Understanding the rationales behind childbearing: A qualitative study based on extended theory of planned behavior

An integrated theory based-educational intervention to change intention to have a child: study protocol of a cluster randomized controlled trial

BACKGROUND

In high- and low-income countries, declining birth rates have become a global concern. Couples do not have enough information about the complications of delaying and reducing childbearing and this leads them to make inappropriate decisions. Therefore, this study aims to evaluate whether an educational program based on integrating the Theory of Planned Behavior (TPB) and the Trans-Theoretical Model (TTM) affects child-free couples' intention to have children and minimizes the consequences of this decline.

METHODS

Thirty couples (intervention, n = 15; control, n = 15) will be enrolled in this cluster randomized controlled trial. After collecting baseline data and separating participants in the pre-contemplation and contemplation stages based on the TTM, the samples were randomly assigned to the intervention and control groups. The intervention group will receive 60-min training based on TPB components for 4 weeks. The first follow-up assessment was performed immediately after the intervention and the final assessment 6 months later. For all 3 time assessments, three questionnaires will be used: The knowledge questionnaire, the TTM, and the TPB questionnaire. The most important consequences are changes in knowledge, attitudes, subjective norms, perceived behavioral control, and stages of intentions to have children.

DISCUSSION

Decision-makers will use the results of this study as a basis to design appropriate, transparent, and useful policies and interventions to improve or stop the decline of the fertility rate at the national level. Also, this study will help young couples who wish to have a child in their lifetime by providing relevant information so that they do not miss this opportunity and face the consequences of delaying having a child. Trial registration This study was approved by the Iranian Registry of Clinical Trials (IRCT), Number: IRCT20220618055210N2, Date of registration: 2023-10-03.

Development and Psychometric Properties of an Extended Theory of Planned Behavior Questionnaire for Childbearing Intentions and Behaviors in Iran

BACKGROUND

Childbearing is the most important determinant of population fluctuations, and its study is more important than other population phenomena. Owing to the lack of a valid questionnaire based on the extended theory of planned behavior, this mixed-method study was conducted to determine the validity and reliability of a questionnaire designed to examine related belief-based factors on the intention to bear children in Iranian society.

METHODS

This study was conducted in two phases in Hamadan city, western Iran, in 2021. Phase 1 consisted of an extensive literature review and a qualitative study using a directed content analysis approach to generate an item pool. Psychometrics were measured in phase 2, including content, face, and construct validity. Reliability was assessed based on internal consistency and stability. The collected data were analyzed using IBM SPSS and AMOS ver. 24.0.

RESULTS

Mean content validity ratio and content validity index were 0.7 and 0.85, respectively. Exploratory factor analysis of the 32 items identified an eight-factor solution. These factors jointly accounted for 79.1% of the observed variance in the outcome variables. Confirmatory factor analysis indicated a good fit for the data. The internal consistency based on Cronbach's α was 0.85 (0.71-0.93). In addition, stability was confirmed using the test-retest method and intraclass correlation coefficient (0.74-0.94).

CONCLUSION

The designed questionnaire is a valid and reliable instrument for evaluating related belief-based factors on the intention and behavior of childbearing among married men and women in Iran.