@2024 Afarand., IRAN
ISSN: 2383-2150 Journal of Education and Community Health 2015;1(4):11-21
ISSN: 2383-2150 Journal of Education and Community Health 2015;1(4):11-21
Using Social Cognitive Theory to Determine Factors Predicting Nutritional Be-haviors in Pregnant Women Visiting Health Centers in Tabriz, Iran
ARTICLE INFO
Article Type
Original ResearchAuthors
Jalili M. (1)Barati M. (2)
Bashirian S. (3*)
(1) Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
(2) Research Canter for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
(3*) Social Determinants of Health Research Canter, Hamadan University of Medical Sciences, Hamadan, Iran
Correspondence
Article History
Received: December 16, 2014Accepted: February 21, 2015
ePublished: June 22, 2015
ABSTRACT
Aims
Women’s nutrition during pregnancy is a key determinant of maternal and fetal health. Therefore, the current study used the social cognitive theory (SCT) to determine factors predicting the nutritional behaviors of pregnant women in Tabriz, Iran.
Materials & Methods This analytic study applied multistage random sampling to select 380 pregnant women who visited health centers in Tabriz during 2014. Data were collected using the Nutritional Behavior Questionnaire and a researcher-made questionnaire on the constructs of the SCT (knowledge, outcome expectations, outcome expectancies, self-efficacy, social support, and self-regulation). The questionnaires were completed through interviews and self-reports. Pearson’s correlation and liner regression analyses were performed to analyze the data in SPSS20.
Findings The participants’ mean age was 27 years. Among the different constructs of the SCT, outcome expectations (P=0.039), outcome expectancies (P=0.046), knowledge (P=0.043), and self-regulation (P=0.001) had significant roles in explaining the variance in nutritional behaviors of pregnant women. These factors could in fact predict 16% of the variance in nutritional behavior. Bread and cereals, meat and beans, fruits, and vegetables consumption were below the recommended level in 54.5%, 73.2%, and 55.3%, and 70.5% of the subjects, respectively.
Conclusion Based on our findings, knowledge, outcome expectations, outcome expectancies, and self-regulation can be used in the development of educational interventions to promote healthy nutri-tional behaviors in pregnant women.
Materials & Methods This analytic study applied multistage random sampling to select 380 pregnant women who visited health centers in Tabriz during 2014. Data were collected using the Nutritional Behavior Questionnaire and a researcher-made questionnaire on the constructs of the SCT (knowledge, outcome expectations, outcome expectancies, self-efficacy, social support, and self-regulation). The questionnaires were completed through interviews and self-reports. Pearson’s correlation and liner regression analyses were performed to analyze the data in SPSS20.
Findings The participants’ mean age was 27 years. Among the different constructs of the SCT, outcome expectations (P=0.039), outcome expectancies (P=0.046), knowledge (P=0.043), and self-regulation (P=0.001) had significant roles in explaining the variance in nutritional behaviors of pregnant women. These factors could in fact predict 16% of the variance in nutritional behavior. Bread and cereals, meat and beans, fruits, and vegetables consumption were below the recommended level in 54.5%, 73.2%, and 55.3%, and 70.5% of the subjects, respectively.
Conclusion Based on our findings, knowledge, outcome expectations, outcome expectancies, and self-regulation can be used in the development of educational interventions to promote healthy nutri-tional behaviors in pregnant women.
CITATION LINKS
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[15]Larson NI, Neumark-Sztainer DR, Wall MM, Eisenberg ME. Fast food intake: longitudinal trends during the transition to young adulthood and correlates of intake. J Adolesc Health.2008; 43(1):79-86.
[16]Mohammad-Alizadeh S, Kamali M, Ebrahimi Mamaghani M, Asghar Jafarabadi M, Omidi F. [Evaluation of the nutritional behavior of women in first trimester of pregnancy and its relationship with some socio-demographic characteristics of whom referred to health centers in Karaj]. Iranian Journal of Obstetrics Gynecology and Infertility.2012; 15(18):10-8. (Persian)
[17]Bojar I, Wdowiak L, Humeniuk E, Blaziak P. Change in the quality of diet during pregnancy in comparison with WHO and EU recommendations--environmental and sociodemographic conditions. Ann Agric Environ Med.2006; 13(2):281-6.
