Application of the health belief model to explain pre-conception care among women with sickle cell disease: a cross-sectional study.

Background: Pre-conception care (PCC) in mothers with sickle cell disease (SCD) is essential to reduce the risk of morbidity and mortality. PCC is not commonly utilized by women of reproductive age. The reason behind this should be assessed using health education theories. This study aims to apply the health belief model (HBM) to explain the adoption of PCC among SCD women.

Methods: A cross-sectional study was conducted in Iran from March 2021 to June 2021. Women with SCD were selected through a systematic sampling framework using the Iranian integrated health system. A demographic, knowledge, HBM, and PCC questionnaire were used as instruments. Pearson's correlation was used to investigate the relationship between HBM constructs and PCC. The effect of health beliefs on PCC was analyzed using a path model, in which the observed HBM variables predicted PCC behavior.

Results: Out of 413 participants, 13 incomplete questionnaires were excluded (Response rate 96.8%). A significant association was observed between women's and husbands' education with the PCC adoption. Pearson correlation test revealed a significant relationship between PCC and HBM constructs; with positive and significant correlation coefficients of 0.651 and 0.599, self-efficacy and perceived susceptibility had the highest correlation with the PCC. Based on the path model analysis, perceived susceptibility (0.26) and self-efficacy (0.36) substantially influenced adopting PCC. The fit indices of this model were acceptable (GFI = 0.98, AGFI = 0.95, CFI = 0.99, and RMSEA = 0.04).

Conclusions: Knowledge, perceived susceptibility, and self-efficacy are the most important determinants of performing PCC. Knowing PCC's most influential and decisive components will help us plan educational content and effective interventions.