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Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Clinical Trial

Effect of a Training Intervention Based on the Theory of Planned Behavior on the Pregnancy Intention in Women with One Child: A Training Trial

Author(s): Masoumeh Farshid Moghadam, Mahboobeh Khorsandi*, Zohreh Khalajinia, Maryam Zamanian and Jane Elizabeth Klobas

Volume 20, Issue 2, 2024

Published on: 28 March, 2023

Article ID: e010323214196 Pages: 9

DOI: 10.2174/1573404820666230301105341

Price: $65

Abstract

Background: Having an only child has positive and negative consequences for the health of the child, mother, and family. However, when one-child families become the norm, the risks of negative long-term impacts increase. In Iran, couples now prefer to have one child. This paper reports on an investigation into the effectiveness of training based on the theory of planned behavior (TPB) on the pregnancy intention in women with one child.

Methods: The trial was conducted in 2019 with 102 women with one child, who was supported by the Health Centers in Qom, Iran. They were randomly divided into two groups: TPB theory-based training (n = 52) and control (routine healthcare training, n = 50) groups. ANCOVA was used to compare the groups' post-training pregnancy intention and its theoretical antecedents.

Results: Three months post-training, participants in the TPB group had higher pregnancy intention (η2 = .4, P<0.001), attitude to having a second child (η2 = .41, P<0.001), subjective (perceived) norm for having a second child (η2 = .08, P<0.004), and perceived control for having a second child (η2 = .35, P<0.001). The TPB-based training intervention increased women's awareness of the consequences of having an only child significantly more than routine training (P<0.001).

Conclusion: Health center training can increase women's intention to have a second child. In this trial, theory-based training resulted in stronger pregnancy intention than participation in routine training. As health centers in Iran update their programs, this trial highlights the value of course design based on established theory.

Keywords: ANCOVA, pregnancy intention, health training, theory of planned behavior (TPB), post-training pregnancy, theoretical antecedents.

