Effect of an Educational Package on Nutritional Knowledge, Beliefs and Behaviors of Pregnant Women: A Randomized Controlled Trial.

Abstract

Abstract: Background & Objectives: Adequate nutrition is an important part of a healthy pregnancy and nutrition education can play an important role in health promotion of the mother and her child. The aim of this study was to determine the effect of an educational package on nutritional knowledge, belief and behavior of pregnant women referred to the public health centers. Methods & Materials: This randomized controlled trial was carried out on 88 women of 8-14 weeks of pregnancy who were selected using convenience sampling method in four public health centers in Karaj, Iran. They were randomly allocated into intervention (who received nutrition education program including an educational booklet and film and two 60-minutes lecture sessions, n=44) and control group (who received sexual education with similar method, n=44). Participants completed a self –made questionnaire including demographic and clinical characteristics (16 questions), nutritional knowledge (21 questions), belief (14 questions) and behavior (21 questions) during 4 stages: before and four weeks after the intervention, 24-28 weeks of pregnancy and 36-40 weeks of pregnancy. Data were analyzed with SPSS ver.13 using Chi square test, t test, repeated measure, and analysis of Covariance, Friedman, Cochrane and Mann –Whitney –U test, logistic and ordinal regression. P<0.05 was determined as statistical significance. Results: At baseline, there was no significant difference between two groups in terms of demographics and clinical characteristics and also mean of nutritional knowledge (37 against 34), belief (70 against 66.7) and behavior scores (34.6 against 33.8). At 3 stages after intervention, the compare mean of adjusted scores in intervention group with control group showed that the means of nutritional knowledge (63.5, 64.4, 63.6 against 65.7, 39.0. 40.4 respectively), belief (74.8, 76.0, 74.5 against 65.0, 66.9, 65.6 respectively) and behavior scores (61.3, 68.4, 71.0 against 36.5, 42.7, 45.3 respectively) were significantly higher in the intervention group compared with the control group (p<0.001). Nutritional behavior score in preventing of complication during pregnancy such as constipation, heartburn, hand & feet swelling and anemia and also nutritional behavior score in preventing of urinary tract infection, Ferrous sulfate & Multivitamin supplements consumption and optima food intake of milk and milk products were significantly higher in the intervention group compared with the control group. Optimal food intake of meat in the 1 & 3 stages after intervention and bread & cereal in the 1 stage after intervention, was significantly more frequent in the intervention group compared with the control group. Conclusion: Findings of the study indicates that content of educational package was effective in promoting nutritional knowledge, belief and behavior of pregnant women. This intervention program is easy to implement. Therefore, is recommended for improving the quality of prenatal care, this educational package should also be provided for pregnant women.