The Effect of Educational Intervention based on Pender’s Health Promotion Model on Calcium Consumption among Pregnant Women

Abstract

Background and objective: The consumption of calcium-rich foods among pregnant women has always been one of the challenging issues of the health care system. The present study aimed to evaluate the effect of educational intervention based on Pender’s HPM on the calcium intake of pregnant women. Materials and method: The pregnant women at three to five months were recruited using convenient sampling method and randomly assigned either to the control (n=37) or intervention (n=36) groups referred to the health centers in Kermanshah, Iran in 2019, 2020. Interventions were implemented based on the structures of Pender’s HPM with three assessments at baseline, immediately after the intervention, and after a one-month follow-up. The food frequency questionnaire was completed before and after the intervention. Data were analyzed in SPSS software version 25. Results: There is no significant difference between the intervention and control groups at baseline (P<0.05). According to the independent sample t-test, all constructs of the Pender’s HPM except for interpersonal influences were significantly improved in the intervention rather than control groups (P>0.05). The repeated measure ANOVA demonstrated a significant difference in the effect of the intervention on the constructs of the knowledge (F=9.40; P-value=0.001), perceived benefits (F=17.24 ; P-value=0.001), perceived barriers (F=40.80 ; P-value=0.001), perceived self-efficacy (F=10.90; P-value=0.001), activity-related affect (F= 14.85; P-value=0.001), interpersonal influences (F=21.51 ; P-value=0.001), commitment to a plan of action (F=20.20 ; P-value=0.001), and immediate competing demands and preferences (F=9.4; P-value=0.001) between the intervention and control groups. However, a significant difference was not observed in the construct of situational influences (F=1.20; P-value=0.296). The ANOVA demonstrated that the calcium consumption significantly increased in the intervention group (P<0.001). Conclusion: Educational intervention based on the HPMchanged the nutritional behavior of calcium-rich food consumption among pregnant women. The use of Pender's HPM is recommended to improve nutritional behaviors. A theory-based educational intervention in the health care system can fill the gap in the successful implementation of nutrition education programs.