Association between health belief model perceptions and self-protective behaviors against fine particulate matter (PM2.5) among pregnant women
Keywords:
Health belief model (HBM), Self-protective behaviors, Health perception, Particulate Matter 2.5 (PM2.5), Pregnant womenAbstract
The escalating prevalence of fine particulate matter (PM2.5) poses a significant threat to maternal and fetal health. Empirical evidence suggests that PM2.5 exposures during pregnancy is associated with the adverse pregnancy outcomes which include low birth weight (LRW), preterm delivery, intrauterine growth restriction (IUGR), and an increased incidence of preeclampsia. This descriptive correlational research aimed to study health belief model (HBM)-based perceptions and self-protective behaviors against PM2.5 exposures among pregnant women. Additionally, it sought to investigate the association between HBM-based perceptions (comprising perceived susceptibility, perceived severity, perceived benefits, and perceived barriers) and self-protective behaviors against PM2.5 exposures. The sample group of 234 pregnant women attending the Antenatal Care (ANC) clinic at Chiang Rai Prachanukroh Hospital was selected using a purposive sampling method. Data collection tools consisted of a demographic questionnaire, a HBM-based perceptions questionnaire with a KR-20 reliability coefficient of .90, and a questionnaire about self-protective behaviors against PM2.5 exposures with a Cronbach's alpha coefficient of .92. Data were analyzed using descriptive statistics and Spearman correlation coefficient. The findings revealed that overall HBM-based perceptions were at a moderate level (x̄=10.09, SD=0.47), whereas the self-protective behaviors against PM2.5 exposures (x̄=22.24, SD=0.79) reached a high level. Furthermore, the overall HBM-based perceptions (rs=.237, p=.001) were statistically significant associated with self-protective behaviors against PM2.5 exposures. Consequently, healthcare professionals should leverage the Health Belief Model (HBM) to enhance health perception among pregnant women in order to facilitate the consistent self-protective behaviors against PM2.5 exposures.
References
American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice. (2021). Reducing prenatal exposure to toxic environmental agents (Committee Opinion No. 832). Obstetrics & Gynecology, 138(1), e40–e51. https://doi.org/10.1097/AOG.0000000000004460
Becker, M.H. (1974). The health belief model and sick role behavior. In M. H. Becker (Ed.), The health belief model and personal health behavior (pp. 82-92). Charles B. Slack.
Best, J. W. (1977). Research in education (3rd ed.). Prentice-Hall.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates. https://doi.org/10.4324/9780203771587
DeFranco, E., Moravec, W., Xu, F., Hall, E., Hossain, M., Haynes, E. N., Muglia, L., & Chen, A. (2016). Exposure to airborne particulate matter during pregnancy is associated with preterm birth: a population-based cohort study. Environmental health: a global access science source, 15, 6. https://doi.org/10.1186/s12940-016-0094-3
Department of Health Service Support. (2019). Guidelines for health behavior assessment based on health promotion principles. Ministry of Public Health. (in Thai)
Huang, C.-C., Chen, B.-Y., Pan, S.-C., Ho, Y.-L., & Guo, Y.-L. (2019). Prenatal exposure to PM2.5 and congenital heart diseases in Taiwan. Science of the Total Environment, 655, 880–886. https://doi.org/10.1016/j.scitotenv.2018.11.284
Intarakamhang, U. (2020). Creating the situations report of environmental health literacy on preventing the health impacts from dust particulate matter of less than 2.5 micrometers (PM2.5) of village health volunteers in ecological industrial urban areas. Health Impact Assessment Division, Department of Health, Ministry of Public Health. (in Thai)
Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11(1), 1–47. https://doi.org/10.1177/109019818401100101
Lamichhane, D. K., Jung, D. Y., Shin, Y. J., Lee, K. S., Lee, S. Y., Ahn, K., Kim, K. W., Shin, Y. H., Suh, D. I., Hong, S. J., & Kim, H. C. (2021). Association between ambient air pollution and perceived stress in pregnant women. Scientific Reports, 11, Article 23496. https://doi.org/10.1038/s41598-021-03316-6
Li, J., Huang, L., Han, B., van der Kuijp, T. J., Xia, Y., & Chen, K. (2021). Exposure and perception of PM2.5 pollution on the mental stress of pregnant women. Environment International, 156, Article 106686. https://doi.org/10.1016/j.envint.2021.106686Li, Z., Tang, Y., Song, X., Lazar, L., Li, Z., & Zhao, J. (2019). Impact of ambient PM2.5 on adverse birth outcome and potential molecular mechanism. Ecotoxicology and environmental safety, 169, 248–254. https://doi.org/10.1016/j.ecoenv.2018.10.109
Malaicharoen, H. (2022). Factors related to self-protective behaviors against particulate matter smaller than 2.5 microns (PM2.5) among people in Na Phra Lan Subdistrict, Chalerm Prakiat District, Saraburi Province. Journal of Public Health and Innovation, 2(3), 82–97. https://he01.tci-thaijo.org/index.php/J-PHIN/article/view/255124 (in Thai)
Maneechot, P. (2020). Factors influencing urban residents’ preventive behaviors against PM2.5 air pollution. [Unpublished manuscript/Research report].
