Effects of an Empowerment Program on Health-Promoting Behaviors and Pregnancy Outcomes among Teenage Pregnant Women

Abstract

Introduction: The issue of teenage pregnancy is well documented and has become a major health problem in Thailand. It is evident that the morbidity and mortality rates of both teenage mothers and newborns are increasing, leading to adverse health, social, and economic consequences. Teenage pregnant women may experience various pregnancy-related complications that can threaten their pregnancy outcomes. Therefore, empowering them with essential knowledge to manage their pregnancy care is crucial.      

Objective: To examine the effects of an empowerment program on health-promoting behaviors and pregnancy outcomes among teenage pregnant women. Gibson’s model of empowerment was utilized as the conceptual framework of this study.      

Design: A quasi-experimental design with two-group pretest and posttest      

Methodology: The sample included 60 teenage pregnant women who registered at a provincial hospital’s antenatal care unit in Thailand from August to December 2020. They were less than 20 years old, with a gestational age between 26-28 weeks. A simple random sampling technique was used to equally assign the participants to both the control and the experimental groups. The control group received standard antenatal care, while the experimental group engaged in the empowerment program and communication via portable communication devices (PREG-CAL 3.0). Data were collected using questionnaires consisting of three parts: 1) personal and demographic information, 2) health-promoting behaviors in teenage pregnancies, and 3) pregnancy outcomes. The instruments were tested for content validity and reliability by experts and Cronbach’s alpha coefficient testing (r = .88). Descriptive statistics, Wilcoxon signed rank test and Mann-Whitney U test were used to analyze the data, with a significance level set at p < .05. 

Results: The results revealed that before participating in the empowerment program, the highest mean score for health behaviors of the experimental group was stress management (M = 3.46, SD = 0.36), followed by spiritual development (M = 3.35, SD = 0.49). In the control group, the highest mean scores for health behaviors were spiritual development (M = 3.48, SD = 0.47, followed by stress management (M = 3.42, SD = 0.47). Both the experimental and control group had moderate mean scores for nutritional health behavior (M =2.60, SD = 0.41 and M = 2.69, SD = 0.39, respectively). After completing the program, the mean score for health-promoting behaviors of the experimental group was significantly higher than before the program (Z = -4.598, p < .001). The overall health-promoting behavior score of the experimental group was significantly higher than that of the control group (Z = -4.530, p < .001). However, there was no statistically significant difference in the mean scores of post-test pregnancy outcomes between the two groups (p > .05). 

Recommendations: The results suggested that the empowerment program and the communications via portable devices can be applied to promote better health-promoting behaviors among teenage pregnantwomen attending antenatal care clinics for their better pregnant care at home.