Date of Completion

Spring 4-24-2023

Thesis Advisor(s)

Ruth Lucas

Honors Major



Maternal, Child Health and Neonatal Nursing | Medicine and Health Sciences | Nursing


Background: Becoming a parent is one of the most demanding and intense social roles individuals can experience in their life (Vance & Brandon, 2017). A lack of maternal confidence and understanding of how to interact with their infant during the first six months of life may adversely affect their lifelong relationship.

Objective: To examine maternal descriptions of text-linked educational modules on infant development and play and their effect on maternal self-efficacy at 6 and 24 weeks.

Method: This study was a mixed-method approach of interviews collected as part of a larger randomized control intervention for mothers to manage their breast and nipple pain during breastfeeding through text messages. Mothers received text-linked educational modules which described their infant’s cognitive, social, and emotional development and age-appropriate infant play activities at 4, 8, 12, 16, 20, and 24 weeks. Mothers were asked face-to-face interview questions to evaluate the modules and complete the Karitane Parenting Confidence Scale to measure maternal self-efficacy at 6 and 24 weeks. Boyatzis’ thematic analysis guided the analysis and Taguette was used to create a codebook of themes. Descriptive statistics were used for demographic variables. Themes were converted to numerical values for regression analysis.

Results: At 6 and 24 weeks postpartum, maternal report of monthly infant development and play modules were positive. The maternal self-efficacy scores increased slightly between 6 (M=40) and 24 (M=41.9) weeks. One overarching theme of maternal confidence was identified with three supporting subthemes: Parental Reflection, Parental Modeling, and Parental-Infant Interaction. Regression analysis showed a statistically significant relationship between time, parity, and interview responses (p=0.011). The subtheme of Parental-Infant Interaction, controlling for time and parity, was near significant in predicting maternal self-efficacy between 6 weeks and 24 weeks (p=0.051).

Conclusion: Mothers reported that the play modules encouraged maternal-infant interaction and increased their self-efficacy. Text-linked support is a powerful platform for accessible maternal intervention that can be implemented across a large population.