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10.1016/s1541-9800(05)70727-4

CrossRef Listing of Deleted DOIs · 2000

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<h4>Aims</h4>To examine longitudinal associations among maternal health literacy, psychological empowerment and health-promoting behaviours across pregnancy among rural pregnant women.<h4>Design</h4>Prospective cohort study.<h4>Methods</h4>Between 1 May 2023 and 15 January 2024, 694 rural pregnant women were assessed at 12, 24 and 32 gestational weeks (T1, T2 and T3). Descriptive, correlation and cross-lagged panel analyses were used.<h4>Results</h4>Significant reciprocal cross-lagged associations were observed among maternal health literacy, psychological empowerment and health-promoting behaviours across pregnancy. Maternal health literacy at T1 significantly predicted psychological empowerment at T2 (β = 0.183, B = 0.056, 95% CI [0.036, 0.075], p < 0.001), and psychological empowerment at T2 predicted health-promoting behaviours at T3 (β = 0.256, B = 0.373, 95% CI [0.246, 0.500], p < 0.001). Longitudinal indirect pathway analysis showed that maternal health literacy at T1 was indirectly associated with health-promoting behaviours at T3 through psychological empowerment at T2 (β = 0.047, B = 0.021, 95% CI [0.010, 0.031], p < 0.001).<h4>Conclusion</h4>Maternal health literacy, psychological empowerment, and health-promoting behaviours were longitudinally and reciprocally associated across pregnancy. Psychological empowerment also carried the longitudinal indirect association between earlier maternal health literacy and later health-promoting behaviours. Early gestation may represent an intervention window.<h4>Implications for the profession and/or patient care</h4>Integrating literacy-sensitive and empowerment-based interventions into antenatal care may help rural pregnant women support sustained health-promoting behaviours throughout pregnancy.<h4>Impact</h4>Clarifies the longitudinal role of maternal health literacy. Demonstrates a significant indirect longitudinal role of psychological empowerment. Supports early-stage capability-based interventions within rural maternal healthcare.<h4>Reporting method</h4>This study is consistent with the STROBE statement for cohort studies.<h4>Patient or public contribution</h4>This study did not include patient or public involvement in its design, conduct or reporting.

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CrossRef Listing of Deleted DOIs
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2000-01-01
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0849-6757
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(2000). 10.1016/s1541-9800(05)70727-4. CrossRef Listing of Deleted DOIs. https://doi.org/10.1111/jan.70727
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