Application of the Information–Knowledge–Attitude–Practice Model in Breastfeeding Management for Pregnant Women with High Hepatitis B Virus Load

Ping Yang,1,* Si Chen,2,* Qiuyun Li,1 Yuzhen Zhang,1 Changjie Li,1 Wenjuan Xu,1 Haihua Yu,1 Lili Zhang21Department of Obstetrics and Gynecology, Beijing You’an Hospital, Affiliated to Capital Medical University, Beijing, 100069, People’s Republic of China; 2Beijing You’an Hospital, Affiliated to Capital Medical University, Beijing, 100069, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lili Zhang, Beijing You’an Hospital, Affiliated to Capital Medical University, No. 8, Xizhoutiao, You’anmenwai, Fengtai District, Beijing, 100069, People’s Republic of China, Tel +86 13716162977, Email [email protected]: This study aimed to evaluate the effectiveness of the Information–Knowledge–Attitude–Practice (IKAP) model in breastfeeding management for pregnant women with high hepatitis B virus (HBV) DNA loads (≥ 2 × 105 IU/mL).Methods: A prospective quasi-experimental study enrolled 136 eligible women between January 2023 and October 2023. Based on compliance, 68 who received the full IKAP-based intervention were assigned to the experimental group, and 68 who received routine health education served as controls. The experimental group received systematic, individualised IKAP-model education from the second trimester through 12 months postpartum, progressing through information, knowledge, attitude and practice stages. The control group received routine education (eg, prenatal classes, outpatient consultations). Primary outcomes (exclusive breastfeeding rate and self-efficacy at 42 days postpartum) and neonatal HBV transmission blockade outcomes at 7– 8 months were compared.Results: The exclusive breastfeeding rate at 42 days was significantly higher in the intervention group (85.29%) than in the control group (67.65%) (absolute risk difference = 17.64%, relative risk = 1.26, p < 0.05). Postpartum breastfeeding self-efficacy scores were also significantly higher in the intervention group (38.2 ± 4. 1 vs 32.5 ± 5.3; mean difference = 5.7, p < 0.05). Neonatal breastfeeding initiation success was 100% in both groups (p > 0.05).Conclusion: The phased IKAP model demonstrated superior outcomes compared with conventional education, safely increasing exclusive breastfeeding rates by approximately 17% and enhancing feeding confidence in high-risk mothers. Despite limitations, such as a non-randomised, single-centre design, it provides an effective and scalable framework for real-world application in supporting this special population.Keywords: Hepatitis B virus, viral load, breastfeeding, patient education as topic