Effectiveness of Enhancing Childbirth Self-Efficacy Support Program via LINE Official Account among Pregnant Adolescents: A Randomized Controlled Trial

Pregnancy and childbirth among adolescents present significant challenges during a transitional phase characterized by profound physical, emotional, and social transformations that affect adolescents and their families due to societal norms. In recent years, mobile health (mHealth) applications have gained popularity, offering continuous educational support during pregnancy and significantly enhancing preparedness for childbirth. This study evaluated the effectiveness of an Enhancing Childbirth Self-Efficacy Support Program delivered via the LINE Official Account application on smartphones incorporating childbirth self-efficacy, fear of childbirth, labor pain, and pain-coping behaviors in pregnant adolescents. A randomized controlled trial was conducted with pregnant adolescents receiving antenatal care and delivering at a tertiary hospital in Bangkok between April and September 2024. Participants were randomly assigned to an experimental group (n = 24), which received the program, or a control group (n = 23), which received only usual care. The research instruments included: 1) a Personal Information Questionnaire, 2) the Thai Childbirth Self-Efficacy Inventory, 3) the Fear of Childbirth of Pregnant Adolescents in the Third Trimester Questionnaire, 4) the Fear of Birth Scale, 5) a Numerical Rating Scale for Pain, and 6) a Labor Pain Coping Behavior Assessment. Data were analyzed using descriptive statistics, paired t-test, independent t-test, and the Mann-Whitney U test. The findings revealed that the program successfully improved self-efficacy in the experimental group. Participants in the experimental group reported significantly less fear of childbirth during pregnancy and labor, experienced lower labor pain, and demonstrated better pain-coping behaviors compared to the control group. Nurses can apply this program to support pregnant adolescents through the developmental process and labor. However, further testing in multi-site studies is necessary.