Investigation of the Psycho-Social Factors Affecting the Adoption of a Healthy Nutrition Style in Women with a History of Gestational Diabetes Using Structural Equation Modeling

Abstract

Background and aims: Women with a history of gestational diabetes mellitus are the main high-risk group for type 2 diabetes; however, a healthy nutrition style can reduce the risk of developing diabetes in this group. The present study aimed to determine the psycho-social factors that affect the adoption of a healthy nutrition style in women with a history of gestational diabetes. Materials and Methods: This cross-sectional study was conducted based on the Health Action Process Approach (HAPA) in the west of Mazandaran province, Iran in 2019. A total of 165 women with a history of gestational diabetes in a recent pregnancy were selected using the convenience sampling method. The required data were collected using a demographic characteristic form, a healthy nutrition style questionnaire, and a researcher-made questionnaire based on HAPA model constructs. Moreover, structural equation modeling was used for data analysis. Results: Based on the results, the data were fit to the model (Tucker–Lewis index=0.924, comparative fit index=0.928, root mean square error of approximation=0.045, χ2/degrees of freedom=1.332). The model constructs predicted 23% and 51% of intention variance and nutrition style variance, respectively. Action self-efficacy and risk perception were the most important predictors of intention. In addition, planning and recovery self-efficacy significantly predicted a healthy nutrition style. Conclusion: As the first step, using the HAPA for the prediction of the nutrition style of women with a history of gestational diabetes was confirmed. Therefore, this model can be used to design educational interventions to prevent diabetes.