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Date of Award


Degree Type

Restricted Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Julie M. Brandy


The Academy of Breastfeeding Medicine (2008) affirms breastfeeding initiatives as one of the most important efforts to reduce infant mortality and morbidity, and encourages more research and program development to improve current breastfeeding rates. As a vital health goal, the American Academy of Pediatrics encourages all health care providers to advocate and support breastfeeding. Best practice recommendations include integrating strategies that address the underlying barriers associated with breastfeeding. One strategy includes the integration of breastfeeding self-efficacy education and screening via the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) screening tool (Dennis, 2003). Prenatal education programs designed to improve breastfeeding self-efficacy have been studied and demonstrate significant outcomes to improve breastfeeding self-efficacy, duration, and exclusivity. The Ace Star Model of Knowledge Transformation (Stevens, 2004) was used to guide the Evidence Based Practice (EBP) project and the theoretical underpinning of Breastfeeding Self-Efficacy (Dennis, 1999) was used to guide behavior change. The purpose of the evidence based practice (EBP) project was to provide a breastfeeding self-efficacy education class, prenatal and postpartum breastfeeding self-efficacy screening, and routine support services. Using the review of literature to evaluate and synthesize the evidence, the PICOT question was: What are the effects of breastfeeding self-efficacy screening, education and support services on breastfeeding self-efficacy, perceptions of support, and breastfeeding duration in postpartum women at 2 and 6 weeks? Outcome measures were evaluated using descriptive statistics and the non-parametric Repeated Measure Friedman Test. Results indicated that there were statistically significant differences in the BSES-SF scores after attending the class, (2)=6.400, p-value = 0.041. Post hoc analysis revealed statistically significant differences in BSES-SF Scores from the prenatal period (median = 50.0) to 6 weeks postpartum (median = 65.0) (p < .034). The integration of theory based breastfeeding self-efficacy screening and education programs by health care providers may serve to benefit their patients by implementing evidence based practice and aid in meeting the needs of their patients, the population, and state and national health care goals. Additional studies using larger sample sizes are needed to further strengthen best practice recommendations.


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