Graphical Abstract
[1]
Firouzbakht, M.; Tirgar, A.; Hajian-Tilaki, K.; Bakouei, F.; Riahi, M.E.; Nikpour, M. Social capital and fertility behaviors: A cross-sectional study in Iranian women health care workers. BMC Womens Health, 2020, 20(1), 83.
[http://dx.doi.org/10.1186/s12905-020-00943-5] [PMID: 32345294]
[2]
Ghotbizadeh, F.; Kaviani, Z.; Shariat, M.; Farrokhzad, N.; Mohammadzadeh, Y.; Sahebi, L. Evaluation of demographic and clinical factors on fertility style in Iran-a review study. Depiction Health., 2019, 10(4), 319-329.
[3]
Baezzat, F.; Ahmadi Ghozlojeh, A.; Marzbani, Y.; Karimi, A.; Azarnioshan, B. A study of psychometric properties of Persian version of attitudes toward fertility and childbearing scale. Nurs. Midwifery J., 2017, 15(1), 37-47.
[4]
Hosseini-Chavoshi, M.; Abbasi-Shavazi, M.J.; McDonald, P. Fertility, marriage, and family planning in Iran: Implications for future policy. Populat. Horizons, 2016, 13(1), 31-40.
[http://dx.doi.org/10.1515/pophzn-2016-0005]
[5]
Baki-Hashemi, S.; Kariman, N.; Ghanbari, S.; Pourhoseingholi, M-A.; Moradi, M. Factors affecting the decline in childbearing in Iran: A systematic review. Adv. Nurs. Midwifery., 2018, 27(4), 11-19.
[6]
Song, Y.P.; Han, X.; Zhang, J.W. Analysis of the situation of school bullying and related factors in junior high school students in China 2016. Chin. J. Prev. Med, 2019, 53(10), 1032-1037.
[PMID: 31607051]
[7]
Liu, N.; Chen, Y.; Yang, X.; Hu, Y. Do demographic characteristics make differences? Demographic characteristics as moderators in the associations between only child status and cognitive/non-cognitive outcomes in China. Front. Psychol., 2017, 8, 423.
[http://dx.doi.org/10.3389/fpsyg.2017.00423] [PMID: 28421006]
[8]
Wang, M.T.; Degol, J.L.; Henry, D.A. An integrative development-in-sociocultural-context model for children’s engagement in learning. Am. Psychol., 2019, 74(9), 1086-1102.
[http://dx.doi.org/10.1037/amp0000522] [PMID: 31829690]
[9]
Rasmussen, Avery "The perceived mental health effects of China’s one-child policy", (2017). Independent Study Project (ISP) Collection. 2735. Available from: https://digitalcollections.sit.edu/isp_collection/2735
[10]
Gui, T.; Koropeckyj-Cox, T. “I am the only child of my parents:” perspectives on future elder care for parents among Chinese only-children living overseas. J. Cross Cult. Gerontol., 2016, 31(3), 255-275.
[http://dx.doi.org/10.1007/s10823-016-9295-z] [PMID: 27236539]
[11]
Yang, J.; Hou, X.; Wei, D.; Wang, K.; Li, Y.; Qiu, J. Only-child and non-only-child exhibit differences in creativity and agreeableness: Evidence from behavioral and anatomical structural studies. Brain Imaging Behav., 2017, 11(2), 493-502.
[http://dx.doi.org/10.1007/s11682-016-9530-9] [PMID: 26956710]
[12]
Li, M.; Xue, H.; Wang, W.; Wen, M.; Wang, Y. Increased obesity risks for being an only child in China: Findings from a nationally representative study of 19,487 children. Public Health, 2017, 153, 44-51.
[http://dx.doi.org/10.1016/j.puhe.2017.07.002] [PMID: 28843799]
[13]
Chu, J.J.; Khan, M.H.; Jahn, H.J.; Kraemer, A. Only-child status in relation to perceived stress and studying-related life satisfaction among university students in China: A comparison with international students. PLoS One, 2015, 10(12), e0144947.
[http://dx.doi.org/10.1371/journal.pone.0144947] [PMID: 26675032]
[14]
Wang, N.; Hu, Q. “It is not simply the loss of a child”: The challenges facing parents who have lost their only child in post-reproductive age in China. Death Stud., 2021, 45(3), 209-218.
[http://dx.doi.org/10.1080/07481187.2019.1626941] [PMID: 31190628]
[15]
Zeng, Y.; Hesketh, T. The effects of China’s universal two-child policy. Lancet, 2016, 388(10054), 1930-1938.
