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In Ethiopia, despite nutrition\u00a0counseling on the maternal diet being given by the health workers\u00a0during pregnancy, maternal undernutrition is still high in the country. Hence, this study aimed to assess the effect of guided counseling using the health belief model and the theory of planned behavior on the nutritional status of pregnant women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A two-arm parallel cluster randomized controlled community trial was conducted in West Gojjam Zone, Ethiopia, from May 1, 2018, to April 30, 2019. The nutritional status of the women was assessed using mid-upper arm circumference. A total of 694 pregnant women were recruited from the intervention (n=346\u00a0) and control (n=348) clusters. Of which endline data were collected from 313 and 332 pregnant women in the intervention and control clusters, respectively. The intervention was started before 16\u2009weeks of gestation\u00a0and pregnant women\u00a0in the intervention group attended 4 counseling sessions. Counseling was given at the participants\u2019 homes using a counseling guide with the core contents of the intervention. Leaflets with appropriate pictures and the core messages were given for women in the intervention arm.<\/jats:p><jats:p>Women in the control group got the routine nutrition education given by the health care system. Data were collected using interviewer administered structured questionnaires and mid-upper arm circumference was measured using an adult MUAC tape. Descriptive statistics\u00a0 and\u00a0linear mixed-effects model were used to assess the intervention effect\u00a0after adjusting for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After the intervention, the prevalence of undernutrition was 16.7% lower in the intervention group compared with the control arm (30.6% Vs 47.3%,<jats:italic>P<\/jats:italic>\u2009=\u2009&lt;\u20090.001). Women in the intervention group showed significant improvement in nutritional status at the end of the trial than the control group (\u03b2\u2009=\u00a00.615,<jats:italic>p<\/jats:italic>\u2009=\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrated that guided counseling using the health belief model and the theory of planned behavior was effective in improving the nutritional status of pregnant women. The results imply the need for the design of\u00a0model and theory based nutrition counseling guidelines. The trial was registered in Clinical Trials.gov (NCT03627156).<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12937-020-00536-w","type":"journal-article","created":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T15:03:56Z","timestamp":1588086236000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Effect of guided counseling on nutritional status of pregnant women in West Gojjam zone, Ethiopia: a cluster-randomized controlled trial"],"prefix":"10.1186","volume":"19","author":[{"given":"Yeshalem Mulugeta","family":"Demilew","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Getu Degu","family":"Alene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tefera","family":"Belachew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,4,28]]},"reference":[{"key":"536_CR1","doi-asserted-by":"publisher","first-page":"632","DOI":"10.3390\/nu11030632","volume":"11","author":"MJ Tahir","year":"2019","unstructured":"Tahir MJ, Haapala JL, Foster LP, Duncan KM, Teague AM, Kharbanda EO, McGovern PM, Whitaker KM, Rasmussen KM, Fields DA, et al. 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Permission was obtained in West Gojjam Zone and each woreda administrators. Written consent (fingerprint for those who could not read and write) was secured from the study participants. Confidentiality was maintained throughout the study. The trial was registered in Clinical Trials.gov (NCT03627156).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"38"}}