Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Julie A. Koch


According to Healthy People 2020, infants who are breastfed have improved nutritional, immunological, developmental, and social outcomes (USDHHS, 2014). Despite the benefits of breastfeeding and the focused international efforts to increase levels of breastfeeding, adolescents remain largely unaware and continue to have among the lowest levels of breastfeeding initiation (CDC, 2013; Spear, 2006). The purpose of this EBP project was to reduce the disparities of breastfeeding initiation by increasing breastfeeding self-efficacy and intention in an inner city specialty high school. Synthesis of the evidence demonstrated that needs-based, repeated antenatal education delivered by a lactation expert including breastfeeding peer counselor supports was best practice for engaging the adolescent population. Utilizing Social Cognitive Theory as the theoretical framework and the Stetler Model for Evidence-Based Practice as a model for practice change, an educational intervention was implemented incorporating an Internationally Board Certified Lactation Consultant (IBCLC), peer counselors, and breastfeeding support. Pre- and post-intervention breastfeeding selfefficacy and intended infant feeding preference were collected utilizing the Prenatal Breastfeeding Self-Efficacy Scale (BSES). Non-parametric statistical testing did not reveal any significant differences between mean self-efficacy scores (81.2 and 83.4 respectively, p = .500). Linear regression was performed on pre and post- intervention breastfeeding intention revealing that, while the intervention did positively impact intention, results were not statistically significant (p = .133).