Pregnant women and their fetus belong to a sensitive group in response to air pollution hazards. The aim of this study was to evaluate the effectiveness of a theory-based educational program to change pollution exposure behavior in pregnant women.
In this randomized controlled trial, pregnant women attending a prenatal clinic in Tehran, Iran were selected and randomized into the experimental and control groups. The inclusion criteria were age between 18 and 35 years, having a history of pregnancies without adverse outcomes and not suffering from chronic diseases. Data collected at baseline and 2-month follow-up. At baseline face-to-face interviews were conducted using a valid and reliable questionnaire including items on demographic characteristics, stages of change, self-efficacy, decisional balance and practice regarding air pollution preventive behaviors. The intervention composed of three parts: motivational interviewing, a booklet and daily small message service (SMS). The control group received no intervention except receiving usual care. Follow-up data were collected after the intervention. Data were analyzed performing t-test, Mann–Whitney U test, and chi-squared.
In all the data for 104 pregnant women (53 in the intervention and 51 in the control group) were analyzed. The mean age of participants was 27.2 (SD = 4.11) years and it was 22.89 (SD = 8.75) weeks for gestational age. At baseline there were no significant statistical differences between intervention and control groups on the study measures while we found significant group differences in terms of stages of change, self-efficacy, perceived benefits and practice regarding air pollution preventive behaviors at follow-up assessment (P < 0.05).
The findings indicated that the TTM-based intervention was effective in increasing air pollution preventive behaviors among pregnant women. This study provided a framework to modify some psychosocial determinants of air pollution preventive behavior other than knowledge using constructs of Transtheoretical model of behavior change, additionally results suggests the importance of education and makes enlightenment of the air pollution risk knowledge accelerate.
Li Z, Bian X, Yin J. The Effect of Air Pollution on the Occurrence of Nonspecific Conjunctivitis. J Ophthalmol. 2016;2016:3628762.
Moore E, Chatzidiakou L, Kuku MO, Jones RL, Smeeth L, Beevers S, et al. Global Associations between Air Pollutants and Chronic Obstructive Pulmonary Disease Hospitalizations: A Systematic Review. Annals of the American Thoracic Society. 2016.
Michikawa T, Morokuma S, Yamazaki S, Fukushima K, Kato K, Nitta H. Exposure to air pollutants during the early weeks of pregnancy, and placenta praevia and placenta accreta in the western part of Japan. Environment international. 2016;92–93:464–70.
Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. Williams Obstetrics. 23rd edition. New York: McGraw Hill, Medical; 2010. p. 872.
Araban M, Kariman N, Tavafian S, Motesaddi S, Alavimajd H, Shokravi FA. Air pollution and low birth weight: a historical cohort study from Tehran. 2012. East Mediterr Health J. 2012;18(6):556–60. PubMed
Araban M, Tavafian SS, Zarandi SM, Hidarnia AR, Gohari MR, Prochaska JM, et al. Introducing a new measure for assessing self-efficacy in response to air pollution hazards for pregnant women. J Environ Health Sci Eng. 2013;11(1):1. CrossRef
Mansfield C, Johnson FR, Van Houtven G. The missing piece: Valuing averting behavior for children’s ozone exposures. Resour Energy Econ. 2006;28(3):215–28. CrossRef
Ghaffarifar S, Ghofranipour F, Ahmadi F, Khoshbaten M. Why Educators Should Apply Theories and Models of Health Education and Health Promotion to Teach Communication Skills to Nursing and Medical Students. Nursing and midwifery studies. 2015;4(4):1–2.
Prochaska JO, Redding CA, Harlow LL, Rossi JS, Velicer WF. The transtheoretical model of change and HIV prevention: A review. Health Educ Behav. 1994;21(4):471–86. CrossRef
Glanz K, Rimer BK, Viswanath K. Health Behavior: Theory, Research, and Practice. New Jersey: Wiley; 2015. p. 600.
Araban M, Tavafian S, Motesaddi S, Hidarnia A, Mahmoodreza G, Laloie A, et al. Effectiveness of a motivational interviewing session to enhance self-efficacy of pregnant women in response to air pollution preventive behavior: a randomized control trial. J Iran Insti Health Sci. 2013;15(4):8.
Aveyard P, Lawrence T, Cheng K, Griffin C, Croghan E, Johnson C. A randomized controlled trial of smoking cessation for pregnant women to test the effect of a transtheoretical model‐based intervention on movement in stage and interaction with baseline stage. Br J Health Psychol. 2006;11(2):263–78. CrossRefPubMed
Salehi L, Mohammad K, Montazeri A. Fruit and vegetables intake among elderly Iranians: a theory-based interventional study using the five-a-day program. Nutr J. 2011;10(1):1. CrossRef
Araban M, Tavafian SS, Hidarnia AR, Motesaddi S, Montazei A. Air pollultion prevantive behavior among pregnant women: a theory based study Journal of the Iranian Institute for Health Sciences Research. 2014;12(4):7.
Araban M, Baharzadeh K, Karimy M. Nutrition modification aimed at enhancing dietary iron and folic acid intake: an application of health belief model in practice. Eur. J. of Public Health. [In press].
- A behavioral strategy to minimize air pollution exposure in pregnant women: a randomized controlled trial
Sedigheh Sadat Tavafian
Saeed Motesaddi Zarandi
Ali Reza Hidarnia
- BioMed Central