Comparison of Awareness about Alcohol Use during Pregnancy among Female College Students by Drinking Levels: Using the Theory of Planned Behavior

Saem Yi Kang; Hae Won Kim

doi:10.4040/jkan.2019.49.6.690

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Kang and Kim: Comparison of Awareness about Alcohol Use during Pregnancy among Female College Students by Drinking Levels: Using the Theory of Planned Behavior

Original Article

J Korean Acad Nurs 2019;49(6):690-700.

Published online: 17 January 2019

DOI: https://doi.org/10.4040/jkan.2019.49.6.690

Comparison of Awareness about Alcohol Use during Pregnancy among Female College Students by Drinking Levels: Using the Theory of Planned Behavior

Saem Yi Kang¹, Hae Won Kim^2,

¹College of Nursing, Seoul National University, Seoul

²College of Nursing · The Research Institute of Nursing Science, Seoul National University, Seoul, Korea

Address reprint requests to : Kim, Hae Won College of Nursing · The Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-740-8820 Fax: +82-2-765-4103 E-mail: haewon@snu.ac.kr

Revised 19 August 2019 Accepted 18 September 2019 Received 8 May 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose:

The purpose of this study was to examine the awareness of alcohol use during pregnancy and factors influencing the intention to abstain from alcohol during pregnancy by drinking levels.

Methods:

Utilizing a comparative descriptive design, a total of 359 female college students were recruited. Measurements were Theory of Planned Behavior (TPB) variables related awareness of alcohol use during pregnancy, Korean Version of the Alcohol Use Disorders Identification Test, knowledge about alcohol use during pregnancy, and socio-demographic factors. Main variables were compared by drinking levels. The factors influencing the intention to abstain from alcohol during pregnancy were identified using hierarchical regression analysis.

Results:

Non-problematic alcohol behavior group (n=185) had higher the intention to abstain from alcohol during pregnancy than problematic alcohol behavior group (n=174) (t=3.13, p=.002). The significant TPB variables influencing the intention to abstain from alcohol during pregnancy were that attitudes (β =-.44, p<.001), subjective norms (β =.14, p=.026), and perceived behavior control (β =.19, p=.002) in non-problematic alcohol behavior group, whereas the corresponding variables in the problematic alcohol behavior group were attitudes (β =-.51, p<.001) and subjective norms (β =.21, p=.006).

Conclusion:

It is necessary to increase the intention to abstain from alcohol during pregnancy for the female college students having problematic alcohol behavior. The following strategies are recommended for them; decreasing acceptable attitudes toward alcohol use during pregnancy and reinforcing the influence of social pressure toward to abstain from alcohol during pregnancy.

Keywords: Alcohol Drinking, Pregnancy, Alcohol-Related Disorders, Awareness

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Table 1.

Drinking Behavior Characteristics of the Subjects (N=359)

Characteristics	Categories	M±SD or n (%)
AUDIT-K	(range 0~33)	8.53±6.57
	Non AP (1~7)	185 (51.5)
	Medium level of AP (8~15)	127 (35.4)
	High level of AP (16~19)	18 (5.0)
	SAD (≥20)	29 (8.1)
Drinking frequency	Not at all	40 (11.1)
	Monthly or less	105 (29.2)
	2 to 4 times a month	178 (49.6)
	2 to 4 times a week	29 (8.1)
	More than 4 times a week	7 (2.0)
Drinking amount (glass)	1~2	69 (19.2)
	3~4	69 (19.2)
	5~6	81 (22.6)
	7~9	70 (19.5)
	10 or more	70 (19.5)
Age at drinking onset (yr)	(range 10~24)	19.04±1.57
(n=356)	≤18	75 (21.1)
	>18	281 (78.9)

AP=Alcohol problems; AUDIT-K=Korean version of the alcohol use disorders identification test; M=Mean; SAD=Suspicious alcohol dependence; SD=Standard deviation.

Table 2.

Comparisons of Socio-demographic Characteristics and Health Behavior Characteristics between Groups (N=359)

Characteristics	Categories	Total	Non problem drinking group (AUDIT-K<8) (n=185)	Problem drinking group (AUDIT-K≥8) (n=174)	χ² or t or Z (p)
Characteristics	Categories	Total	M±SD or n (%)		χ² or t or Z (p)
Socio-demographic characteristics
Age (yr)	(range 18~29)	21.24±2.05	21.41±2.18	21.07±1.90	1.56 (.120)^†
Grade	Freshmen	107 (29.8)	50 (27.0)	57 (32.8)	8.47 (.037)
	Sophomore	99 (27.6)	55 (29.7)	44 (25.3)
	Junior	61 (17.0)	24 (13.0)	37 (21.2)
	Senior	92 (25.6)	56 (30.3)	36 (20.7)
Religion	No	230 (64.1)	122 (65.9)	108 (62.1)	0.59 (.444)
	Yes	129 (35.9)	64 (34.1)	66 (37.9)
Allowance (10,000 won) (n=340)	(range 5~200)	47.43±24.16	44.89±20.84	50.03±26.97	-2.23 (.026)^††
Boy friend	No	219 (61.0)	128 (69.2)	91 (52.3)	10.75 (.001)
	Yes	140 (39.0)	57 (30.8)	83 (47.7)
Education of alcohol use during	No	34 (9.5)	18 (9.7)	16 (9.2)	0.03 (.863)
pregnancy is needed	Yes	325 (90.5)	167 (90.3)	158 (90.8)
Health behavior characteristics
Smoking experience	No	341 (95.0)	182 (98.4)	159 (91.4)	9.22 (.002)
	Yes	18 (5.0)	3 (1.6)	15 (8.6)
Feel stressed	Not at all	9 (2.5)	6 (3.2)	3 (1.7)	2.47 (.494)^§
	A little	151 (42.1)	83 (44.9)	68 (39.1)
	A lot	143 (39.8)	68 (36.8)	75 (43.1)
	Very much	56 (15.6)	28 (15.1)	28 (16.1)
Feel depressed	No	247 (68.7)	131 (70.8)	116 (66.7)	0.72 (.397)
	Yes	112 (31.2)	54 (29.2)	58 (33.3)
Have thought about suicide	No	241 (67.1)	122 (65.9)	119 (68.4)	0.24 (.622)
	Yes	118 (32.9)	63 (34.1)	55 (31.6)

