School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
PLoS One. 2020 May 26;15(5):e0233429. doi: 10.1371/journal.pone.0233429. eCollection 2020.
In Ethiopia, although nutrition education has been given during pregnancy, most women have inadequate nutrient intakes. As a result, the prevalence of malnutrition is high during pregnancy. In this study, we set out to evaluate the effect of guided counseling based on the health belief model and the theory of planned behavior on the dietary practices of pregnant women.
A two-arm parallel cluster randomized controlled community trial was carried out among pregnant women in West, Gojjam Zone, Ethiopia from May 1, 2018, to April 30, 2019. A total of 346 and 348 pregnant women were recruited from the intervention and control clusters, respectively. Of which endline data were collected from 313 and 332 pregnant women in the intervention and control groups, respectively. Each woman in the intervention group attended four counseling sessions. Women in the control group attended the routine nutrition education given by the health care system. Data were collected using a structured questionnaire. McNemar test and Generalized Estimating Equations were used to evaluate the intervention effect.
The average difference of appropriate dietary practice between the two groups was 30.7%. After controlling for the possible confounders, women in the intervention group had 7.2 times [AOR = 7.187, 95% CI: (4.49, 11.49)] higher odds of having appropriate dietary practices compared with the control group. Dietary diversity and meal frequency of counseled women were 7 [AOR = 6.994, 95% CI: (4.59, 10.66)] and 8 [AOR = 8.146, 95% CI: (5.377, 12.341)] times higher than dietary diversity and meal frequency of women in the control group, respectively.
Counseling based on the health belief model and the theory of planned behavior is an effective approach in increasing the proportion of women who had appropriate dietary practices. Thus, these findings suggest the need for employing trimester based counseling using the HBM and the TPB to improve the dietary practices of pregnant women.
The trial was registered in Clinical Trials.gov (NCT03627156).
在埃塞俄比亚，尽管在怀孕期间已经进行了营养教育，但大多数妇女的营养摄入量仍然不足。因此，怀孕期间营养不良的患病率很高。在这项研究中，我们旨在评估基于健康信念模型和计划行为理论的指导咨询对孕妇饮食行为的影响。
这是一项在埃塞俄比亚西部戈贾姆地区的社区进行的、基于双臂平行集群随机对照的临床试验，于 2018 年 5 月 1 日至 2019 年 4 月 30 日期间开展。干预组和对照组各招募了 346 名和 348 名孕妇。其中，干预组和对照组分别有 313 名和 332 名孕妇完成了最终的数据分析。干预组中的每位女性参加了四次咨询会议。对照组的女性则参加了由医疗保健系统提供的常规营养教育。使用结构化问卷收集数据。采用 McNemar 检验和广义估计方程来评估干预效果。
两组之间适当饮食实践的平均差异为 30.7%。在控制了可能的混杂因素后，与对照组相比，干预组的女性有 7.2 倍的可能性（AOR=7.187，95%CI：4.49，11.49）采取适当的饮食行为。接受咨询的女性的饮食多样性和用餐频率分别是对照组女性的 7 倍（AOR=6.994，95%CI：4.59，10.66）和 8 倍（AOR=8.146，95%CI：5.377，12.341）。
基于健康信念模型和计划行为理论的咨询是提高适当饮食行为比例的有效方法。因此，这些发现表明需要采用基于 HBM 和 TPB 的基于孕期的咨询来改善孕妇的饮食行为。
该试验在 ClinicalTrials.gov 注册（NCT03627156）。