[18]Farahaninia M, Farahaninia S, Chamari M, Haghani H. [Nutritional pattern of pregnant women attending to health centers affiliated to Tehran university of medical sciences]. Iran Journal of Nursing.2013; 25(80):34-45. (Persian)
[19]Santiago SE, Park GH, Huffman KJ. Consumption habits of pregnant women and implications for developmental biology: a survey of predominantly Hispanic women in California. Nutr J.2013; 12:91.
[20]Fowles ER, Walker LO. Correlates of dietary quality and weight retention in postpartum women. J Community Health Nurs.2006; 23(3):183-97.
[21]Mohammadi M, Amir AliAkbari S, Mohammadi F, Estaki T, Alavi Majd H, Mirmiran P. [Weight Gain and Food Group Consumption Patterns in Pregnant Women of North and East Hospitals of Tehran]. Iranian Journal of Endocrinology and Metabolism.2011; 12(6):609-17. (Persian)
[22]Nakhaei M, Almasi-Hashyani A, Ebrahimzadehkor B. [The nutritional status of pregnant mothers referring to hospitals in Arak on the basis of anthropometric measurements and dietary intakes]. Arak Medical University Journal.2013; 16(4):54-61. (Persian)
[23]Kooshki A, Yaghoubifar MA, Rahnama Rahsepa F. [Comparison of energy and nutrient intakes in pregnant women in sabzevar with dietary reference intakes]. The Iranian Journal of Obstetrics, Gynecology and Infertility.2009; 12(1):49-53. (Persian)
[24]Cheng Y, J Dibley MJ, Zhang X, Zeng L, Yan H. Assessment of dietary intake among pregnant women in a rural area of western China. BMC Public Health.2009; 9:222.
[25]Swensen AR, Harnack LJ, Ross JA. Nutritional assessment of pregnant women enrolled in the special supplemental program for women, infants, and children (WIC). J Am Diet Assoc.2001; 101(8):903-8.
[26]Powers AR, Struempler BJ, Guarino A, Parmer SM. Effects of a nutrition education program on the dietary behavior and nutrition knowledge of second-grade and third-grade students. J Sch Health.2005; 75(4):129-33.
[27]Najimi A, Ghaffari M, Alidousti M. [Social cognitive correlates of fruit and vegetables consumption among students: a cross-sectional research]. Pajoohandeh.2012; 17(2):81-6. (Persian)
[28]Beiranvandpour N, Karimi-Shahanjarini A, Rezapur-Shahkolai F, Moghimbeigi A. [Factors affecting the consumption of fast foods among women based on the Social Cognitive Theory]. Journal of Education and Community Health.2014; 1)1(:19-26. (Persian)
[29]Fowles ER, Gabrielson M. First trimester predictors of diet and birth outcomes in low-income pregnant women. J Community Health Nurs.2005; 22(2):117-30.
[30]Rezaei AM, Esfandiari F. Investigate the relationship between attitudes and self-regulation of eating in obese and normal lifestyle. Journal of Women and Society.2010; 1(1):115.
[31]Ievers-Landis CE, Burant Ch, Drotar D, Morgan L, Trapl E, Kwoh K. Social support knowledge and self-efficacy as correlates of osteoporosis preventive behaviors among preadolescent females. J Pediatr Psychol.2003; 28(5):333-45.
[32]Baranowski T, Watson K, Missaghian M, Broadfoot A, Cullen K, Nicklas T, et al. Social support is a primary influence on home fruit, 100% juice, and vegetables availability. J Am Diet Assoc.2008; 108(7):1231-5.
[33]Baranowski T, Missaghian M, Broadfoot A, Watson K, Cullen K, Nicklas T, et al. Fruit and vegetables shopping practices and social support scales: a validation. J Nutr Educ Behav.2006; 38(6):340-51.