AUDIT-K=Korean version of the Alcohol use disorders identification test; M=Mean; SD=Standard deviation.

^† Independent t-test,

^†† Mann-Whitney U test,

^§ Fisher’s exact test.

Table 3.

Comparisons of Knowledge about Alcohol Use during Pregnancy and TPB Variables between Groups (N=359)

Characteristics	Total	Non problem drinking group (AUDIT-K<8) (n=185)	Problem drinking group (AUDIT-K≥8) (n=174)	χ² or t (p)
Characteristics	Total	M±SD or Correcct answer, n (%)		χ² or t (p)
1. Knowledge about alcohol effects on pregnancy outcomes
Heavy drinking during pregnancy increases the chances of^†
1) Miscarriage	258 (71.9)	128 (69.2)	130 (74.7)	1.35 (.245)
2) Mental retardation	319 (88.9)	163 (88.1)	156 (89.7)	0.22 (.642)
3) Low birth weight	131 (36.5)	66 (35.7)	65 (37.4)	0.11 (.741)
4) Birth defects	284 (79.1)	144 (77.8)	140 (80.5)	0.38 (.541)
Heard of FAS	194 (54.0)	107 (57.8)	87 (50.0)	2.22 (.136)
Knowledge score (range 0~5)	3.30±1.23	3.27±1.28	3.32±1.17	-0.37 (.714)^††
Best definition of FAS				1.85 (.411)^§
1) Baby born drunk	8 (2.2)	6 (3.2)	2 (1.1)
2) Baby born addicted to alcohol	126 (35.1)	66 (35.7)	60 (34.5)
3) Baby born with certain birth defects	225 (62.7)	113 (61.1)	112 (64.4)
2. TPB variables related to alcohol use during pregnancy
1) Attitudes (range 4~20)	5.93±2.43	5.87±2.46	5.99±2.40	-0.46 (.645)^††
2) Subjective norms (range 3~15)	13.64±1.62	13.69±1.60	13.59±1.63	0.59 (.559)^††
3) Perceived behavior control (range 4~20)	17.74±2.37	17.81±2.24	17.66±2.51	0.60 (.550)^††
4) Intention (range 3~15)	12.90±2.19	13.24±2.14	12.53±2.18	3.13 (.002)^††

AUDIT-K=Korean version of the Alcohol use disorders identification test; FAS=Fetal alcohol syndrome; M=Mean; SD=Standard deviation; TPB=Theory of planned behavior.

^† Multiple choice questions,

^†† Independent t-test,

^§ Fisher’s exact test.

Table 4.

Factors Influencing the Intention to Abstain from Alcohol during Pregnancy (N=359)

Variables	Non drinking problem group (n=185)				Drinking problem group (n=174)
	Model 1		Model 2		Model 1		Model 2
	B	β (p)	B	β (p)	B	β (p)	B	β (p)
(Constant)	8.88		8.52		12.73		16.63
Age	0.10	.10	0.03	.03	-0.09	-.08	-0.14	-.12
		(.144)		(.548)		(.281)		(.050)
Drinking frequency	-0.81	-.30	-0.63	-.23	-0.06	-.02	-0.42	-.13
		(<.001)		(<.001)		(.800)		(.038)
Have thought about suicide^†	-0.04	-.01	0.20	.05	-1.13	-.24	-0.68	-.15
		(.882)		(.368)		(.001)		(.020)
Education of alcohol use during pregnancy is needed^†	2.22	.31	0.85	.12	1.31	.17	-0.26	-.04
		(<.001)		(.026)		(.019)		(.595)
Knowledge score about alcohol use during pregnancy	0.38	.23	0.14	.09	0.30	.16	0.13	.07
		(.001)		(.100)		(.031)		(.247)
Attitude			-0.38	-.44			-0.47	-.51
				(<.001)				(<.001)
Subjective norm			0.19	.14			0.28	.21
				(.026)				(.006)
Perceived behavior control			0.18	.19			-0.08	-.09
				(.002)				(.211)
R² (ΔR²)	.	26	.59	(.33)	.	15	.44	(.29)
Adj R²	.	24	.57		.	13	.41
F (p)	12.81	(<.001)	45.67	(<.001)	6.07 (	(<.001)	28.24	(<.001)

^† Dummy variables (Ref. no).

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