Effectiveness of an educational intervention using theory of planned behavior on health care empowerment among married reproductive-age women: A randomized controlled trial

BACKGROUND: Empowerment is an essential issue in women's lives. Powerful women can act successfully in health-related issues more than others. This study aimed to determine the effectiveness of an educational intervention designed based on theory of planned behavior (TPB) on health care empowerment among married women in reproductive age. METHODS: This randomized controlled trial was carried out among 488 reproductive-age women between 2018 and 2019 in Tehran, Iran. Participants were recruited using randomized cluster sampling and divided into intervention (n = 243) and control (n = 245) groups by random allocation. Data were collected using a self-administered researcher-made questionnaire based on TPB and Health Care Empowerment Questionnaire. Validity (content validity index = 0.87; content validity ratio = 0.89) and reliability of the questionnaires were confirmed (α = 0.96). Intervention was implemented within four sessions (lasting 60 min) using eight health related scenarios based on TPB constructs. Baseline and post intervention data (6 months after the intervention) were analyzed by SPSS(25) (Inc., Chicago, IL, USA) using independent t-test, Chi-squared test, Fisher's Exact test, Mann–Whitney, path analysis, and regression of generalized estimating equation model. P < 0.05 was considered statistically significant. RESULTS: Results showed the mean ± standard deviation age of the participants was 33.6 ± 7.1. Six months after the intervention, a significant difference was highlighted in health care empowerment domains as well as behavioral intention, attitude toward behavior, subjective norms, and perceived behavioral control (P < 0.001) between intervention and control groups. CONCLUSION: TPB-based educational intervention can significantly improve women's perception about health care empowerment. Tailoring and implementation of TPB-based intervention by health policy makers and health care providers is suggested to achieve better perception of empowerment toward receiving health care among women.