Factors influencing adolescents' healthy pregnancy preparation behavior: a cross-sectional gender comparison applying the health belief model

Abstract

Background Interventions to prepare for a healthy pregnancy from an early age can ensure the health of both mother and child. This study aims to compare the factors associated with healthy pregnancy preparation behavior (HPPB) among male and female adolescents. Methods A total of 690 Korean adolescents participated in this cross-sectional study from July 11 to August 24, 2018. Determinants of the likelihood of engaging in HPPB were described using hierarchical regression about the importance of and confidence in HPPB, the gender equality related to pregnancy and birth, and the health belief model (HBM) constructs about HPPB. Results Smoking experience (beta = - 0.18, p < 0.001 for boys, beta = - 0.25, p < 0.001 for girls), and HBM constructs were identified as factors correlated with HPPB in both genders. The significant factors in boys were perceived susceptibility (beta = - 0.13, p = 0.005), perceived severity (beta = 0.12, p = 0.015), perceived benefits (beta = 0.23, p < 0.001), and perceived barriers (beta = - 0.18, p < 0.001), whereas the corresponding factors in girls were perceived severity (beta = 0.20, p = 0.001), and perceived barriers (beta = - 0.23, p < 0.001). The importance of HPPB was identified as a factor only among girls (beta = 0.19, p = 0.005), while confidence in HPPB (beta = 0.12, p = 0.401), gender equality related to pregnancy and childbirth (beta = - 0.20, p = 0.001 for women's responsibility variable, beta = 0.14, p = 0.018 for men's responsibility variable), and alcohol (beta = - 0.10, p = 0.022) were factors identified only among boys. Conclusions The gender differences in opinions on HPPB identified in this study can help nurses and community health care professionals recognize issues for which they can develop and implement preventive interventions. For healthy pregnancy preparation, interventions based on HBM constructs and smoking should be presented for both male and female adolescents. Imparting education to females on the importance of HPPB and to males on confidence in HPPB, gender equality related to pregnancy and childbirth, and alcohol consumption, should be emphasized. In addition, as perceived susceptibility may be low in a disease prevention model using the health belief model, it is necessary to prioritize increasing the perceived susceptibility of school-age children as an intervention. Plain Language Summary In the context of pregnancy preparation, attention has recently shifted from the period just before pregnancy to the early years, or even throughout one's life. The World Health Organization identifies adolescents as requiring specific attention. Adolescents' health behaviors can impact their adulthood years and have significant repercussions on the health of the future generation. In addition, recent studies consistently report that the preparedness of both men and women is essential to pregnancy preparation. Therefore, it is now time to present a new strategy by identifying and grasping the different factors that influence the two genders. This study can raise awareness of healthy pregnancy preparation behavior from adolescence onwards of both genders. There were differences in factors affecting HPPB by gender. For healthy pregnancy preparation, interventions based on HBM constructs and smoking should be presented for both male and female adolescents. Imparting education to females on the importance of HPPB (beta = 0.19, p = 0.005) and males on confidence in HPPB (beta = 0.12, p = 0.401), gender equality related to pregnancy and childbirth (beta = - 0.20, p = 0.001 for women's responsibility variable, beta = 0.14, p = 0.018 for men's responsibility variable), and alcohol consumption (beta = - 0.10, p = 0.022) should be emphasized; and effective healthy pregnancy preventive strategies should be developed based on these findings. Interventions to prepare for a healthy pregnancy from an early age can ensure the health of both mother and child.