Abstract
Introduction: Nutritional practices during pregnancy are crucial for maternal and fetal health, yet suboptimal dietary behaviors persist globally, particularly in low-resource settings. Behavior-change interventions (BCIs) have emerged as a promising strategy. This scoping review examines the evidence of BCIs aimed at enhancing nutritional practices during pregnancy and suggests recommendations for future interventions.
Methods: A systematic search using PRISMA-ScR guidelines was conducted across MEDLINE (PubMed), Scopus, and CINAHL to identify theory-based studies on behavior change interventions (BCIs) aimed at improving nutritional practices during pregnancy.
Results: Nine studies met the inclusion criteria. The interventions spanned diverse geographic regions and employed various theoretical frameworks such as the Theory of Planned Behavior, Social Cognitive Theory, and the Health Belief Model. Delivery methods included education, counseling, and mobile health (mHealth) tools. Improvements included increased dietary diversity (OR=4.18, P<0.01), higher micronutrient intake (iron, folate, calcium; P<0.001), and enhanced nutritional knowledge (3 studies, P<0.001). Positive shifts were observed in behavior change constructs such as self-efficacy (P<0.0001) and intention (P<0.001). Favorable maternal and neonatal health outcomes included increased birth length (P=0.043) and maternal weight gain (P<0.05).
Conclusion: The review highlights the effectiveness of education-based BCIs but identifies limitations such as small sample sizes and lack of process evaluations. Sustaining behavior change remains a challenge. Future research should focus on process evaluation, sustainability, and scalability of BCIs.