Page 21 - Zero for nine: Reducing alcohol use during pregnancy via health counselling and Internet-based computer-tailored feedback
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The theoretical background of the interventions to reduce prenatal alcohol use
The seriousness and magnitude of the health problem justify the development of an intervention to reduce prenatal alcohol use. In this dissertation two brief interventions to reduce prenatal alcohol use are described. For these interventions to be effective, they should focus on the most important and changeable determinants of the health behaviour under consideration. The I-Change Model was used as framework to identify these determinants (Figure 1.1 and Chapter 4).
The I-Change model has been applied within several previous Dutch studies, for example concerning smoking in pregnancy (De Vries, et al., 2006a), sunscreen use (De Vries, et al., 2012), cancer screening (Knops-Dullens, de Vries, & de Vries, 2007) and breast-feeding (Kools, et al., 2005b). It is an integration of various behaviour-oriented theories such as the Social Cognitive Theory (Bandura, 1986), the Health Belief Model (Janz & Becker, 1984), the Theory of Planned Behaviour (Ajzen, 1985), the Transtheoretical Model (Prochaska & Velicer, 1997), and Goal Setting theories (Gollwitzer, 1999; Schwarzer, Lippke, & Luszczynska, 2011). The model maps the psychological determinants of behaviour change, distinguishing three motivational change phases (De Vries, et al., 2003). In the pre-motivational phase, people need to become aware of a health problem. In this phase, preceding or predisposing factors (e.g. demographics, prenatal alcohol use and pregnancy characteristics), information factors (e.g. messages and sources) and awareness factors (e.g. knowledge and risk perceptions) are important determinants. For instance, people may become aware of the risks of prenatal alcohol use when they have more knowledge about the consequences of prenatal alcohol use for the unborn baby. In the motivational phase, people need
General Introduction
8. How do Dutch pregnant women experience midwives’ alcohol advice?
9. How do partners of pregnant women experience midwives’ alcohol advice?
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