Individual Counseling Based on Fogg Behavior Model and Its Effect on Decision Self-Efficacy and Decision Conflict in Choice of Vaginal Birth After Cesarean Section: A Randomized Clinical Trial

Background: Given the high rate of cesarean section complications, mothers who have had previous cesarean sections should change their behavior toward delivery. Self-efficacy plays important role in mother's ability to adapt to vaginal birth and reduce tendency to cesarean section.Aim: The current research was conducted with aim to investigate the individual counseling based on Fogg behavior model and its effect on decision self-efficacy and decision conflict to choose vaginal birth after cesarean section.Method: This randomized clinical trial study was performed on 62 pregnant women referred to the comprehensive health centers of Mashhad in 2020. The intervention group received two face-to-face individual counseling sessions based on Fogg’s model every 2 weeks for 45-60 minutes and one virtual session on the Telegram channel. Data analysis was done using SPSS software (version 25) and the statistical tests of Mann-Whitney, Chi-square, Fisher exact, independent t and paired t-test. p<0.05 was considered significant.Results: Mean score of Fogg’s model showed a significant difference between the two groups (2.79±0.52 vs. 2.33±0.31). Mean score of decision self-efficacy and decision conflict had a statistically significant difference after the intervention (3.44±0.45 and 1.03±0.33, respectively) compared to before the intervention (2.57±0.97 and 1.44±0.59, respectively) in two groups. The mean score of Fogg’s questionnaire was significantly different between the two groups (p<0.05).Implications for Practice: Counseling based on Fogg model promotes decision self-efficacy and reduces decision conflict in choosing vaginal birth after cesarean section. Maternal health care providers should consider this approach in consultation with previous cesarean section mothers.