Ministry of Public Health. (2021). Medical and public health operations manual for dust particles not exceeding 2.5 microns (PM2.5) (2021). Ministry of Public Health. (in Thai)
Niampradit S, Kliengchuay W, Mingkhwan R, Worakhunpiset S, Kiangkoo N, Sudsandee S, Hongthong A, Siriratruengsuk W, Muangsuwan T, Tantrakarnapa K. The Elemental Characteristics and Human Health Risk of PM2.5 during Haze Episode and Non-Haze Episode in Chiang Rai Province, Thailand. Int J Environ Res Public Health. 2022 May 18;19(10):6127. https://doi.org/10.3390/ijerph19106127
Oudin, A., Frondelius, K., Haglund, N., Källén, K., Forsberg, B., Gustafsson, P., & Malmqvist, E. (2019). Prenatal exposure to air pollution as a potential risk factor for autism and ADHD. Environment international, 133(Pt A), 105149. https://doi.org/10.1016/j.envint.2019.105149
Phupong, V. (2019). Particulate Matter 2.5 and Obstetric Complications. Thai Journal of Obstetrics and Gynaecology, 27(1), 2-5. https://doi.org/10.14456/tjog.2019.1 (in Thai).
Pollution Control Department. (2024). Thailand pollution situation report 2023. Ministry of Natural Resources and Environment. https://www.pcd.go.th (in Thai)
Rattasumpun, S., Sirabarameesith, N. & Rattasumpun, C. (2022). Relationship between Health Literacy and Preventive Behavior Regarding PM2.5 Exposure among Pregnant Women, Pathum Thani Hospital. Songklanagarind Journal of Nursing, 42(3). 53-62. (in Thai).
Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328–335. https://doi.org/10.1177/109019817400200403
Sopajaree, C., Kamfoo, K., Shatpattananunt, B., Kietmaneerut, S., Kodyee, S., Wuttipan, N., Thammetha, P., & Chanthapreeda, N. (2023). The perceptions of pregnant women towards PM 2.5 pollution. Journal of Science and Technology Phetchabun Rajabhat University, 3(2), 9–22. https://so04.tci-thaijo.org/index.php/jstpcru/article/view/267863 (in Thai)
Sripaung, N., & Anantagulnathi, P. (2021). Manual for surveillance, prevention, and control of diseases and health threats caused by PM2.5. Division of Occupational and Environmental Diseases, Department of Disease Control, Ministry of Public Health. https://ddc.moph.go.th/uploads/publish/1202520211213111057.pdf
Wang, W., Mu, S., Yan, W., Ke, N., Cheng, H., & Ding, R. (2023). Prenatal PM2.5 exposure increases the risk of adverse pregnancy outcomes: Evidence from meta-analysis of cohort studies. Environmental Science and Pollution Research, 30(48), 106145–106197. https://doi.org/10.1007/s11356-023-29700-5
Wichaino, P. (2023). Risk perception and perceived impacts of PM2.5 haze among residents in an industrial urban area of Samut Prakan Province. Sahassart. Journal of Social Sciences and Humanities, 22(2), 23–41. Retrieved from https://so02.tci-thaijo.org/index.php/sahasart/article/view/256400
World Health Organization. (2021). WHO global air quality guidelines: Particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. World Health Organization. https://apps.who.int/iris/handle/10665/345329
Yang, S., Tan, Y., Mei, H., Wang, F., Li, N., Zhao, J., Zhang, Y., Qian, Z., Chang, J. J., Syberg, K. M., Peng, A., Mei, H., Zhang, D., Zhang, Y., Xu, S., Li, Y., Zheng, T., & Zhang, B. (2018). Ambient air pollution the risk of stillbirth: A prospective birth cohort study in Wuhan, China. International journal of hygiene and environmental health, 221(3), 502–509. https://doi.org/10.1016/j.ijheh.2018.01.014
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Journal of Nursing and Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
