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.