Prediction of Adequate Prenatal Care Utilization Based on the Extended Parallel Process Model.
Sepideh Hajian, Fatemeh Imani, Hedyeh Riazi and 1 others
PMID 29043280WHAT IT FOUND
In rural Iran, women who felt less able to attend regular prenatal visits were more likely to receive inadequate care.
Distance, transport and caring for others at home also mattered, and 44.3% of those with inadequate care gave no reason.
Key findings
01Women whose perceived efficacy score was lower than their perceived threat score did not receive adequate or any prenatal care (100%), while 88.8% of those whose perceived efficacy score was higher received adequate care.
02Overall, 26.6% received inadequate prenatal care; 44.3% of those with inadequate care gave no reason, while distance, transport and caring for minors or elderly were named.
03Belief in one's ability to attend care was the factor most closely linked to intention to attend (r=0.75).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done only in rural Qeshm, Iran. It included women who already had health records in local facilities, so it may not apply to women who never visited a facility or to other settings. Sampling was not random; it used quota and convenience methods, with census only at small facilities. 192 women were enrolled, but 14 ended pregnancy before 37 weeks and 178 were followed to term. Adequate care was defined as at least six visits, not the national guideline of five of eight visits. Perceptions were self-reported, and the study measured associations, not the effect of any intervention. Some odds ratios were very large with wide confidence intervals, so the size of the effect is uncertain.
The easy way to misread this
Do not conclude that increasing fear about pregnancy risks will improve prenatal care. Higher perceived susceptibility and severity were associated with lower odds of adequate care, and the study did not test an intervention.