This randomized controlled, open-label study evaluated the effects of two delivery methods for education based on Pender's Health Promotion Model on healthy lifestyle behaviors in pregnant women. The study was conducted at two family health centers in Istanbul, Turkey, between April 2025 and February 2026.
A total of 102 eligible primigravida pregnant women at 12-16 weeks of gestation were randomly assigned to three groups, with 34 participants in each group. The first experimental group received three weekly individual education sessions delivered through immersive 360-degree virtual reality videos. The second experimental group received the same educational content through printed booklets in three weekly individual face-to-face sessions. Following the educational sessions, both experimental groups received five monthly motivational interviewing telephone calls. The control group received routine prenatal care without additional education or motivational interviewing.
The Healthy Lifestyle Behaviors in Pregnancy Scale and the Depression Anxiety Stress Scale-21 were administered face-to-face at baseline and by telephone at 36-38 weeks of gestation. The primary outcomes were the total and subscale scores of the Healthy Lifestyle Behaviors in Pregnancy Scale following the intervention period. The secondary outcomes were the depression, anxiety, and stress subscale scores of the Depression Anxiety Stress Scale-21 following the intervention period. These scores were compared among the virtual reality education, booklet-based education, and routine-care control groups.