Table 1_The effect of the social and interpersonal-based intervention on calcium consumption among pregnant women.docx

IntroductionThe present study aimed to evaluate the effect of educational intervention based on Pender’s health promotion model on the calcium intake of pregnant women.
MethodsThe pregnant women at three to 5 months were recruited using convenient sampling method and randomly assigned either to the control (n = 37) or intervention (n = 36) groups referred to the health centers in Kermanshah, “Iran,” in 2022, 2023. Participants were randomly assigned to either the intervention group or the control group. The intervention consisted of a series of educational workshops that provided information on the importance of calcium, dietary sources, and practical methods for increasing calcium intake. Participants received personalized dietary plans, and improve knowledge, perceived benefits of action, perceived barriers to action, perceived self-efficacy, activity-related affect, interpersonal influences, situational influences, immediate competing demands and preferences, commitment to plan of action and over 8-week period, and ongoing support through one-month follow-up. The control group received standard prenatal care without additional nutritional education. Pre- and post-intervention assessments measured calcium intake and HPM constructs using validated questionnaires. The food frequency questionnaire was completed before and after the intervention. Data were analyzed in SPSS software version 25.
ResultsThere is no significant difference between the intervention and control groups at baseline (p < 0.05). According to the independent sample t-test, all constructs of the Pender’s HPM except for interpersonal influences were significantly improved in the intervention rather than control groups (p > 0.05). The repeated measure ANOVA demonstrated a significant difference in the effect of the intervention on the constructs of the knowledge (F = 9.40; p-value = 0.001), perceived benefits (F = 17.24; p-value = 0.001), perceived barriers (F = 40.80; p-value = 0.001), perceived self-efficacy (F = 10.90; p-value = 0.001), activity-related affect (F = 14.85; p-value = 0.001), interpersonal influences (F = 21.51; p-value = 0.001), commitment to a plan of action (F = 20.20; p-value = 0.001), and immediate competing demands and preferences (F = 9.4; p-value = 0.001) between the intervention and control groups. The ANOVA demonstrated that the calcium consumption significantly increased in the intervention group (p < 0.001).
DiscussionA theory-based educational intervention in the health care system can fill the gap in the successful implementation of nutrition education programs.

引言
本研究旨在评估基于潘德健康促进模型（Pender’s health promotion model，以下简称HPM）的教育干预对孕妇钙摄入量的影响。

研究对象与方法
于2022至2023年，在伊朗克尔曼沙赫的卫生中心通过便利抽样法招募孕3~5个月的孕妇，将其随机分为对照组（n=37）与干预组（n=36）。干预组接受系列教育讲习班，内容涵盖钙的重要性、膳食来源及增加钙摄入的实用方法，同时为研究对象提供个性化膳食计划，并在为期8周的干预周期内，对其HPM相关维度（包括行动知识、行动感知益处、行动感知障碍、感知自我效能、活动相关情感、人际影响、情境影响、即时竞争性需求与偏好、行动计划承诺）进行提升干预，且通过1个月随访提供持续支持。对照组仅接受标准产前保健，未获得额外营养教育。干预前后，采用经过信效度验证的问卷评估研究对象的钙摄入量及HPM各维度得分，所有数据采用SPSS 25.0统计软件进行分析。

结果
基线时，干预组与对照组无显著统计学差异（p<0.05）。独立样本t检验结果显示，除人际影响维度外，干预组HPM的其余各维度得分均优于对照组（p>0.05）。重复测量方差分析结果表明，两组在以下HPM维度上存在显著组间差异：知识（F=9.40；p=0.001）、感知益处（F=17.24；p=0.001）、感知障碍（F=40.80；p=0.001）、感知自我效能（F=10.90；p=0.001）、活动相关情感（F=14.85；p=0.001）、人际影响（F=21.51；p=0.001）、行动计划承诺（F=20.20；p=0.001）以及即时竞争性需求与偏好（F=9.4；p=0.001）。方差分析结果显示，干预组的钙摄入量显著提升（p<0.001）。

讨论
在医疗保健体系中开展基于理论的教育干预，可填补营养教育项目成功实施中的空白。