Promoting Childbearing Intention WithTeach-Back Method: The Role of Attitudes and Perceived Behavioral Control Among Married Women

The Effect of the Teach-Back Educational Method on Childbearing Intention Based on the Theory of Planned Behavior Among Married Women in Khoy

This study was a parallel-group, open-label, cluster quasi-experimental controlled trial conducted on 150 eligible women (75 intervention, 75 control). To prevent contamination, allocation was performed at the cluster level across eight comprehensive health centers, randomly assigning four centers to the intervention group and four to the control group, followed by simple random sampling of participants from each center

Conducted on TPB-based fertility intention across 8 urban health centers in Khoy. Cluster allocation of centers into intervention and control groups (4 each). Baseline face-to-face interview surveys. Intervention received four 45-minute Teach-Back sessions; control received routine care. Follow-up after 3 months. Unblinded due to educational intervention.

Inclusion Criteria: Women of reproductive age (15–49 years); no medical contraindication for pregnancy; having an active health record at a comprehensive health service center; willingness to participate and providing informed consent. Exclusion Criteria: Pregnancy during the study period; infertility in either partner.

Intervention Group: Participated in four 45-minute sessions (25 minutes of TPB-based education and 20 minutes of Teach-Back) to improve fertility knowledge, attitudes, subjective norms, and perceived behavioral control. Control Group: Received routine care with no specific intervention during the study period; educational materials were provided only after the 3-month follow-up (to uphold ethical principles).

Fertility intention; Reproductive knowledge; Attitude toward childbearing; Subjective norms; Perceived behavioral control

Randomization was conducted using a multistage cluster-randomized design. Khoy city was initially divided into two geographic zones based on municipal divisions. From each zone, four urban comprehensive health service centers were randomly selected (total of 8 centers). Within each zone, two centers were randomly allocated to the intervention group and two centers to the control group (resulting in 4 intervention clusters and 4 control clusters). In the final stage, 20 eligible women from each health center were selected using simple random sampling from the center’s registry list. The primary unit of randomization for group allocation was at the cluster level (comprehensive health service centers) to prevent contamination and information exchange between groups, while the secondary selection of participants was at the individual level. Stratified randomization was applied based on the two municipal geographical regions of Khoy city as strata to ensure socioeconomic and geographical balance across study arms. The random allocation sequence for both cluster assignment and individual participant sampling was generated using a random number table. Cluster allocation was determined prior to participant enrollment. Eligible participants were unaware of the alternative group allocation across other centers during recruitment and consent, and geographical separation between health centers ensured effective concealment and prevented contamination across study arms.

Due to the sensitivity of the study topic and the potential risk of re-identification of participants within a small-scale sample, we are unable to share individual participant data in order to strictly protect participant confidentiality and privacy.