Pormehr-Yabandeh Asiyeh, Aghamolaei Teamur, Hosseini Zahra, Roozbeh Nasibeh, Ghanbarnezhad Amin
Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
BMC Pregnancy Childbirth. 2025 Sep 2;25(1):922. doi: 10.1186/s12884-025-08070-5.
Pre-conception care (PCC) in mothers with sickle cell disease (SCD) is essential to reduce the risk of morbidity and mortality. PCC is not commonly utilized by women of reproductive age. The reason behind this should be assessed using health education theories. This study aims to apply the health belief model (HBM) to explain the adoption of PCC among SCD women.
A cross-sectional study was conducted in Iran from March 2021 to June 2021. Women with SCD were selected through a systematic sampling framework using the Iranian integrated health system. A demographic, knowledge, HBM, and PCC questionnaire were used as instruments. Pearson's correlation was used to investigate the relationship between HBM constructs and PCC. The effect of health beliefs on PCC was analyzed using a path model, in which the observed HBM variables predicted PCC behavior.
Out of 413 participants, 13 incomplete questionnaires were excluded (Response rate 96.8%). A significant association was observed between women's and husbands' education with the PCC adoption. Pearson correlation test revealed a significant relationship between PCC and HBM constructs; with positive and significant correlation coefficients of 0.651 and 0.599, self-efficacy and perceived susceptibility had the highest correlation with the PCC. Based on the path model analysis, perceived susceptibility (0.26) and self-efficacy (0.36) substantially influenced adopting PCC. The fit indices of this model were acceptable (GFI = 0.98, AGFI = 0.95, CFI = 0.99, and RMSEA = 0.04).
Knowledge, perceived susceptibility, and self-efficacy are the most important determinants of performing PCC. Knowing PCC's most influential and decisive components will help us plan educational content and effective interventions.
镰状细胞病（SCD）母亲的孕前保健（PCC）对于降低发病和死亡风险至关重要。育龄妇女通常未采用PCC。应使用健康教育理论评估其背后的原因。本研究旨在应用健康信念模型（HBM）来解释SCD女性采用PCC的情况。
2021年3月至2021年6月在伊朗进行了一项横断面研究。通过使用伊朗综合卫生系统的系统抽样框架选择患有SCD的妇女。使用人口统计学、知识、HBM和PCC问卷作为工具。采用Pearson相关性分析来研究HBM结构与PCC之间的关系。使用路径模型分析健康信念对PCC的影响，其中观察到的HBM变量预测PCC行为。
在413名参与者中，排除了13份不完整的问卷（回复率96.8%）。观察到女性和丈夫的教育程度与采用PCC之间存在显著关联。Pearson相关性检验显示PCC与HBM结构之间存在显著关系；自我效能感和感知易感性与PCC的相关系数分别为0.651和0.599，呈正相关且具有统计学意义，与PCC的相关性最高。基于路径模型分析，感知易感性（0.26）和自我效能感（0.36）对采用PCC有显著影响。该模型的拟合指数可接受（GFI = 0.98，AGFI = 0.95，CFI = 0.99，RMSEA = 0.04）。
知识、感知易感性和自我效能感是实施PCC的最重要决定因素。了解PCC最具影响力和决定性的组成部分将有助于我们规划教育内容和有效的干预措施。
