Conceptual Framework

PRENATAL CARE PRACTICES

NUTRITION, CONSULTATION, LIFESTYLE LIFE

PREVALENCE OF LOW BIRTH WEIGHT

CONFOUNDERS
GENES, AGE, CHRONIC CONDITIONS, FINANCES, SMOKING,ENVIRONMENT, PERSONAL REASONS

The conceptual framework was adapted from the Health Promotion Model (HPM) by Nola Pender. Health promotion is defined as activities directed toward the development of resources that maintain or enhance an individuals well-being and actualize human health potential. The Health Promotion Model is motivated by personal positive approach or wellness orientation. (Pender et. al, 2002) The Health Promotion Model includes behavioral science perspectives with factors that impact health behaviors. The model uses constructs from the value expectancy theory and the social cognitive theory. Social cognitive theory focuses on the persons belief interacting with environmental influences. Behavior or practices is not only solely driven by inner forces or automatically shaped by external stimuli. Rather, there is an interaction between cognitive factors, personal factors and environmental events. Beliefs about oneself formed through self-observation and self-reflective thought have the

greatest potential for influencing behavior. The value expectancy theory suggests that behavior is rational and economical. This means that people will not waste their time and resources on behavioral change that have little value to them. It identifies factors that enhance or decrease participation in health promotion and tries to explain the reason that individuals engage in health activities. The conceptual paradigm of the study shows three parts, which are health practices pertaining to prenatal care and prevalence of low birth weight and other factors that might affect either prenatal care practices and prevalence of low birth weight babies. Practices refer to the actions or behavior that the adolescent mother performs in relation to prenatal care as to nutrition, lifestyle and consultation as shown in the blue circle. Nutrition refers to the foods, fluids and other nourishing substances that the pregnant adolescent needs during her pregnancy. This will also include food supplements prescribed in the health center that supplies nutrients that are missing or not consumed in sufficient quantity in a pregnant adolescents diet such as ferrous sulfate, folic acid, multivitamins, and calcium. Consultation refers to prenatal visits of pregnant adolescents to public health centers and the factors that affect their attendance to prenatal visits such as personal reasons and systemic barriers of pregnant adolescents. The lifestyle in this study refers to other social factors like drinking, smoking and work or studying that might be sources of stress that can affect the pregnancy. Confounders, which are extraneous variables that correlate with both the dependent and independent variables, are seen in the purple circle. Some confounders in this study are personal reasons, genes, age, chronic conditions, finance, smoking and environmental factors. The pregnant adolescents beliefs about health are shaped in part by their knowledge or misinformation about body functions and illnesses, educational background and past experiences. It shapes the way a person thinks, including the ability to understand factors involved in health and apply knowledge of health and illness to personal health practices.

Both benefits (pregnant adolescents health beliefs that nutrition, lifestyle, and consultation will help improve both her and the babys well being and prevent possible complications) and barriers to action (complexity, availability, accessibility and affordability of the prenatal practices as to nutrition, lifestyle and consultation) trigger activity in health promoting behavior or practices. Thus, the better the pregnant adolescents perceive their health, the more likely that they will act in ways to maintain it. Aside from genes from the parents of the baby, chronic conditions of the mother like diabetes, heart defects or kidney diseases can lead to low birth weight babies. Bacterial infections can also lead to complications in pregnancy and therefore affect the baby. One factor that can affect low birth weight is the adolescent mothers young gynecological age. The female reproductive system is still developing, it is not yet at its full potential to support a fetus life thus this may predispose them to infections precipitating low birth weight infants in the long run. The adolescents are still growing themselves hence the competition for nutrients is more. Financial status of the mother can also be a source of problems by not having enough money to support the prenatal needs. Smoking during pregnancy is correlated with low birth weight babies. Lastly, environmental factors also play a role in affecting the mother through emotional or physical stress. A non smoking mother for example, in a smoking environment, can still inhale the chemicals and affect the baby.