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Applying the ARCS design model to breastfeeding adviceby midwives in order to motivate mothers to personalisetheir experience

Stockdale, Doreen, Sinclair, Marlene and KERNOHAN, WG (2014) Applying the ARCS design model to breastfeeding adviceby midwives in order to motivate mothers to personalisetheir experience. Evidence Based Midwifery, 12 (1). pp. 4-10. [Journal article]

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Abstract

Background. Improving the implementation of evidence-based practice is critical to achieving the public health agenda.However, progress is hampered by the lack of a comprehensive and coherent framework to guide the theoretical and systematicdesign of complex interventions. Breastfeeding is a good example; in spite of the immense public health value, no theoreticallydesigned,complex intervention exists that is capable of establishing persistence to breastfeed.Objective. This paper reports how a complex intervention was designed by applying the systems approach of the Attention,Relevance, Confidence, Satisfaction (ARCS) model of motivational design, as a means of theoretically addressing low maternalpersistence in the first three weeks of learning.Design. Following an introduction to the model, a stepwise account of the diagnostic, design and evaluation phases appliedwithin a suburban trust (3600 births annually) is reported. The diagnostic phase included nine structured observation studiesof routine educational environments (167 hours observing 130 women and 20 midwives over a three-month period) andmotivational profiling of 202 women who were learning to breastfeed in the early weeks using the Breastfeeding MotivationalInstructional Measurement Scale. Diagnostic results identified a direct theoretical relationship between routine antenataleducation and the lack of maternal goals and postnatal motivation to persist. The design phase reports how the motivationaldeficits mapped in the diagnostic phase were resolved through the application of theoretical motivational tactics and redesignedbreastfeeding education. Evaluation phase summarises the findings from a feasibility trial (ISRCTN47056748) confirming ashypothesised. Following motivational enhancement of breastfeeding education, there was a significant increase (p<0:05) forfirst-time mothers’ confidence in their ability to breastfeed (t=4.81; df=89.22; p<0.001) and in their perceived relevancy ofthe goal-structuring provided (t=7.21; df=80.39; p<0.001). A significant increase in persistent breastfeeding at three weekspostnatal was also noted (χ2 =16.26; df=1; p<0.001).Conclusion. This paper contributes to our understanding of the value of theoretically and systematically designed complexinterventions; the ARCS model offers health educators a robust approach to designing and implementing relevant and effectivehealth education, therefore connecting the effects of health education with the causal links of ‘what works’ and ‘for whom’.

Item Type:Journal article
Keywords:ARCS model, breastfeeding, complex intervention, goals, motivation, theory, evidence-based midwifery
Faculties and Schools:Faculty of Life and Health Sciences > School of Nursing
Faculty of Life and Health Sciences
Research Institutes and Groups:Institute of Nursing and Health Research
Institute of Nursing and Health Research > Managing Chronic Illness Research Centre
Institute of Nursing and Health Research > Centre for Maternal, Fetal and Infant Research
ID Code:29461
Deposited By: Professor Marlene Sinclair
Deposited On:13 May 2014 08:49
Last Modified:13 May 2014 08:49

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