International Journal of Community Based Nursing & Midwifery

International Journal of Community Based Nursing & Midwifery

Effect of Group Counseling based on Theory of Planned Behavior on Health Promotion Lifestyle in Mothers with Overweight and Obesity during Postpartum Period: A Randomized Controlled Trial

Authors
Fatemeh Nikkhah 1
Fatemeh Moghaddam-Tabrizi 2
Alireza Didarloo 3
Rasool Gharaaghaji-Asl 4
1 Department of Consultation on Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran;
2 Maternal and Childhood Obesity Research Center, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran;
3 Department of Public Health, School of Health, Urmia University of Medical Sciences, Urmia, Iran;
4 Department of Epidemiology and Biostatistics, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
10.30476/ijcbnm.2026.103965.2595
Abstract
Background: Overweight and obesity are significant risk factors for chronic diseases, with their prevalence being a major concern during pregnancy and postpartum. This study aimed to determine the effect of group counseling based on the Theory of Planned Behavior (TPB) on health promotion lifestyle in mothers with overweight and obesity during the postpartum period.
Methods: In a randomized controlled trial conducted from July 2021 to March 2022 in Urmia, Iran, 104 mothers with overweight or obesity were randomly assigned to either an intervention or a routine care group. Data were collected using demographic and Health-Promoting Lifestyle Profile II (HPLP-II) questionnaires. The intervention group received six weeks of TPB-based group counseling via WhatsApp. HPLP, as the primary outcome, was measured at three distinct time points including prior before the intervention, and one month and three months after the completion of the intervention. Data were analyzed using SPSS software version 20.0 through repeated measures analysis of variance, Chi-square, and independent t-tests. A p-value of P<0.05 was considered statistically significant.
Results: The mean age of the participants was 27.06±5.98 years. In the intervention group, significant improvements were observed from baseline to onemonth followup in total and the mean scores of HPLP of the subscales (P<0.001), except for nutrition and spiritual growth (P>0.05). These gains were sustained three months after intervention (P<0.05). Nutrition showed a delayed effect, with a mean score improvement from the baseline to three months after the intervention (P=0.005) and from one month to three months after the intervention (P=0.008). Spiritual growth also showed a delayed but significant improvement from one month to three months postintervention (P<0.001), but no significant changes were observed from baseline to one month or baseline to three months (P>0.05).
Conclusion: The WhatsAppbased TPB intervention effectively improved healthpromoting behavior. It supports the feasibility of using theorydriven digital platforms in women with overweight and obesity during the postpartum period.
The trial registration number: IRCT20210811052148N1

Highlights

Fatemeh Nikkhah (PubMed)

Fatemeh Moghaddam Tabrizi  (PubMed)

Keywords
Health Behavior
Mothers
Obesity
Postpartum Period
Theory of Planned Behavior
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