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      The effect of an instructional program based on health belief model in decreasing cesarean rate among primiparous pregnant mothers

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          Abstract

          Introduction:

          Although cesarean section has saved many mothers’ and infants’ lives, the problem is in its increasing prevalence. According to recent statistics, the current rate of cesarean in Iran is in fact 3–4 times as more than the standard rate defined by WHO. Therefore, the present study is aimed to estimate the effect of an instructional program based on health belief model on reducing cesarean rate among primiparous pregnant women.

          Materials and Methods:

          In this semi-experimental research, 60 primiparous women who had visited Bandar Abbas Healthcare Centers were selected as the subjects. They were in their 26–30 th week of pregnancy. They were selected in a multi-stage cluster sampling method (a combination of clustering and simple randomization), and were divided into two groups, subjects and control group. The data were gathered using a valid and reliable questionnaire. The instructional intervention was done after the completion of the pretest questionnaire based on the sub-constructs of the health belief model in six instructional sessions. 1 month after the intervention, posttest questionnaires were completed by the subjects in both groups. The data were analyzed using descriptive statistics, standard deviation, independent t-test, and paired t-test. The significance level was set at <0.05.

          Results:

          Two groups had a significant difference between awareness score, perceived sensitivity, intensity, benefits, barriers, self-efficacy, and the performance ( P < 0.001). In the experimental group, nine subjects (30%) had a natural delivery.

          Conclusion:

          According to the findings of the current research, an instructional program illuminated (designed) by the health belief model can significantly influence pregnant women's awareness, intention, and choice of delivery type.

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          Most cited references34

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          Cesarean delivery rates vary tenfold among US hospitals; reducing variation may address quality and cost issues.

          Cesarean delivery is the most commonly performed surgical procedure in the United States, and cesarean rates are increasing. Working with 2009 data from 593 US hospitals nationwide, we found that cesarean rates varied tenfold across hospitals, from 7.1 percent to 69.9 percent. Even for women with lower-risk pregnancies, in which more limited variation might be expected, cesarean rates varied fifteenfold, from 2.4 percent to 36.5 percent. Thus, vast differences in practice patterns are likely to be driving the costly overuse of cesarean delivery in many US hospitals. Because Medicaid pays for nearly half of US births, government efforts to decrease variation are warranted. We focus on four promising directions for reducing these variations, including better coordinating maternity care, collecting and measuring more data, tying Medicaid payment to quality improvement, and enhancing patient-centered decision making through public reporting.
            • Record: found
            • Abstract: found
            • Article: not found

            Maternal confidence for labor: development of the Childbirth Self-Efficacy Inventory.

            The Childbirth Self-Efficacy Inventory (CBSEI) is a self-report instrument that measures outcome expectancies and self-efficacy expectancies for coping with an approaching childbirth experience. The CBSEI scales have excellent internal consistency reliability (.86 to .96) and factor analysis suggested that each CBSEI scale is unidimensional. Validity of the CBSEI was supported by significant positive correlations with the criterion variables of generalized self-efficacy, self-esteem, and internal health locus of control; and significant negative correlations with external health locus of control and learned helplessness. Validity was also supported by significantly higher self-efficacy scores for multiparous as compared to nulliparous pregnant women.
              • Record: found
              • Abstract: found
              • Article: not found

              Communicating the threat of emerging infections to the public.

              Communication theory and techniques, aided by the electronic revolution, provide new opportunities and challenges for the effective transfer of laboratory, epidemiologic, surveillance, and other public health data to the public who funds them. We review the applicability of communication theory, particularly the audience-source-message-channel meta-model, to emerging infectious disease issues. Emergence of new infectious organisms, microbial resistance to therapeutic drugs, and increased emphasis on prevention have expanded the role of communication as a vital component of public health practice. In the absence of cure, as in AIDS and many other public health problems, an effectively crafted and disseminated prevention message is the key control measure. Applying communication theory to disease prevention messages can increase the effectiveness of the messages and improve public health.

                Author and article information

                Journal
                J Educ Health Promot
                J Educ Health Promot
                JEHP
                Journal of Education and Health Promotion
                Medknow Publications & Media Pvt Ltd (India )
                2277-9531
                2319-6440
                2016
                23 June 2016
                : 5
                : 1
                Affiliations
                [1] Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
                [1 ] Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
                Author notes
                Address for correspondence: Ms. Sakineh Dadipoor, Hormozgan Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran. E-mail: mdadipoor@ 123456yahoo.com
                Article
                JEHP-5-1
                10.4103/2277-9531.184558
                4959261
                27512693
                8fdb4737-4b39-44ee-b59b-f7af693cad31
                Copyright: © 2016 Journal of Education and Health Promotion

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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                Original Article

                health belief model,instruction,performance,pregnant women

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