[34]Abedini Z, Ahmari Tehran H, Gaini M, Khoramirad A. [Dietary food intake of pregnant women based on food guide pyramid and its related factors]. Iranian Journal of Nursing.2011; 24(73):36-40. (Persian)
[35]Guillaumie L, Godin G, Vézina-Im LA. Psychosocial determinants of fruit and vegetable intake in adult population: a systematic review. Int J Behav Nutr Phys Act.2010; 7:12.
[2]Escott-Stump S, Krause MV, Mahan LK, Raymond JL. Krause's food & the nutrition care process. 13thed. Missouri: Elsevier/Saunders; 2012. p. 132-43.
[3]World Health Organization. Nutrition health: Feto-maternal nutrition and low birth weight. 2013. Available from: http://www.who.int/nutrition/topics/feto_maternal/en
[4]Martin-Gronert MS, Ozanne SE. Maternal nutrition during pregnancy and health of the offspring. Biochem Soc Trans.2006; 34(5):779-82.
[5]Kind KL, Moore VM, Davies MJ. Diet around conception and during pregnancy-effects on fetal and neonatal outcomes. Reprod Biomed Online.2006; 12(5):532-41.
[6]Gilbert JS, Cox LA, Mitchell G, Nijland MJ. Nutrient restricted fetus and the cardio renal connection in hypertensive offspring. Expert Rev Cardiovasc Ther.2006; 4(2):227-37.
[7]Haimov-Kochman R. Fetal programming-the intrauterine origin of adult morbidity. Harefuah.2005; 144(2):97-101.
[8]George GC, Hanss-Nuss H, Milani TJ, Freeland-Graves JH. Food choices of low-income women during pregnancy and postpartum. J Am Diet Assoc.2005; 105(6):899-907.
[9]Allen LH, Lungaho MS, Shaheen M, Harrison GG, Neumann C, Kirksey A. Maternal body mass index and pregnancy outcome in the nutrition collaborative research support program. Eur J Clin Nutr.1994; 48(3):68-76.
[10]Panahandeh Z, Pour Ghasemi M, Asgarnia M. [Body mass index and prenatal weight gain]. Journal of Gilan University of Medical Sciences.2006; 15(57):15-20. (Persian)
[11]Delvarian Zadeh M, Ebrahimi H, Bolbol Haghighi N. [Surveying pregnant women's nutritional status and some factors affecting it; in cases referring to Shahrood health-care centers]. Journal of Birjand University of Medical Science.2007; 13(4):9-15. (Persian)
[12]Nutbeam D, Harris E. [Theory in a nutshell: A guide to health promotion theory]. Translat: Keshavarz N. Tehran: Boshra Publication; 2010. p: 26-7. (Persian)
[13]Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research and practice. 4th ed. San Francisco: Jossey-Bass publisher; 2008.
[14]Gaines A, Turner LW. Improving fruit and vegetables intake among children: a review of interventions utilizing the social cognitive theory. Californian J Health Promot.2009; 7(1):52-66.
[15]Larson NI, Neumark-Sztainer DR, Wall MM, Eisenberg ME. Fast food intake: longitudinal trends during the transition to young adulthood and correlates of intake. J Adolesc Health.2008; 43(1):79-86.
[16]Mohammad-Alizadeh S, Kamali M, Ebrahimi Mamaghani M, Asghar Jafarabadi M, Omidi F. [Evaluation of the nutritional behavior of women in first trimester of pregnancy and its relationship with some socio-demographic characteristics of whom referred to health centers in Karaj]. Iranian Journal of Obstetrics Gynecology and Infertility.2012; 15(18):10-8. (Persian)
[17]Bojar I, Wdowiak L, Humeniuk E, Blaziak P. Change in the quality of diet during pregnancy in comparison with WHO and EU recommendations--environmental and sociodemographic conditions. Ann Agric Environ Med.2006; 13(2):281-6.
