title: Use of the extended parallel process model (EPPM) to predict Iranian women's intention for vaginal delivery.
abstract: OBJECTIVE
  To explicate whether knowledge, perception of health threat, efficacy, and personal beliefs act as predictors for women's intention to have a normal vaginal birth.
  
  
  METHODS
  The study uses a mixed approach. Simultaneously, 290 pregnant women who visited prenatal clinics completed the study. Quantitative and qualitative data were collected using a structured questionnaire based on Witte's extended parallel process model and four focus groups, respectively.
  
  
  RESULTS
  Women perceived lower risk but higher levels of efficacy. Perceived self-efficacy, severity, and response efficacy were identified as significant predictors of intention to experience vaginal birth. Participants' insufficient knowledge and misconceptions about birth methods were dominant. Two major themes were identified and divided into negative and positive beliefs about vaginal birth.
  
  
  CONCLUSIONS
  The extended parallel process model provides a useful framework to assess women's intention to have a vaginal birth, especially when it is combined with a qualitative approach. Within Iranian women, self-confident mothers are more likely to intend to deliver vaginally.
  Prenatal care provides an opportunity for nurses and midwives to explore mothers' beliefs and intended childbirth method prior to offering medical intervention.
authors.affiliation: Shahid Beheshti University of Medical Sciences, Tehran, Iran hajian74@yahoo.com.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Hajian
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Shariati
authors.affiliation: Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Khadijeh
authors.initials: K
authors.lastname: Mirzaii Najmabadi
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Yunesian
authors.affiliation: Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Mohammad Ismail
authors.initials: MI
authors.lastname: Ajami
mesh_terms: D036861:Delivery, Obstetric / Q000379:methods* / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D007492:Iran; D008960:Models, Psychological; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D020377:Self Efficacy; D011795:Surveys and Questionnaires
keywords: Extended Parallel Process Model; normal vaginal birth; transcultural health