Exclusive Breastfeeding Behavior Model in Rural Central Java, Indonesia: The Application of Theory of Planned Behavior

Abstract

Exclusive breastfeeding’s coverage is low in Indonesia, because attitude, subjective norm and perceived behavioral control fail affecting exclusive breastfeeding intention and behavior. Objectives of research were to formulate exclusive breastfeeding behavior and to explore the relationship of attitude, subjective norm, and behavioral control to exclusive breastfeeding intention and behavior. Mixed method was conducted in rural areas of Karanganyar Regency, Indonesia. Firstly, this was a survey research with attitude, subjective norm, and perceived behavioral control being independent variables. Dependent variables were exclusive breastfeeding intention and behavior. Population of research consisted of 873 lactating mothers. Sampling technique employed was multistage random sampling, with 126 lactating mothers being the sample. Data was collected using questionnaire, data analysis using path analysis. Secondly, case study was conducted through in-depth interview, focus group discussion (FGD), document review, and observation. In-depth interview and FGD was conducted with 49 participants: 30 lactating mothers and 19 health workers. Data analysis was conducted content analysis. The result showed that attitude, affective norm, and perceived behavioral control correlated with exclusive breastfeeding intention (ß = 0.09; p = 0.084; ß = 0.09; p = 0.027; ß = 0.51; p <0.001, respectively). Perceived behavioral control and intention correlated with exclusive breastfeeding behavior (ß = 0.08; p = 0.059; ß = 0.09; p = 0.068, respectively). Exclusive breastfeeding behavior model included attitude, subjective norm, perceived behavioral control, and exclusive breastfeeding behavior. Attitude, subjective norm, and perceived behavioral control collectively correlated with intention; intention and perceived behavioral perception were direct determinants of exclusive breastfeeding behavior.