Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)

Graduate Group


First Advisor

Robert C. Hornik


This dissertation explores whether a mass media campaign, comprised of two television spots promoting exclusive breastfeeding (EBF), was successful in changing EBF behavior when implemented alone and when implemented in conjunction with other media materials, the training of service providers, and the establishment of a franchise network of infant and young child feeding counseling centers.

The data were collected at five waves in four provinces of Vietnam through a three-stage cluster sampling methodology for a total of 11,277 face-to-face interviews with mothers of infants under the age of six months. Although the same individuals were not interviewed over time, the same 118 communes were sampled at each wave. The core analyses explore the longitudinal effects of commune level exposure on commune level EBF.

Commune level EBF rates never differed significantly from baseline in mass media only communes. In franchise communes, however, EBF rates improved sharply (from 24% before to 55% after). Further longitudinal analyses indicate that communes that were going to be high in exposure after the campaign began experienced significantly greater overtime increases in EBF than communes that were going to be low in exposure.

Mediation analyses suggest that, in franchise communes, the mass media campaign had an effect by driving women to franchise centers to seek additional IYCF support and that appears to have had an effect on EBF behavior.

Moderation analyses suggest that exposure to the mass media campaign did not, for the most part, have differential effects on EBF behavior among mothers of younger infants compared to mothers of older infants, first-time mothers as compared to experienced mothers, and mothers with more versus less education.

From the studies that comprise this dissertation, we can conclude that: 1) Mass media alone, in the format of two 30-second spots, was not effective in changing EBF behavior in Vietnam; 2) Where other intervention strategies were implemented alongside mass media, the mass media campaign led to greater EBF behavior change; 3) In geographic areas where the intervention was comprised of multiple components, the mass media campaign had effects through a process of social diffusion.

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