The Effect of “Motivational Interviewing” and “Information, Motivation, and Behavioral Skills Model” Counseling Interventions on the Choice of Delivery Mode in Pregnant Women Using Face-to-Face Training vs. Mobile App: A Randomized Controlled Trial

Abstract

Objective. To investigate the impact of counseling interventions, using face-to-face training vs. mobile app for choosing mode of delivery. Design. A four-armed, randomized, controlled parallel-design trial. Setting. Ebnesina Private Hospital in Tehran, Iran. Population. Pregnant women, between 24 and 32 weeks of gestation (n = 120). Methods. Pregnant women were randomly assigned in three psycho-educational intervention groups: (1) motivational interviewing via face-to-face training, (2) information, motivation, and behavioral skills model via face-to-face training, (3) the same model via a mobile application, and (4) usual antenatal care (control group). To assess the face-to-face and mobile app training method on women’s self-efficacy and intention in choosing a mode of delivery. Main Outcome Measures. Mode of delivery (Cesarean section). Results. While all three intervention groups showed significant increases in women’s self-efficacy and intentions to choose vaginal delivery, the increase was particularly noticeable among those using mobile applications: Before the intervention, self-efficacy and intention Mean ± SD were 77.1 ± 38.6 (CI-95%: [62.72, 91.60]) and 1.10 ± 0.305 (CI-95%: [0.99, 1.21]), respectively. After the intervention, these scores increased to 99.7 ± 30.7 (CI-95%: [88.27, 111.20]) for self-efficacy and 1.70 ± 0.466 (CI-95%: [1.53, 1.87]) for intention. Although 56.7% of women in the intervention groups expressed a preference for vaginal delivery, only 37.5% ultimately pursued this birthing method. Conclusions. Brief psycho-educational interventions, particularly technology-driven interventions (mobile apps) can increase the likelihood of women choosing vaginal delivery. To enhance the effectiveness of such interventions, they can be conducted in conjunction with interventions for doctors and healthcare providers. This trial is registered with IRCT20151208025431N7.