The effect of nutritional education based on the health action process approach (HAPA) on the pregnancy outcomes among malnourished pregnant mothers.

OBJECTIVE: To examine the effectiveness of nutritional education based on the health action process approach (HAPA) on pregnancy outcomes among malnourished pregnant mothers utilizing nutritional support. METHODS: In a randomized controlled trial, 234 malnourished pregnant women under nutritional support from the fourth month of pregnancy participated. Participants were randomly allocated in study groups by the balance block randomization method. Data were collected using a socio-demographic and pregnancy outcomes checklist as well as self-devised questionnaire assessing the constructs of the HAPA model before and three months after the educational intervention. The framework of the educational intervention was based on the constructs of the HAPA and included three one-hour training sessions through lectures, group discussions, 'question and answer' sessions, and the use of educational tools. Data were analyzed using analysis of covariance (ANCOVA) and SPSS software. RESULTS: Pregnancy outcomes including optimal weight gain during pregnancy (p = 0.47), neonate's birth weight (p = 0.58), gestational age at delivery (p = 0.83), type of delivery (p = 0.48) gestational anemia (p = 0.22), diabetes (p = 0.59) and hypertension (p = 0.29) were not significantly different in the intervention and control groups. The results showed that the educational intervention produced a significant increase in the total score (24 points) in the intervention group. Improvement of scores in the intervention group compared to the control was observed in all of the model constructs except outcome expectation (0.68 decrease). The educational intervention in the present study had a large measure of effect in total (SMD: 2.69, partial eta2: 0.664). CONCLUSION: A nutritional education intervention based on the HAPA model for malnourished pregnant women increased behavioral intention and planning for action to have better nutritional behavior. However, the intervention did not change the pregnancy outcomes significantly. PRACTICE IMPLICATIONS: Nutritional education based on the HAPA model can be used to improve nutritional behaviors of malnourished pregnant women.

The relationship between fear of COVID-19 and food choice motives in the Iranian population.

BACKGROUND AND AIM: The long-term impact of COVID-19 on nutrition and community health is inevitably noticeable. These effects can change the nutritional behavior and lifestyle of survivors. Due to the COVID consequential fear and anxiety, the pandemic can alter the motivations for choosing, buying, and consuming food. The relationship between nutritional behavior and COVID-19 fear is the primary purpose of this research. MATERIALS & METHODS: This cross-sectional study was conducted via online and face-to-face surveys. Accessing participants was through health centers of Qazvin, Iran, and the selected centers were sampled by cluster sampling method. The study population included 331 adults aged 18 to 65. Data were collected in three sections using valid questionnaires. The Demographic Questionnaire, FCV-19S, and FCQ were used to gather demographic information, the level of fear caused by COVID-19, and food choice motivations, respectively. The statistical analyzes were performed using R software. Analysis of variance and linear regression methods were used to determine the effect of independent variables on dependent variables (p = 0.05). RESULTS: The mean score of fear of COVID-19 in the study population was 15.25 ± 5.78. Price, Mood, Natural content, Familiarity, Convenience, and Ethical concerns were significantly and positively associated with fear of COVID-19 (p<0.05). The only food motive significantly different than before during COVID-19 was Health, which was increased (p = 0.02). Sensory appeal and Health were the most important motivations for food choices before and during COVID-19. The Ethical concern was considered the least important food motivation. DISCUSSION AND CONCLUSION: Some food motivations were associated with fear of COVID-19, possibly due to their psychological nature. The increasing importance of the Health factor and Natural content motivations can relate to the advice of experts on the importance of eating healthy food to counteract COVID-19 and indicate people's preference for this training.