Social-cognitive correlates of expectant mothers’ safe communication behaviour: Applying an adapted HAPA model

Abstract

To improve patient safety in obstetrics, patients should perform safe communication. However, there is a lack of attempts in targeting expectant mothers. Behaviour change theories can potentially be applied to safe communication behaviour to understand and target contributing factors. The objective of this study was to apply the Health Action Process Approach (HAPA) to obstetric patients’ safe communication behaviour to understand underlying mechanisms of social-cognitive HAPA variables. N = 424 expectant mothers from two university hospitals participated in a cross-sectional survey which was the baseline of a larger randomized controlled trial. The proposed HAPA model with iterative theory-driven extensions were fitted to the data via path modelling. Fit indices were compared. Post-hoc analyses asserted sufficient statistical power. An adapted HAPA model fitted the data best. The adaptation concerned two sequential mediation pathways: The association of intention and safe communication behaviour was mediated by coping self-efficacy and via social support and action planning. Congruent with theory, intention and action planning, mediated by social support and coping self-efficacy, emerged as core factors contributing to safe communication behaviour. The HAPA model can be applied to safe communication behaviour in obstetric patients. Hence, future interventions to enhance expectant mothers’ safe communication should be based on behaviour change theories like the hereby tested HAPA model.

Keywords:

• HAPA
• action planning
• intention
• safe communication behaviour
• obstetric patients

Acknowledgements

We thank Genevieve Barlow and Katharina Schiffer for spell and reference checking the manuscript. We appreciate the help with data collection by Frank Louwen, Frank Reister, Johanna Dietl, Freya Häusler, Martina Schmiedhofer and Sandra Riedmüller. We would like to thank Maya Ahlden and Kim Sousa for proofreading the manuscript.

Disclosure statement

The authors declare that the research was conducted in the absence of any commercial or financial relationship that could be construed as a potential conflict of interest.

Data Availability

The data that support the findings of this study are available on request to the corresponding author, SL. The data are not allowed to be made publicly available due to privacy and data security reasons of research participants.

Author contributions

LK, FMK, CD, and SL contributed to data collection and monitoring as well as conceptual aspects of the present study. LK analysed and described the data statistically and wrote all parts of the manuscript. NTH has provided advice on the methodology and reviewed the results. SL also advised on the methodological conception of the paper. NTH, FMK and CD have provided advice on the logic and structure of the paper. All co-authors endorsed the present version and contributed to the manuscript’s process .

Correction

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The TeamBaby project was funded by the German Innovation Fund (Project No. 01VSF18023) of the Federal Joint Committee (G-BA) as part of a third-party project funding. The project was registered with ClinicalTrials (ClinicalTrials.gov Identifier: NCT03855735).