Kamalikhah Tahereh, Rakhshani Fatemeh, Rahmati Najarkolaei Fatemeh, Gholian Avval Mehdi
Department of Health Education, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran.
School of Health, Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Iran Red Crescent Med J. 2015 Oct 13;17(10):e18895. doi: 10.5812/ircmj.18895. eCollection 2015 Oct.
It cannot be denied that many improvements in female and child health have been achieved worldwide through international family planning programs. More than half of the females (57%) with unintended pregnancy admitted that they had not used birth control the month before conception.
The aim of this study was to promote family planning practice among females of Zahedan (southeast of Iran) through the transtheoretical model (TTM).
The current quasi-experimental study was conducted on 96 eligible females, who were allocated either to the case or the control group and were selected from homes in the border of Zahedan city (southeast of Iran) during 2010. Convenience sampling by door-to-door visits was used for finding eligible cases. A TTM-based self-administrated family planning questionnaire was used for data collection. Participants in the intervention group received education in two groups, based on their stage of change: precontemplation, contemplation, preparation, action, maintenance, and all groups were followed for three months.
The result of the chi-square test did not show any significant difference in the stage of change: precontemplation, contemplation, preparation, action, maintenance before education between the control and intervention groups (P = 0.55). After education, subjects in the intervention group moved forward through stage of change and got at least one step closer to the family planning behavior., with this change being significant (P < 0.001), while the movement of participants through stage of change not being significant in control group (P = 1). The results of statistical tests illustrated that the mean knowledge of the intervention group was 7.5 ± 7.1 versus 0.5 ± 4 for the control group (P < 0.001), mean of attitude of the intervention group was 5.5 ± 5.41 versus 0.09 ± 2.04 for the control group (P < 0.001), and practicing family planning methods (P < 0.007) in the intervention group was higher than the control group after education based on TTM.
According to this study, the educational plan based on TTM was effective in changing knowledge, attitude, and practice and directing females towards taking action. Moreover, self-efficacy, perceived barriers and benefits are factors that affect the use of family planning methods.
不可否认，通过国际计划生育项目，全球在妇幼健康方面已取得诸多进步。超过半数意外怀孕的女性（57%）承认，她们在受孕前一个月未采取避孕措施。
本研究旨在通过跨理论模型（TTM）促进伊朗东南部扎黑丹女性的计划生育实践。
本项现况准实验研究选取了96名符合条件的女性，她们于2010年从扎黑丹市（伊朗东南部）边境的家庭中选出，并被分配至病例组或对照组。通过挨家挨户走访的便利抽样方式来寻找符合条件的病例。使用基于跨理论模型的计划生育自填问卷收集数据。干预组参与者根据其改变阶段分为两组接受教育：前意向阶段、意向阶段、准备阶段、行动阶段、维持阶段，所有组均随访三个月。
卡方检验结果显示，对照组与干预组在教育前的改变阶段（前意向阶段、意向阶段、准备阶段、行动阶段、维持阶段）无显著差异（P = 0.55）。教育后，干预组受试者在改变阶段向前推进，至少向计划生育行为迈进了一步，这一变化具有显著性（P < 0.001），而对照组参与者在改变阶段的进展不显著（P = 1）。统计检验结果表明，干预组的平均知识得分是7.5 ± 7.1，而对照组为0.5 ± 4（P < 0.001）；干预组的平均态度得分是5.5 ± 5.41，而对照组为0.09 ± 2.04（P < 0.001）；基于跨理论模型的教育后，干预组的计划生育方法实践情况（P < 0.007）高于对照组。
根据本研究，基于跨理论模型的教育计划在改变知识、态度和实践以及引导女性采取行动方面是有效的。此外，自我效能感、感知到的障碍和益处是影响计划生育方法使用的因素。
