Factors Predicting Behavioral Intentions to Prevent COVID-19 Infection and Transmission among Postpartum Women

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the physical and mental health of postpartum women. Physiological changes and a weakened immune system during this period increase the risk of respiratory complications if infected. These challenges further affect childcare, breastfeeding, and maternal-infant bonding due to the necessity of social distancing or reduced physical contact. Additionally, these circumstances contribute to increased stress, anxiety, and postpartum depression. While extensive research exists on COVID-19 prevention in the general population and among pregnant women, studies focusing specifically on postpartum women remain limited. In particular, studies examining factors that predict the intention to engage in preventive behaviors against COVID-19 infection and transmission during the postpartum period are scarce. Therefore, investigating the predictive factors influencing postpartum women’s intentions to practice COVID-19 preventive behaviors is essential to provide empirical evidence for the development of appropriate strategies to promote infection-prevention behaviors.

This predictive correlational research aimed to identify factors predicting the intention to practice COVID-19 prevention and control behaviors among postpartum women, using the Theory of Planned Behavior (TPB) as the conceptual framework. A sample of 202 postpartum mothers was selected through convenience sampling. The inclusion criteria required participants who were 18 years of age or older, provided care for their infants, stayed in the same clinic, and were able to read and understand the Thai language. The research instruments consisted of five sets of questionnaires, as follows: 1) a demographic questionnaire, 2) the Attitude Toward the Behavior Scale, comprising a behavioral beliefs questionnaire and an outcome evaluation questionnaire,3) the Subjective Norm Scale, comprising a normative beliefs questionnaire and a motivation to comply questionnaire, 4) the Perceived Behavioral Control Scale, comprising a control beliefs questionnaire and a perceived power questionnaire, and 5) the Behavioral Intention Questionnaire. Data were analyzed using descriptive statistics, including percentages, means,and standard deviations. Spearman’s rank correlation coefficient and multiple regression analysis were used to predict behavioral intentions to prevent COVID-19 infection and transmission
among postpartum women.

The results showed that perceived behavioral control (β = .57, p < .001), subjective norms (β = .17, p = .002), and attitudes toward the behavior (β = .15, p = .009) significantly mutually predicted the intention to practice preventive behaviors, accounting for 63.30% of the variance (R² = .63, F = 113.71, p < .001). Perceived behavioral control emerged as the strongest predictor of postpartum women’s behavioral intention. Therefore, healthcare providers should enhance postpartum women’s ability to adhere to disease prevention measures by ensuring adequate access to protective equipment, providing appropriate guidance, and creating an environment conducive to infection prevention during childcare and breastfeeding. Furthermore, programs should be developed to strengthen social support from significant others, emphasizing family involvement in health education and promoting proper health behaviors. Fostering positive attitudes is also essential to help postpartum women recognize the importance and value of preventing COVID-19 infection and transmission. This includes recommending vaccination for postpartum women and promoting the consumption of foods that help strengthen immune function, maintaining well-ventilated environments, and encouraging hand hygiene or wearing face masks when visiting places with a high risk of respiratory infection. In addition, integrating a mobile application notification platform facilitates the tracking of health-related behaviors, and providing health education may further support the promotion of positive postpartum health outcomes.

Keywords: COVID-19, Intention, Postpartum women, Theory of Planned Behavior,Transmission

Author Contributions:
VP: Conceptualization, Method and design, Tool validation, Data collection and analysis, Writing and revising the manuscript
PP: Conceptualization, Method and design, Data collection and analysis, Writing, revising,editing the manuscript, Corresponding with the editor-in-chief
PD: Conceptualization, Method and design, Data collection and analysis, Revising the manuscript
TC: Writing and revising the manuscript
SL: Conceptualization, Method and design, Data collection, Editing the manuscript
WR: Writing and revising the manuscript