The correlation between a healthy lifestyle among pregnant women and their compliance with educational guidelines in Iran's health system using best-evidence audit criteria
Authors: habibi farangis , Shahhosseini Zohreh , Jahanfar Shayesteh , Fendereski Afsaneh , Ahmadi Mohammad , Hamzehgardeshi Zeinab 
Published: September 2023

Background and Aim:
Considering pregnancy as a critical period, pregnant women are obligated to maintain a healthy lifestyle. With this perspective, the present study aimed to investigate the correlation between the healthy lifestyle of pregnant women and their compliance with educational guidelines in Iran's health system using best-evidence audit criteria.
Materials and Methods
Utilizing a descriptive-analytical study with a correlational design, this study was conducted on 136 pregnant women receiving services from Behshahr Healthcare Network centers, Behshahr, Mazandaran Province, Iran, in December 2022 and June 2023. The research tools included a sociodemographic-medical questionnaire, the Health-Promoting Lifestyle Profile-II (HPLP-II) by Walker et al. (1987), and the Best-Evidence Audit Criteria Checklist. Moreover, descriptive and inferential statistics were recruited to analyze the data. For this purpose, the data were imported into the IBM SPSS Statistics 24, and then frequency and percentage were applied for the qualitative variables and mean and standard deviation (M ± SD), median, and interquartile range (IQR) were devoted to the quantitative ones. The Kolmogorov-Smirnov statistic was further operated to find the normality of the study variables, and the Mann-Whitney U test and Kruskal-Wallis test were exploited to compare health lifestyle dimensions concerning the independent variables. The relationship between the lifestyle dimensions and the independent variables was further explored via the generalized linear models (GLMs), and the results were presented through correlation coefficients and confidence intervals (CIs). Ultimately, 'Spearman's correlation coefficient assessed the correlation between the compliance criteria and the lifestyle dimensions.
Results
The lifestyle M ± SD values among the pregnant women were 2.59 ± 0.32, in which the maximum scores were for nutrition (2.83 ± 0.34) and interpersonal relations/support (2.83 ± 0.47), but the minimum ones were associated with physical activity/exercise (2.06 ± 0.47) and stress management (2.47 ± 0.41). The study results revealed that Criterion VII (viz., pregnant women are allowed to discuss and ask questions regarding the education or information they have received) with the M ± SD = 17.32 ± 6.79 took the highest scores, and Criterion II (namely, pregnant women receive written information regarding healthy lifestyles) with the M ± SD = 5.17 ± 5.31 was ranked as the lowest. No compliance was reported in the first six criteria, but Criterion VII was so. The study results further demonstrated a positive significant relationship between all compliance criteria and lifestyle dimensions.
Conclusion
A significant relationship was established between the low levels of compliance criteria and the dimensions of a healthy lifestyle among pregnant women. To enhance compliance and ultimately promote healthy lifestyles in pregnant women, researchers, health system policymakers, and healthcare providers (HCPs) are encouraged to prioritize the implementation of evidence-based practices in educating about healthy lifestyles during pregnancy.