevalence; Hospitals; Human immunodeficiency virus test; Incidence; Individual; Infant; Infant formula; Infection; Influentials; Intention; International; Intervention; Interview; Life; Literature; Location; Measurement; Measures; Mediating; Methodology; Methods; Modeling; Morbidity - disease rate; Mothers; Patients; Planning Theory; Population; Postpartum Period; Postpartum Women; Pregnant Women; Prevalence; Prevention; Questionnaires; Recruitment Activity; Relative (related person); Research; Resources; Sampling; Services; Socioeconomic Status; Surveys; Survival Rate; Target Populations; Techniques; Time; Vertical Disease Transmission; Viral; Woman; World Health Organization; antiretroviral therapy; base; cohort; combat; cost effective; demographics; design; evidence based guidelines; feeding; model development; mortality; pediatric human immunodeficiency virus; pediatric human immunodeficiency virus infection; prospective; psychologic; public health relevance; response; social norm; socioeconomics

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.

描述（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着下降。然而，联邦卫生部认识到，对艾滋病毒母婴传播的预防不足（通常是通过不理想的婴儿喂养方式）阻碍了这一努力。虽然已经确定了纯母乳喂养（EBF）这一关键但未充分利用的积极喂养做法的一些相关性，但可能阐明因果关系的中介因素仍然很大程度上未知。本研究将利用计划行为理论来研究女性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) 基于 TPB，制定并验证文化相关的调查问卷，重点关注亚的斯亚贝巴 HIV 阳性母亲的 EBF； 2) 评估TPB解释EBF行为意图以及出生时和产后三个月实际行为的能力； 3) 识别改变 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艾滋病毒呈阳性的孕妇和产后妇女，这里的艾滋病毒感染率是埃塞俄比亚最高的。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实现，以引出目标人群中与 EBF 实践相关的显着行为、规范和控制信念。结果将用于开发和验证文化相关的调查问卷，以便定量测量 随着时间的推移，TPB 结构之间的因果关系。第二个和第三个目标将通过对出生时和产后 3 个月的艾滋病毒阳性妇女前瞻性队列进行定量调查来实现。该调查将收集人口和社会经济特征的数据，利用李克特量表（基于形成性研究）来衡量态度、社会规范、感知行为控制和行为意图，并确定实际的婴儿喂养行为。将使用结构方程模型 (SEM) 来分析数据，这是一种类似于回归模型的技术，允许同时分析多个自变量和因变量。