The Effect of Nutrition Education on Gestational Weight Gain based on the Pender's Health Promotion Model: A Randomized Clinical Trial Study

Document Type : Original Article (s)

Authors

1 Professor, Department of Health Education and Promotion, School of Public Health AND Social Determinants of Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Professor, Department of Health, Firoozabad Branch, Islamic Azad University, Firoozabad, Iran

3 Associate Professor, Nutrition and Food Security Research Center AND Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

4 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

5 PhD Student, Department of Mathematical Sciences, Isfahan University of Technology, Isfahan, Iran

6 Midwife, School of Nursing and Midwifery, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran

7 Midwife, School of Nursing and Midwifery, Falavarjan Branch, Islamic Azad University, Falavarjan, Iran

8 PhD by Research, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Weight gain more than the recommended range by the Institute of Medicine (IOM) is one of the most common complications of pregnancy, which would be ended to gestational diabetes, preeclampsia, cesarean section, or maternal, and child obesity. Few successful studies in this area include nutrition and physical activity. We examined a simple, practical, and cost-effective solution as nutrition training based on the Pender’s model, because this is one of the most effective patterns for nutritional behavior.Methods: This single-blind randomized controlled clinical trial study was performed on 192 nulliparous pregnant women. During training sessions, mothers of intervention group learned how to prevent excessive weight gain over healthy eating habits. Mothers’ weight, nutrients intake, and physical activity levels were estimated before, during, and after intervention.Findings: The constructs of perceived benefits, perceived self-efficacy, behavior-related feelings, interpersonal influences, competing demands and preferences, and commitment to action increased significantly. In the intervention group, 58.6% gained weight within the recommended range compared to 50.0% in control group. Moreover, 28.7% in the intervention group versus 45.6% in the control gained weight more than the IOM limits while 12.6% in the intervention group and 4.4% in the control gained weight less (P = 0.020). The perceived self-efficacy and commitment to the plan constructs were associated with normal weight gaining. Conclusion: Pender model-based nutrition education considering the national guideline prevented excessive gestational weight gain in pregnant women. The Effect of Nutrition Education on Gestational Weight Gain based on the Pender's Health Promotion Model: A Randomized Clinical Trial Study

Keywords

References

  1. Phelan S, Phipps MG, Abrams B, Darroch F, Schaffner A, Wing RR. Randomized trial of a behavioral intervention to prevent excessive gestational weight gain: The fit for delivery study. Am J Clin Nutr 2011; 93(4): 772-9.
  2. Skouteris H, Hartley-Clark L, McCabe M, Milgrom J, Kent B, Herring SJ, et al. Preventing excessive estational weight gain: A systematic review of interventions. Obes Rev 2010; 11(11): 757-68.
  3. Delvarian Zadeh M, Ebrahimi H, Haghighi B. Surveying pregnant women's nutritional status and some factors affecting it; in cases referring to Shahrood health-care centers. J Birjand Univ Med Sci 2006; 13(4): 42-9. [In Persian].
  4. Bakhshandeh M, Pooraram H, Torkestani F, Torabi P, Abedini MD. The national comprehensive guideline for mothers: An eating guide with practical educational points specifically developed to promote healthy eating during pregnancy and breast feeding. Tehran, Iran: Andishe Mandegar Publications; 2013. [In Persian].
  5. Asbee SM, Jenkins TR, Butler JR, White J, Elliot M, Rutledge A. Preventing excessive weight gain during pregnancy through dietary and lifestyle counseling: A randomized controlled trial. Obstet Gynecol 2009; 113(2 Pt 1): 305-12.
  6. Goodarzi-Khoigani M, Baghiani Moghadam MH, Nadjarzadeh A, Mardanian F, Fallahzadeh H, Mazloomy-Mahmoodabad S. Impact of nutrition education in improving dietary pattern during pregnancy based on Pender's Health Promotion Model: A randomized clinical trial. Iran J Nurs Midwifery Res 2018; 23(1): 18-25.
  7. Huang TT, Yeh CY, Tsai YC. A diet and physical activity intervention for preventing weight retention among Taiwanese childbearing women: A randomised controlled trial. Midwifery 2011; 27(2): 257-64.
  8. Asci O, Rathfisch G. Effect of lifestyle interventions of pregnant women on their dietary habits, lifestyle behaviors, and weight gain: A randomized controlled trial. J Health Popul Nutr 2016; 35: 7.
  9. Chmitorz A, von Kries R, Rasmussen KM, Nehring I, Ensenauer R. Do trimester-specific cutoffs predict whether women ultimately stay within the Institute of Medicine/National Research Council guidelines for gestational weight gain? Findings of a retrospective cohort study. Am J Clin Nutr 2012; 95(6): 1432-7.
  10. Alipour Birgani R. Food safety, health nutrition. 1st ed. Isfahan, Iran: Isfahan University of Medical Sciences; 2008. p. 19-32. [In Persian].
  11. Contento IR. Nutrition education: Linking research, theory, and practice. 2nd ed. Sudbury, MA: Jones and Bartlett ; 2011. p. 70, 96, 107, 113, 151, 210, 272.
  12. Mansourian M, Mohammadi R, Marateb HR, Yazdani A, Goodarzi Khoigani M, Molavi S Comprehensive maternal characteristicsassociated with birth weight: Bayesian modeling in a prospective cohort study from Iran J Res Med Sci 2017; 22: 107.
  13. Chasan-Taber L, Schmidt MD, Roberts DE, Hosmer D, Markenson G, Freedson PS. Development and validation of a Pregnancy Physical Activity Questionnaire: Corrigendum. Med Sci Sports Exerc 2004; 43(1): 195.
  14. Reyes NR, Klotz AA, Herring SJ. A qualitative study of motivators and barriers to healthy eating in pregnancy for low-income, overweight, African-American mothers. J Acad Nutr Diet 2013; 113(9): 1175-81.
  15. Sui Z, Turnbull DA, Dodd JM. Overweight and obese women's perceptions about making healthy change during pregnancy: A mixed method study. Matern Child Health J 2013; 17(10): 1879-87.
  16. Guedes NG, Moreira RP, Cavalcante TF, de Araujo TL, Ximenes LB. Students' physical activity: an analysis according to Pender's health promotion model. Rev Esc Enferm USP 2009; 43(4): 774-80. [In Portuguese].
  17. Szwajcer EM, Hiddink GJ, Koelen MA, van Woerkum CM. Nutrition-related information-seeking behaviours before and throughout the course of pregnancy: Consequences for nutrition communication. Eur J Clin Nutr 2005; 59(Suppl 1): S57-S65.
  18. Thornton YS, Smarkola C, Kopacz SM, Ishoof SB. Perinatal outcomes in nutritionally monitored obese pregnant women: A randomized clinical trial. J Natl Med Assoc 2009; 101(6): 569-77.
  19. Khodaveisi M, Omidi A, Farokhi S, Soltanian AR. 131: The effect of pender's health promotion model in improving the nutritional behavior of overweight and obese women. BMJ Open 2017; 7(Suppl 1): bmjopen-2016-015415.131.
Journal of Isfahan Medical School
Volume 37, Issue 552 - Serial Number 552
September and October 2020
Pages 1272-1279

Files

History

  • Receive Date: 01 June 2019
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics