Determinants of Childbearing: Behavioral Change Models and Theories: A Systematic Review

Tayebeh Mokhtari  Sorkhani; Mahshid  Bokaie; Farzan  Madadizadeh; Manoj Sharma; Bendaoud  Nadif; Seyed Saeed Mazloomy  Mahmoodabad

doi:10.18502/ijph.v54i8.19578

Tayebeh Mokhtari Sorkhani Social Determinants of Health Research Center, Non-Communicable Diseases Research Institute, Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Mahshid Bokaie Research Center for Nursing and Midwifery Care, Department of Midwifery, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Farzan Madadizadeh Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Manoj Sharma Department of Social and Behavioral Health, School of Public Health, University of Nevada (UNLV), Las Vegas, United States
Bendaoud Nadif ESEF, Sultan Moulay Slimane University, Beni Mellal, Morocco
Seyed Saeed Mazloomy Mahmoodabad Social Determinants of Health Research Center, Non-Communicable Diseases Research Institute, Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

DOI: https://doi.org/10.18502/ijph.v54i8.19578

Keywords: Behavior change models; Behavioral theories; Childbearing; Health education; Health promotion

Abstract

The decline in total fertility rate (TFR) below replacement levels has significant implications for public health. This comprehensive narrative review aimed to examine behavioral change models and theories pertinent to childbearing decisions. Articles published between 1977 and 2024 were retrieved from from domestic databases (Magiran, SID) and international databases (Web of Science, Scopus, ProQuest, PubMed, MEDLINE), as well as Google Scholar using relevant keywords. Out of 90 articles initially identified, 36 met the inclusion criteria and were selected for analysis. Existing behavioral change models in health education have limitations in motivating couples to increase childbearing. These models do not fully address complex and multifaceted factors such as socio-economic and cultural influences. Furthermore, there is a need for more rigorous and comprehensive evaluations of the effectiveness of interventions based on these models. Evidence-based educational programs, tailored incentive policies, and rigorous model evaluation are essential to promote positive attitudes towards parenthood. Future interventions should assess the applicability of novel theories to optimize fertility program outcomes, with a particular focus on the role of public health. Further research is needed to investigate innovative models for explaining and changing childbearing behaviors.