Changing Knowledge and Attitude Toward Maternity Care Practices Consistent With the Baby-Friendly Hospital Initiative


Poster Presentation


Will an educational intervention increase knowledge and positively influence attitudes of birthing center staff in regards to maternity-care practices related to the Baby-Friendly Hospital Initiative? This intervention will serve as a foundational step to prepare our hospital for Baby-Friendly Hospital Initiative designation.


This study used a pretest–posttest quasi-experimental design with the target population healthcare practitioners in facilities that provide maternity-care services.


The accessible study population consisted of birthing center staff in a rural community hospital.


The study participants consisted of 8 pediatricians, 4 obstetricians, and 28 nurses. Included in the nurses' (possessive) group were three nursing students and four obstetric technicians.


The pre- and post- test knowledge/attitude survey tool was an investigator-developed tool. The survey tool items were developed in accordance with the Baby-Friendly Hospital Initiative “10 Steps to Successful Breastfeeding.” Content validity of the survey tool was verified by expert staff from the Baby-Friendly Hospital Initiative. A paired-samples t test using pre- and post test survey results was conducted on each individual survey item to evaluate the impact of the educational intervention on the understanding of and attitudes about maternity care practices consistent with the Baby-Friendly Hospital Initiative. The eta-squared statistics were calculated for effect size.


On the survey's 10 knowledge questions, the average overall pretest score was 76%. This increased to 95% following the staff training. Of these 10 questions, further analysis demonstrated that five of the questions did not meet criteria for statistical significance when calculated separately but when combined had a pretest score of 97% and a post test score of 98.5%. On questions 3, 6, 7, 8, and 9, the percentage correct was high on pre- and post tests indicating either foreknowledge or a simplistic question. The remaining five questions demonstrated strong statistical significance with a combined mean p < .01 indicating the effectiveness of the training on the participants knowledge. On the Likert scale questions concerning attitude with 1 representing strongly disagree and 5 representing strongly agree, the pretest mean score was 3.84, increasing to 4.53 following the intervention. This increase carries a p < .0012, indicating a strongly significant increase in positive attitude toward Baby-Friendly Hospital Initiative maternity care practices.

Conclusion/Implications for Nursing Practice

Our findings indicate a significant impact on knowledge and attitude about Baby-Friendly Hospital Initiative consistent maternity-care practices when healthcare staff is provided with targeted education.