Sahraei Mina, Kohan Shahnaz, Mohebbi-Dehnavi Zahra, AbdiShahshahani Mahshid
Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Educ Health Promot. 2024 Jul 5;13:183. doi: 10.4103/jehp.jehp_505_23. eCollection 2024.
In today's society, for many reasons, families have tended toward selective single-child upbringing. Single-child couples' decisions about continuing to have children depend on their attitudes about the consequences of having the next child, perceived norms about it, and perception of control over childbearing behavior. Therefore, this study was conducted with the aim of determining the effect of single-child couples' education based on the theory of planned behavior on their intention to have next child.
This study is a field trial that was conducted in 2022. Eight girls' and boys' primary schools in Golpayegan City, Isfahan Province, were randomly selected for sampling the intervention and control groups. Parents of 70 first-grade students who were single children were selected and placed in groups. 35 couples in the intervention group received education about parenting based on the constructs of the theory of planned behavior during 4-weekly sessions. The questionnaire for the evaluation of childbearing behavior intention was completed by the research samples before the intervention, immediately, and three months after the intervention. Data were analyzed using analysis of variance (ANOVA), independent-samples -test, and Mann-Whitney statistical tests.
Demographic and fertility characteristics were homogeneous in the intervention and control groups. The results showed that the changes in the average score of the attitude toward childbearing ( = 0.004), abstract norms ( = 0.001), perceived behavioral control ( = 0.01), behavioral intention ( = 0.003), and the overall score for the evaluation of childbearing behavior intention ( = 0.001) were significant in the intervention group. Comparing the intervention and control groups, the abstract norms immediately after the intervention ( = 0.002) and three months after the intervention ( = 0.002), behavioral intention immediately after the intervention ( = 0.006) and three months after the intervention ( = 0.009), and the overall score of the questionnaire to evaluate the intention to have children immediately after the intervention ( = 0.004) and three months after the intervention ( = 0.008) had significant differences. However, the two groups did not have significant differences in the dimensions of attitude toward having children and perceived behavioral control, immediately and 3 months after the intervention.
The results obtained from this study showed that parenting education based on the theory of planned behavior generally improved couples' intention to have children, abstract norms, and also the intention to have children later, but it had no effect on the attitude of couples toward having children and controlling their perceived behavior in having children. It seems that couples having only one child are rooted in environmental conditions, such as the economic and social status of society, rather than being under the control and desire of the couple. Therefore, other environmental conditions should also be taken into consideration in fertility promotion policies. Adaptation and implementation of theory of planned behavior (TPB)-based intervention by health policymakers and healthcare providers achieve a better understanding of childbearing.
在当今社会，由于多种原因，家庭倾向于选择生育独生子女。独生子女夫妇关于是否继续生育的决定取决于他们对生育下一胎后果的态度、对此的感知规范以及对生育行为的控制感。因此，本研究旨在基于计划行为理论确定独生子女夫妇的教育对其生育下一胎意愿的影响。
本研究是一项于2022年进行的现场试验。随机选择了伊斯法罕省戈尔帕耶甘市的八所男女小学，用于抽取干预组和对照组样本。选取了70名单独子女一年级学生的家长并分组。干预组的35对夫妇在为期四周的课程中接受了基于计划行为理论构建的育儿教育。生育行为意愿评估问卷由研究样本在干预前、干预后即刻以及干预后三个月完成。数据采用方差分析（ANOVA）、独立样本t检验和曼-惠特尼统计检验进行分析。
干预组和对照组的人口统计学和生育特征具有同质性。结果显示，干预组在生育态度平均得分（P = 0.004）、抽象规范（P = 0.001）、感知行为控制（P = 0.01）、行为意愿（P = 0.003）以及生育行为意愿评估总分（P = 0.001）方面的变化具有显著性。比较干预组和对照组，干预后即刻（P = 0.002）和干预后三个月（P = 0.002）的抽象规范、干预后即刻（P = 0.006）和干预后三个月（P = 0.009）的行为意愿以及干预后即刻（P = 0.004）和干预后三个月（P = 0.008）评估生育意愿问卷的总分存在显著差异。然而，干预后即刻和三个月时，两组在生育态度维度和感知行为控制方面没有显著差异。
本研究结果表明，基于计划行为理论的育儿教育总体上提高了夫妇的生育意愿、抽象规范以及随后的生育意愿，但对夫妇对生育的态度以及对生育行为的感知控制没有影响。似乎独生子女夫妇的情况受社会经济地位等环境条件影响，而非受夫妇自身控制和意愿左右。因此，在生育促进政策中也应考虑其他环境条件。卫生政策制定者和医疗服务提供者采用并实施基于计划行为理论（TPB）的干预措施，能更好地理解生育行为。
