Intentions of preventive depression management for a healthy pregnancy by gender among unmarried college students in Korea: a cross-sectional study

Abstract

Background Early adulthood is a significant period for preventive depression management for a healthy pregnancy. However, previous public health initiatives have not yet emphasized preparation for a healthy pregnancy in this population. In addition, pregnancy planning has traditionally been regarded as women's responsibility, so intervention strategies may differ by gender. This study explored intentions of preventive depression management for a healthy pregnancy among unmarried college students, as well as factors influencing those intentions, by applying the Theory of Planned Behavior (TPB) model. Methods For this cross-sectional survey, 828 unmarried college students aged 18-29 were recruited from a national university in Korea from July to September 2019. The chi-square test and t-test were used to compare gender differences in general characteristics, the current level of depression, and constructs of the extended TPB. Hierarchical regression was performed to identify factors influencing the intention of preventive depression management for a healthy pregnancy. Results The intention to manage depression was significantly higher in men than in women (t = 2.36, p = 0.019). The factors affecting the intention of preventive depression management for a healthy pregnancy were components of TPB in both women and men, of which self-efficacy had the greatest effect (female: beta = 0.34, p < 0.001, male: beta = 0.30, p < 0.001). The current level of depression was a significant factor for women only (beta = 0.10, p = 0.014). Conclusions Our study results underscore the need for nurses to perform preventive interventions and provide directions to develop interventions to improve the intention of depression management for unmarried college students. It is necessary to intervene with all the constructs of the TPB, especially self-efficacy, for both men and women. It is also important to check and address the current depression status of unmarried female college students. Plain English summary Starting in early adulthood, such as college students in the preconception stage, it is necessary to take care of one's mental health (including depression) in order to have a healthy pregnancy in the future. The early identification of adults needing depression management is also a major challenge. In this study, an online survey was conducted to investigate levels of depression among Korean college students and their intention to manage depression for a healthy future pregnancy, as well as to identify the influencing factors. Convenience recruitment was conducted by e-mail at one university in Korea, and 828 male and female college students responded to the survey. An analysis of the factors affecting the intention to manage depression for a healthy future pregnancy identified the components of the Theory of Planned Behavior as influencing factors in both men and women. In particular, self-efficacy had the greatest influence. However, the current level of depression was only a significant factor among women. These findings could help nurses recognize differences in gender characteristics for the intention of preventive depression management for a healthy pregnancy, and provide evidence to develop and implement the intervention. These efforts will ultimately reduce high-risk pregnancies due to poor mental health.