The Effect of an Application Based Educational Intervention With a Social Cognitive Theory Model on Pregnant Women in Denpasar, Bali, Indonesia: a Randomized Controlled Trial

Background: Ariyani et al. 2022 is a experimental study using randomized controlled trial design. They aimed to determine the effect of a web application-based antenatal education program using an SCT model (with social modeling, social persuasion, and peer modeling) on Health Promoting Lifestyle Profile II (HPLP II) scores, compliance with iron tablet consumption, and readiness for childbirth and complications among pregnant women in Denpasar City, Bali, Indonesia.

Methods: The treatment group of 92 pregnant women received web application-based antenatal education using the SCT model. Over the course of 3 months participants attended a minimum of 4 in person meetings and received 1 month worth of tablets at each visit. The control group of 101 pregnant women attended antenatal education classes at midwife clinics and city health centers where they attended 120-minute meetings and received three materials about pregnancy, childbirth, postpartum depression, family planning, and baby care. Participants were recruited if they were receiving pregnancy examinations at midwifery independent practices and public health centers in the city. Inclusion criteria were as follows: (1) parity 1 to 4 and a healthy condition, (2) gestational age of 13 to 20 weeks after the intervention, (3) having and being able to use a smartphone, (4) an educational level of junior high school or higher, and (5) voluntary agreement to participate in the research. The exclusion criterion was unwanted pregnancy. A pretest (assessing HPLP II, readiness for delivery and pregnancy-related complications, and iron tablet consumption) was taken after consent during the antenatal visit and posttest taken after three months participation.

Results: There were 71 participants in the treatment group and 74 participants in the control group. This study showed that application-based antenatal education with the SCT model was more effective in increasing HPLP II scores than conventional classes. There was a significant increase (p < 0.05) in readiness for labor and complications in the treatment and control groups. No significant difference was found in iron tablet consumption.

Conclusions: This study used social modeling and persuasion to increase self-efficacy by addressing the environment with web-based antenatal education as a medium to seek out health- and pregnancy-related information. Both antenatal education models were effective in improving pregnant women’s behavior. The conventional model could be useful in areas with a good participation rate, while the application-based model could be useful for busy pregnant women with internet access. It is recommended to increase the length of the intervention to 6 months in future studies.