A Randomized Controlled Trial of a Theory-Based Health Education on Prevention of Elective Cesareans in Iran

Aims: The high prevalence of Cesarean section (CS) is a global health concern globally, especially in Iran. The current study aimed to evaluate the effect of a Theory of Planned Behavior (TPB) based educational intervention on preventing elective cesareans. Materials & Methods: An interventional study (NCT۰۲۹۲۹۸۷۵) was conducted on a sample of ۱۰۰ nulliparous pregnant women attending health care centers in Kermanshah, Iran, ۲۰۱۶. Women were randomly selected and assigned into either intervention or control groups on a ۱:۱ basis. The intervention group received a theory-based (Theory of Planned Behavior) health education intervention, while the control group received only standard care. A questionnaire containing items on TPB constructs, including attitude, subjective norms, perceived behavioral control, and intention, was used to collect baseline and ۱-month follow-up assessments. Each woman also received a phone call after childbirth to record their delivery method. Data were analyzed using SPSS version ۱۵ at a significance level of p<۰.۰۵. The paired t-test, the independent t-test, the chi-square, and ANCOVA were used for data analysis. Findings: The results revealed significant differences in scores of attitude, subjective norms, perceived behavioral control, and behavioral intention in the intervention group before and after the intervention (p<۰.۰۵). Additionally, the intervention group chose elective cesarean less than the control group (p<۰.۰۵). The risk of having an elective cesarean section in the intervention group was about one-fifth of the control group (RR= ۰.۲۱; CI=۰.۴۱۹۷ to ۰.۰۰۱۸). Conclusion: According to this randomized control trial results, the TPB-based education improved the TPB constructs and NVD rates by providing education to women and their close friends or relatives during pregnancy.

Keywords:

Health Behavior , Health Education , Natural Childbirth , Cesarean Section