[http://dx.doi.org/10.1016/S0140-6736(16)31405-2] [PMID: 27751400]
[16]
Moeeni, M.; Pourreza, A.; Torabi, F.; Heydari, H.; Mahmoudi, M. Analysis of economic determinants of fertility in Iran: A multilevel approach. Int. J. Health Policy Manag., 2014, 3(3), 135-144.
[http://dx.doi.org/10.15171/ijhpm.2014.78] [PMID: 25197678]
[17]
Lotfi, R.; Rajabi Naeeni, M.R.N.; Rezaei, N.; Farid, M.; Tizvir, A. Desired numbers of children, fertility preferences and related factors among couples who referred to pre-marriage counseling in Alborz province. Iran. Int. J. Fertil. Steril., 2017, 11(3), 211-219.
[PMID: 28868844]
[18]
Liefbroer, AC.; Klobas, JE.; Philipov, D.; Ajzen, I. Reproductive decision-making in a macro-micro perspective: A conceptual framework.Reproductive decision-making in a macro-micro perspective; Philipov, D,; Liefbroer, AC; Klobas, JE, Eds.; Springer Netherlands: Dordrecht, 2015, pp. 1-15.
[19]
Liefbroer, A.C.; Klobas, J.E.; Philipov, D.; Ajzen, I. Reproductive decision-making in a macro-micro perspective: A conceptual framework; Springer: Dordrecht, 2015.
[http://dx.doi.org/10.1007/978-94-017-9401-5_1]
[20]
Akbarian Moghaddam, Y.; Moradi, M.; Vahedian Shahroodi, M.; Ghavami, V. Effectiveness of the education based on the theory of planned behavior on childbearing intention in single-child women. J. Holistic Nurs. Midwifery, 2021, 31(2), 135-145.
[http://dx.doi.org/10.32598/jhnm.31.2.2135]
[21]
Wang, S.; Xu, H.; Zhang, S.; Wan, Y.; Tao, F. Mediating effects of self-esteem in the relationship between childhood maltreatment and non-suicidal self-injury among adolescents: The roles of sex and only-child status. Soc. Sci. Med., 2020, 249, 112847.
[http://dx.doi.org/10.1016/j.socscimed.2020.112847] [PMID: 32086153]
[22]
Xu, H.; Song, X.; Wang, S.; Zhang, S.; Xu, S.; Wan, Y. Mediating effect of social support in the relationship between childhood abuse and non-suicidal self-injury among Chinese undergraduates: The role of only-child status. Int. J. Environ. Res. Public Health, 2019, 16(20), 4023.
[http://dx.doi.org/10.3390/ijerph16204023] [PMID: 31640165]
[23]
Seyed Mohammad Mehdi, H.; Shohreh, E.; Mehdi, K. Models and theories of health education and health promotion in physical activity interventions for women: A systematic review. J. Education Community Health, 2014, 1(2), 67-84.
[http://dx.doi.org/10.20286/jech-010267]
[24]
Montano, D.E.; Kasprzyk, D. Theory of reasoned action, theory of planned behavior, and the integrated behavioral model.Health behavior: Theory, research, and practice; Glanz, K.; Rimer, B.K.; Viswanath, K.V., Eds.; Jossey-Bass/Wiley, 2015, pp. 95-124.
[25]
Klobas, J. The theory of planned behaviour as a model of reasoning about fertility decisions. Vienna Yearb. Popul. Res., 2012, 9, 47-54.
[http://dx.doi.org/10.1553/populationyearbook2011s47]
[26]
Ajzen, I. The theory of planned behaviour: Reactions and reflections; Taylor & Francis, 2011, pp. 1113-1127.
[27]
Mencarini, L.; Vignoli, D.; Gottard, A. Fertility intentions and outcomes. Adv. Life Course Res., 2015, 23, 14-28.
[http://dx.doi.org/10.1016/j.alcr.2014.12.004] [PMID: 26047838]
[28]
Aizen, I.; Klobas, J. Fertility intentions. Demogr. Res., 2013, 29, 203-232.
[http://dx.doi.org/10.4054/DemRes.2013.29.8]
[29]
Klobas, J. Social psychological influences on fertility intentions: A study of eight countries in different social, economic and policy contexts; Bocconi University. Carlo F; Dondena Centre for Research on Social Dynamics: Vienna, Austria/Milan, Italy, 2010.
[30]
Kariman, N; Simbar, M; Ahmadi, F. The idea of two strains, resulting in a womans childbearing decisions. 2001, 1(1), 65-76.
[31]
Sharma, M. Theoretical foundations of health education and health promotion, 3rd ed; Jones and Bartlett: Sudbury, MA, USA, 2017.
