Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Chinaro Kennedy


Breastfeeding reduces morbidity and mortality among mothers and children, yet African-American women breastfeed at lower rates than women of other racial and ethnic groups do. Higher rates of overweight, obesity, and low socioeconomic status may be contributing factors in this population; however, limited research exists regarding the roles of maternal overweight and obesity on breastfeeding outcomes. The purpose of this study was to examine whether social support and self-efficacy positively influence breastfeeding outcomes among overweight and obese African American women. Self-efficacy and social support theories provided the theoretical framework for the study. Research questions examined whether (a) maternal overweight and obesity, social support, and self-efficacy were associated with breastfeeding initiation and duration among African-American women; and (b) self-efficacy mediated this association. The study design was a quantitative retrospective analysis of a subset of secondary data from the 2009-2011 Pregnancy Risk Assessment Monitoring System (n = 10,926). SPSS 21.0-® was used for analyses. Obesity was significantly associated with breastfeeding durations of 9-16 weeks and 17 or more weeks. Self-efficacy was significantly associated with breastfeeding initiation only. Social support was negatively associated with breastfeeding durations of 9-16 weeks among obese women. Positive social change implications include increased knowledge of the associations between overweight, obesity, social support, self-efficacy, and breastfeeding outcomes among African-American women. This knowledge could be used to inform the development of interventions to improve breastfeeding and weight related health outcomes.