Page 17 - Zero for nine: Reducing alcohol use during pregnancy via health counselling and Internet-based computer-tailored feedback

In addition to predisposing and awareness determinants, several health 1 behavioral models suggested that health behavior is also determined by motivational factors (e.g. Ajzen, 1985; De Vries, et al., 2003). Thus far, only
a few studies have provided evidence on the relevance of motivational
factors on prenatal alcohol use. Peadon and colleagues (2011) have shown that women with a neutral or positive attitude towards prenatal alcohol use are more likely to continue their alcohol use during pregnancy. In addition, women with a partner using alcohol more often consume alcohol when they are pregnant (Bakhireva, et al., 2011; Chang, et al., 2011; Waterson, Evans, & Murray-Lyon, 1990). The scarcity of research on the role of motivational factors in reducing prenatal alcohol use is in contrast with the evidence that motivational factors play an important role in changing other health behavior (e.g. Ajzen, 1985; Bandura, 1986; Janz & Becker, 1984; Schwarzer, Lippke, & Luszczynska, 2011), such as for example smoking cessation (e.g. De Vries, et al., 1998) or attending cancer screening programmes (Knops-Dullens, et al., 2007). In order to compensate for this scarcity of attention, this dissertation focuses on these factors in general and social influences as one of these factors in specific.
The few studies on social influence and prenatal alcohol abstinence (Bakhireva, et al., 2011; Chang, et al., 2011; Waterson, Evans, & Murray- Lyon, 1990) providing first evidence of the importance of these factors in reducing prenatal alcohol use, paved the way for further research on social influence and prenatal alcohol use. Social influence incorporates three elements: social norm, social modelling and social pressure (De Vries, et al., 1995). Social norm refers to the perceived opinions of important others around the respondent, such as her partner. Social modelling refers to perceived behaviour of important others. Social pressure is regarded as a respondent’s perceived pressure from important others to behave in a certain way (De Vries, et al., 1995). The pregnant woman’s partner can be regarded as an important other affecting the pregnant woman’s behaviour (Ockene, et al., 2002). Thus far, current research has merely provided evidence that modelling of the partner has an effect on prenatal alcohol use (Bakhireva, et al., 2011; Chang, et al., 2011; Waterson, et al., 1990). Firm scientific evidence for the effect of partner’s norm and support on prenatal alcohol use is still lacking.
General Introduction
15