Graduation Date

Fall 12-17-2021

Document Type


Degree Name

Doctor of Philosophy (PhD)


Medical Sciences Interdepartmental Area

First Advisor

Dr. Kathleen Hanna

Second Advisor

Dr. Lani Zimmerman

Third Advisor

Dr. Lois Starr

Fourth Advisor

Dr. Susan Wilhelm


African American (AA) women continue to have the lowest rates of breastfeeding. This continues to create a health disparity even though breastfeeding is extensively recognized in the scientific and health care communities as the optimal feeding choice for infants. This study examined the relationship between the external variables (social support network and community resources) and the explanatory variables (attitudes, norms, and perceived self-efficacy) and intention to breastfeed, for the AA, first time, low-income, emerging adult pregnant woman. The Integrated Behavior Model (IBM) was used as the theoretical framework to guide this study in better understanding the variables influencing breastfeeding intention. Survey instruments, including the Iowa Infant Feeding Scale, Perceived Norms Scale, Breastfeeding Self Efficacy Scale- Short Form, Social Support Network Checklist and Community Resources Checklist; were completed with 60 self-identified African American women aged 18–30 (M = 26.47 years), with 9–17 (M = 12.8) years of education who were also in their last trimester of pregnancy. All participants were also primiparous and WIC eligible. Instruments were conducted at a one-time occurrence. A logistic regression analysis was used to determine the significant contribution of the external and explanatory variables on breastfeeding intention. Breastfeeding self-efficacy was found to be a statistically significant predictor of intention to breastfeed.

African American women such as our participants are critical partners as we develop systems of care to decrease disparities and increase African American women’s successes with the breastfeeding behavior. These findings support the importance of having diverse, culturally sensitive mechanisms that support self-efficacy around intention of this behavior. Targeting self-efficacy with future interventional research is paramount.