Transtheoretical Model of Change – Empowering Breastfeeding

Social exchange theory example

Using the Transtheoretical Model of Change to Influence the Breastfeeding Debate

Following the public response from our previous article on breastfeeding we take a deeper look at influencing the influencers using the transtheoretical model of change to address different stages of the decision-making process.

We make decisions not on our own, but by a committee. Often we don’t even know that the committee exists. That’s because we are governed by subjective norms. That is, we perceive a level of social pressure that makes us behave the way we do. There’s a number of people who influence our world and they can change depending on our situation. For a pregnant lady, there are three key influencers:

  • Partner
  • Midwife/nurse
  • Mother

We should consider these people in isolation. Then make an intervention that will influence all those involved with the mother. This will come together to form a marketing mix. For those of you who don’t know what a marketing mix it’s a tool used to develop our intervention. It considers:

  • how we are going to reach people (promotion);
  • the cost/benefit for adopting our desired behaviour (price);
  • what we are going to provide as a service to support those people (product); and
  • where we’re going to offer that product (place).

The opinions of our key influencers

We found in one research paper that partners and midwives were more likely to support the decision to breastfeed. Mothers of the pregnant women were more likely to promote bottle-feeding. We saw previously that older women were likely to discourage breastfeeding; perhaps they are relaying their own experience. We call this conservatism bias. They decide breastfeeding will be a problem for their daughter, even before the child is born.

As we saw, poorer households are less likely to adopt breastfeeding. One of the key reasons identified in this report was a lack of support from a partner. I couldn’t find the stats, but around one-quarter of mothers in the UK are single parents. That’s a large group of people. Especially ones who would normally be pro-breastfeeding.

Let’s first look at the theoretical model.

What is the transtheoretical model of change

The transtheoretical model or stages of change model will help us break down groups into manageable groups:

  • Those who haven’t considered breastfeeding as an option (precontemplators)
  • Others who know about the available options (contemplation)
  • Then those who take (action) to support the mother to breastfeed
  • And finally, the group who provide ongoing support (maintenance)

It’s likely that the family members are going about their own lives. At this stage, breastfeeding might not have crossed their mind. However, it’s the best time to reach out. Past bad experiences can cloud judgement. This is where we can use anchoring as a way to change opinion. For instance, saying 50% of mothers are able to latch to begin with. This allows the receiver to weigh up if their own experience. Promoting these kinds of messages early on means we can reduce mixed messages to the expectant mother.

Weighing up all the options

At the contemplation stage, it’s about understanding the pros and the cons. Here communications are most critical. I looked, there isn’t really an independent website for birthing support. It could be a missed opportunity. I spoke earlier about ‘place’ within the marketing mix, this could be a virtual space. The cost/benefit needs to be clear as we’re dealing with deep-set beliefs. One solution to creating credible cost/benefit messages is to us opinion formers. An example being other sceptical parents and partners. Using opinion leaders like TV celebrities, male and female, can create reassurance.

Taking the first steps

The action stage is the point where we empower our audience. This is where the most support to the expectant mother will happen. We’re looking for a balanced viewpoint. If the expectant mother chooses not to breastfeed, that’s their prerogative. Here though we can arm the supporter with the tools to help the mother with her decision. Breastfeeding can be uncomfortable for some, and there’s a lot of products around that can help. So providing reviews and best value options can be an enabler. This falls under the element of ‘product’ in the marketing mix.

Keep on, keeping on

The last stage is maintenance. And here is where the big drops in breastfeeding numbers can happen. I can imagine it becomes more difficult as the new mum becomes more mobile. Other things get in the way, like working and issues of the mind, such as anxiety of public breastfeeding. Providing emotional support is probably the best gift they can give. That might just be lending an ear. You could promote support videos around emotional first aid and active listening. Also pointing towards breastfeeding friendly places, there’s an app called Feedfinder. There’s also a Breastfeeding Welcome Scheme. Encouraging the supporters to nudge new mums towards these places, can change a view overnight.

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