{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:46:02Z","timestamp":1791776762704,"version":"4.3.4"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Prenatal education is key to promoting breastfeeding. To address equity and access challenges, health care facilities are increasingly offering online prenatal education in addition to in\u2010person sessions. This study aimed to estimate the influence of online and group prenatal education services, used separately or together, on breastfeeding determinants (intentions, self\u2010efficacy) and outcomes (initiation, exclusivity) among nulliparous pregnant persons, compared with standard prenatal care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective cohort study was conducted from June 2018 to September 2020 in Qu\u00e9bec, Canada with 863 nulliparous pregnant persons from 2 adjacent regions. Prior to the COVID\u201019 pandemic, 358 participants completed questionnaires at 3 time points about their use of prenatal education services in which breastfeeding\u2010related content was optional. Based on their self\u2010reported use, participants were divided into 5 categories: (1) face\u2010to\u2010face group prenatal education, (2) asynchronous online prenatal education, (3) both (with breastfeeding), (4) either group\/online\/both (opted out of breastfeeding content), and (5) standard prenatal care only. Repeated\u2010measures analysis of variance, generalized linear mixed models, mixed\u2010effects logistic regression, \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      , and Fisher's exact test were conducted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 53.3% of participants chose the prenatal education services with breastfeeding information. When compared with standard prenatal care only, exposure to breastfeeding information from the online option alone or from both services was associated with breastfeeding intentions and initiation. No prenatal education services were associated with self\u2010efficacy or exclusivity; however, higher prenatal breastfeeding self\u2010efficacy predicted exclusivity 4 weeks after childbirth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Study findings highlight the complementary contribution of asynchronous online and in\u2010person group prenatal education services to breastfeeding, adding to the scant literature comparing these educational options. This can help health care providers, decision\u2010makers, and policy makers identify avenues to strengthen equity in the administration of breastfeeding education, thereby providing expectant persons with better strategies for choosing and maintaining breastfeeding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jmwh.70156","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:56:49Z","timestamp":1783493809000},"page":"771-781","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effectiveness of Online Versus Group Prenatal Education on Breastfeeding Determinants and Outcomes in Nulliparous Women: A Prospective Cohort Study"],"prefix":"10.1111","volume":"71","author":[{"given":"Marie\u2010Violaine","family":"Ponte","sequence":"first","affiliation":[{"name":"Centre de recherche du CHU de Qu\u00e9bec\u2013Universit\u00e9 Laval  Qu\u00e9bec Qu\u00e9bec 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