Feasibility of a Bilingual, Interactive, Computer‐Based Breastfeeding Support Program for Rural Hispanic Women

Susan Wilhelm, Trina Aguirre

Research output: Contribution to journalArticlepeer-review


Objective: To develop and evaluate the acceptance and usability of a bilingual, interactive, touch screen, computer‐based breastfeeding education program for rural Hispanic women. Design: Focus groups were used to explore factors influencing breastfeeding practices among rural Hispanic women. Quantitative data were collected using sociodemographic questionnaires, the Breastfeeding Self‐Efficacy Scale Short Form (BFSE‐SF), and the revised Breastfeeding Attrition Prediction Tool (BAPT). Setting: Regional West Medical Center in rural western Nebraska. Sample: Participants included convenience samples of self‐described Hispanic women age ≥ 19 years old (focus groups n = 12, usability assessments n = 10). Methods: Qualitative data were collected using open‐ended questions based on predicting and changing behavior theory. Univariate statistical analyses were performed to describe quantitative data, and framework analysis was used to thematically analyze narrative data. A prototype program was developed by modifying a Patient Education and Motivation Tool that integrates several cognitive‐behavioral theories and utilizes multimedia formats. To evaluate usability, participants were given a brief introduction to the program and then asked to perform a predefined set of tasks. Data included the time to complete each task, number of attempts, and need for assistance. System usability was assessed using the System Usability Scale (SUS). Results: The majority of participants (83%) had not taken prenatal breastfeeding classes nor did they intend to. Although BAPT results indicated above average intention to breast feed, 33% of the participants had BFSE‐SF scores indicating they were at greater risk for early discontinuation of breastfeeding. Most mothers (67%) decided to breastfeed because of perceived benefits for infant health. Feedback obtained during the focus groups and the results of the BAPT and BFSE‐SF guided the development of content for the computer‐based breastfeeding education program. Participants navigated through the prototype program with ease and no assistance was needed. Average SUS scores were high (90, SD = 10.5). Conclusion/Implications for Nursing Practice: We identified factors that affect breastfeeding practices among rural Hispanic women, which were then used to guide the development of a bilingual, interactive, touch screen, computer‐based, breastfeeding education program. The prototype was well accepted, and participants were able to navigate through the program with ease. Based on these assessments, the program has been further refined and is currently being evaluated to determine whether it is effective in changing breastfeeding behavior in this population.

Original languageEnglish (US)
Pages (from-to)S60
JournalJOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing
StatePublished - Jun 2015


  • Hispanic
  • breastfeeding
  • computer‐adapted program

ASJC Scopus subject areas

  • Pediatrics
  • Critical Care
  • Maternity and Midwifery


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