Mira Triharini, Kusnul Chotimah, Praba Diyan Rachmawati, Eka Mishbahatul Mar’ah Has

Development of Self-Regulation Model Based on Health Promotion Model on Anemia Prevention Behavior in Pregnant Women

Introduction

Development of self-regulation model based on health promotion model on anemia prevention behavior in pregnant women. Develops a self-regulation model based on the Health Promotion Model for anemia prevention in pregnant women. Highlights self-regulation's pivotal role and offers a framework for nursing interventions.

Abstract

Background: Anemia prevention in pregnant women is essential to reduce health risks for both mother and fetus. This study aimed to develop a self-regulation model for anemia prevention behavior based on the Health Promotion Model. Methods: An explanatory design with a cross-sectional approach was applied to 115 pregnant women attending health centers in Surabaya, selected through cluster sampling. Data were collected using a structured questionnaire and analyzed using SEM-PLS. Results: The findings showed that anemia prevention behavior was significantly influenced by behavioral self-regulation (T=2.945) through personal regulation (T=5.932), which was shaped by environmental self-regulation (T=8.611) and individual characteristics (T=3.302). Commitment did not directly affect anemia prevention behavior (T=0.144; p=0.886). The model demonstrated substantial explanatory power, with R² values of 71.9% for behavioral self-regulation and 43.1% for anemia prevention behavior. Predictive relevance (Q² > 0) confirmed the model’s robustness across different contexts. Conclusion: This study highlights the pivotal role of self-regulation processes in shaping anemia prevention behavior. The model can serve as a framework for nursing interventions to strengthen self-regulation among pregnant women and improve maternal and fetal health outcomes.

Review

This study addresses a critically important public health issue: anemia prevention in pregnant women, a significant factor in maternal and fetal health outcomes. The authors' initiative to develop a self-regulation model, grounded in the Health Promotion Model, is a commendable approach to understanding and influencing health behaviors. Methodologically, the application of an explanatory design with a cross-sectional approach, utilizing SEM-PLS analysis, is appropriate for model development and testing complex relationships. The reported substantial explanatory power of the model, with R² values of 71.9% for behavioral self-regulation and 43.1% for anemia prevention behavior, suggests a robust and meaningful contribution to the field, particularly in highlighting the hierarchical influence from environmental self-regulation and individual characteristics through personal regulation to behavioral self-regulation, ultimately impacting anemia prevention. While the study provides valuable insights, some areas warrant further consideration. The cross-sectional design, inherent in an explanatory approach, limits the ability to infer direct causality, despite the use of "influenced by" in the results. A longitudinal study would provide stronger evidence for the temporal sequence of these relationships. Additionally, while the abstract states the model is "based on the Health Promotion Model," the specific constructs from HPM that were integrated or how they interface with the self-regulation components are not detailed, which could clarify the theoretical advancement. The finding that "Commitment did not directly affect anemia prevention behavior" is intriguing and deserves more in-depth discussion within the full paper to provide theoretical context or suggest alternative pathways for commitment's influence. Furthermore, relying solely on self-reported data collected via questionnaires might introduce social desirability bias, potentially affecting the accuracy of reported behaviors. Despite these points, the study offers a valuable framework for understanding and addressing anemia prevention behavior. The identified pivotal role of self-regulation processes provides a clear target for intervention strategies. The model's practical utility as a foundation for nursing interventions to strengthen self-regulation among pregnant women is a significant implication. Future research could build upon this by conducting longitudinal studies to establish causality, replicating the model in diverse populations and settings to enhance generalizability, and potentially integrating qualitative methods to explore the nuances of self-regulation and commitment in this specific context. Overall, this research contributes significantly to behavioral science and public health by offering a novel, evidence-based approach to improving maternal and fetal health outcomes through enhanced self-regulation.

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