Identifying behavior mediators influencing caregivers of infants participating in an mhealth intervention: qualitative evaluation of the Baby-Feed trial through interviews.

BACKGROUND

There are only a few online infant nutrition interventions based on a behavior change theory, and none have used a thematic analysis to understand which constructs may have contributed to behavioral change. We developed an online infant nutrition education web platform (Baby-Feed) based on the Social Cognitive Theory (SCT). This qualitative study aimed to identify among participants of the Baby-Feed intervention arm, which SCT behavior mediators (self-efficacy, outcome expectations, observational learning, and incentive motivation) influenced them to move them from intention into action to improve feeding behaviors.

METHODS

This qualitative study employed semi-structured interviews with 20 caregivers from the intervention arm of the Baby-Feed trial. The Baby-Feed online trial was a randomized, controlled, parallel trial that tested an educational website providing real-time feedback on infant feeding and weight gain among 155 caregivers with infants less than 4 months old and followed them until their infant completed the scheduled 9-month well-baby visit. Participants completed an interview with five questions (one or two per construct of the SCT: self-efficacy, outcome expectations, observational learning, and incentive motivation). Methods associated with deductive and inductive analysis were utilized to develop key themes on early feeding practices.

RESULTS

Among first-time mothers (n=10), 100% reported that their confidence either slightly or greatly increased with the use of Baby-Feed. Caregivers (n=11; 55%) reported that they found the "Educational Resources by Nutrition Experts" to be very helpful in their food choices and for modeling infant feeding behaviors. Some (n=3; 15%) also reported that they shared their newly acquired knowledge with others (i.e., friends, spouse, and grandparents), reinforcing the value of the information and that it would benefit others.

CONCLUSIONS

Caregivers found the Baby-Feed website to be a helpful tool to increase their confidence in feeding their baby.