[32]
Safari, M.; Shojaeizadeh, D. Theories Models and methods of health education and promotion; Asar-E Sobhan Publishing: Iran, 2009, pp. 22-24.
[33]
Li, X.; Fan, Y.; Assanangkornchai, S.; McNeil, E.B. Application of the theory of planned behavior to couples’ fertility decision-making in inner Mongolia, China. PLoS One, 2019, 14(8), e0221526.
[http://dx.doi.org/10.1371/journal.pone.0221526] [PMID: 31442271]
[34]
Sarayloo, K.; Moghadam, Z.B.; Saffari, M.; Esmaily, H.; Najmabadi, K.M. The effect of educational program based on theory of planned behavior on health promotion and childbearing of minor thalassemia couples. J. Educ. Health Promot., 2019, 8, 200.
[PMID: 31807590]
[35]
Caplescu, R. Using the theory of planned behaviour to study fertility intentions in Romania. Procedia Econ. Finance, 2014, 10, 125-133.
[http://dx.doi.org/10.1016/S2212-5671(14)00285-8]
[36]
Mirmohammadi, M.; Ghaznavian, L.; Rezaei, M.; Karimi, Z.; Ghaznavian, M.; Saghafipoor, A. The effects of pre-marriage education on their reproductive health among couples participating in marriage classes of Qom, 2016. Quarterly J. Health Breeze., 2016, 5(1), 7-17.
[37]
Erfani, A. Low fertility intention in Tehran, Iran: The role of attitudes, norms and perceived behavioural control. J. Biosoc. Sci., 2017, 49(3), 292-308.
[http://dx.doi.org/10.1017/S0021932016000109] [PMID: 27086667]
[38]
Ansari Majd, M.; Khalajabadi Farahani, F.; Naghibi, A.; Moosazadeh, M.; Khani, S. Effect of transtheoretical model-based education on women attitudes and stages of change toward childbearing behavior. J. Mazandaran Univ. Med. Sci., 2019, 29(174), 134-147.
[39]
Kariman, N.; Hashemi, S.B.; Ghanbari, S.; Pourhoseingholi, M.; Alimoradi, Z.; Fakari, F. The effect of an educational intervention based on the theory of planned behavior on childbearing intentions in women: A quasi-experimental study. J. Educ. Health Promot., 2020, 9(1), 96.
[http://dx.doi.org/10.4103/jehp.jehp_2_20] [PMID: 32509904]
[40]
Billari, F.C.; Philipov, D.; Testa, M.R. Attitudes, norms and perceived behavioural control: explaining fertilityintentions in Bulgaria. Eur. J. Popul., / Revue européenne de Démographie, 2009, 25(4), 439-465.
[http://dx.doi.org/10.1007/s10680-009-9187-9]
[41]
Shahraki, Z.; Shahraki, T.; Badakhsh, M.; Saravani, K.; Shahraki, G.; Abdollahi Mohammad, A. The effect of prenatal preparation classes on the choice of the delivery method. Tehran Univer. Medic. J. TUMS Publicat., 2020, 78(7), 455-460.
[42]
Roudsari, R.L.; Khadivzadeh, T.; Bahrami, M. A grounded theory approach to understand the process of decision making on fertility control methods in urban society of Mashhad, Iran. Iran. J. Nurs. Midwifery Res., 2013, 18(5), 408-415.
[PMID: 24403945]
[43]
Choromzadeh, R.; Akhound, M.R.; Rasekh, A. Factors affecting women’s birth intervals: The case of women referred to health centers in Ahwaz. J. Hayat, 2015, 20(4), 35-50.
[44]
Dommermuth, L.; Klobas, J.; Lappegård, T. Now or later? The theory of planned behavior and timing of fertility intentions. Adv. Life Course Res., 2011, 16(1), 42-53.
[45]
Ciritel, A.A.; De Rose, A.; Arezzo, M.F. Childbearing intentions in a low fertility context: The case of Romania. Genus, 2019, 75(1), 4.
[http://dx.doi.org/10.1186/s41118-018-0046-6] [PMID: 30930473]
[46]
Khani Jeihooni, A.; Layeghiasl, M.; Yari, A.; Rakhshani, T. The effect of educational intervention based on the theory of planned behavior on improving physical and nutrition status of obese and overweight women. BMC Womens Health, 2022, 22(1), 13.
[http://dx.doi.org/10.1186/s12905-022-01593-5] [PMID: 35033045]

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