[18]Farahaninia M, Farahaninia S, Chamari M, Haghani H. [Nutritional pattern of pregnant women attending to health centers affiliated to Tehran university of medical sciences]. Iran Journal of Nursing.2013; 25(80):34-45. (Persian)
[19]Santiago SE, Park GH, Huffman KJ. Consumption habits of pregnant women and implications for developmental biology: a survey of predominantly Hispanic women in California. Nutr J.2013; 12:91.
[20]Fowles ER, Walker LO. Correlates of dietary quality and weight retention in postpartum women. J Community Health Nurs.2006; 23(3):183-97.
[21]Mohammadi M, Amir AliAkbari S, Mohammadi F, Estaki T, Alavi Majd H, Mirmiran P. [Weight Gain and Food Group Consumption Patterns in Pregnant Women of North and East Hospitals of Tehran]. Iranian Journal of Endocrinology and Metabolism.2011; 12(6):609-17. (Persian)
[22]Nakhaei M, Almasi-Hashyani A, Ebrahimzadehkor B. [The nutritional status of pregnant mothers referring to hospitals in Arak on the basis of anthropometric measurements and dietary intakes]. Arak Medical University Journal.2013; 16(4):54-61. (Persian)
[23]Kooshki A, Yaghoubifar MA, Rahnama Rahsepa F. [Comparison of energy and nutrient intakes in pregnant women in sabzevar with dietary reference intakes]. The Iranian Journal of Obstetrics, Gynecology and Infertility.2009; 12(1):49-53. (Persian)
[24]Cheng Y, J Dibley MJ, Zhang X, Zeng L, Yan H. Assessment of dietary intake among pregnant women in a rural area of western China. BMC Public Health.2009; 9:222.
[25]Swensen AR, Harnack LJ, Ross JA. Nutritional assessment of pregnant women enrolled in the special supplemental program for women, infants, and children (WIC). J Am Diet Assoc.2001; 101(8):903-8.
[26]Powers AR, Struempler BJ, Guarino A, Parmer SM. Effects of a nutrition education program on the dietary behavior and nutrition knowledge of second-grade and third-grade students. J Sch Health.2005; 75(4):129-33.
[27]Najimi A, Ghaffari M, Alidousti M. [Social cognitive correlates of fruit and vegetables consumption among students: a cross-sectional research]. Pajoohandeh.2012; 17(2):81-6. (Persian)
[28]Beiranvandpour N, Karimi-Shahanjarini A, Rezapur-Shahkolai F, Moghimbeigi A. [Factors affecting the consumption of fast foods among women based on the Social Cognitive Theory]. Journal of Education and Community Health.2014; 1)1(:19-26. (Persian)
[29]Fowles ER, Gabrielson M. First trimester predictors of diet and birth outcomes in low-income pregnant women. J Community Health Nurs.2005; 22(2):117-30.
[30]Rezaei AM, Esfandiari F. Investigate the relationship between attitudes and self-regulation of eating in obese and normal lifestyle. Journal of Women and Society.2010; 1(1):115.
[31]Ievers-Landis CE, Burant Ch, Drotar D, Morgan L, Trapl E, Kwoh K. Social support knowledge and self-efficacy as correlates of osteoporosis preventive behaviors among preadolescent females. J Pediatr Psychol.2003; 28(5):333-45.
[32]Baranowski T, Watson K, Missaghian M, Broadfoot A, Cullen K, Nicklas T, et al. Social support is a primary influence on home fruit, 100% juice, and vegetables availability. J Am Diet Assoc.2008; 108(7):1231-5.
[33]Baranowski T, Missaghian M, Broadfoot A, Watson K, Cullen K, Nicklas T, et al. Fruit and vegetables shopping practices and social support scales: a validation. J Nutr Educ Behav.2006; 38(6):340-51.
[34]Abedini Z, Ahmari Tehran H, Gaini M, Khoramirad A. [Dietary food intake of pregnant women based on food guide pyramid and its related factors]. Iranian Journal of Nursing.2011; 24(73):36-40. (Persian)
[35]Guillaumie L, Godin G, Vézina-Im LA. Psychosocial determinants of fruit and vegetable intake in adult population: a systematic review. Int J Behav Nutr Phys Act.2010; 7:12.