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 (NCT02929875) was conducted on a sample of 100 nulliparous pregnant women attending health care centers in Kermanshah, Iran, 2016. Women were randomly selected and assigned into either intervention or control groups on a 1:1 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 1-month follow-up assessments. Each woman also received a phone call after childbirth to record their delivery method. Data were analyzed using SPSS version 15 at a significance level of p<0.05. 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<0.05). Additionally, the intervention group chose elective cesarean less than the control group (p<0.05). The risk of having an elective cesarean section in the intervention group was about one-fifth of the control group (RR= 0.21; CI=0.4197 to 0.0018).
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.