{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:13:48Z","timestamp":1785510828047,"version":"3.56.0"},"reference-count":38,"publisher":"Belitung Raya Foundation","issue":"1","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"award":[""],"award-info":[{"award-number":[""]}]}],"content-domain":{"domain":["belitungraya.org"],"crossmark-restriction":true},"short-container-title":["Belitung Nurs J"],"abstract":"<jats:p>Background: Excessive gestational weight gain can adversely affect maternal and fetal health. Dietary behavior change can help control gestational weight gain and prevent adverse pregnancy outcomes.\nObjective: This study aimed to examine the effect of the Capability-Opportunity-Motivation Behavior (COM-B) model of dietary behavior program on gestational weight gain.\nMethods: This single-blind randomized controlled trial used a pre-posttest control group design and included 96 pregnant women from a northern province of Thailand. Participants were randomly assigned equally to the experimental and control groups (48 each) using permuted block randomization. The experimental group received a 14-session COM-B model of dietary behavior program, while the control group received usual care. Data were collected via questionnaires between November 2023 and October 2024, and were analyzed using SPSS version 26, employing descriptive and inferential statistical methods.\nResults: At 36 weeks\u2019 gestation, pregnant women in the experimental group had a significantly lower mean difference in gestational weight gain based on the Institute of Medicine (IOM) recommendation compared with both their baseline at 20 weeks and the control group. After adjusting for maternal age and education, the experimental group continued to show significantly lower gestational weight gain than the control group. The adjusted intention-to-treat analysis indicated a mean difference of -2.227 kg (95% CI: -3.75 to -0.70; p = 0.005; partial \u03b7\u00b2 = 0.084), while the adjusted per-protocol analysis showed a mean difference of -2.648 kg (95% CI: -4.31 to -0.99; p = 0.002; partial \u03b7\u00b2 = 0.110). These results suggest that the COM-B model of dietary behavior program effectively limited gestational weight gain, independent of sociodemographic differences. Even modest reductions in gestational weight gain may contribute to lowering the risk of pregnancy complications such as gestational diabetes and preeclampsia. Dietary behavior change was monitored, but not a predefined secondary outcome.\nConclusion: The COM-B model of dietary behavior program led to minimal but potentially clinically relevant reductions in gestational weight gain. The findings highlight the clinical relevance of nurse-led interventions, underscoring the need for nurse training to implement the program in routine antenatal care.\nTrial Registry Number: Thai Clinical Trials Registry (TCTR20230907001)<\/jats:p>","DOI":"10.33546\/bnj.4215","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T03:57:56Z","timestamp":1769140676000},"page":"21-29","update-policy":"https:\/\/doi.org\/10.33546\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of the Capability-Opportunity-Motivation Behavior (COM-B) model of dietary behavior program on gestational weight gain in Thailand: A randomized controlled trial"],"prefix":"10.33546","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2845-7331","authenticated-orcid":false,"given":"Pantipa","family":"Buakhai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1338-0789","authenticated-orcid":false,"given":"Piyanut","family":"Xuto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2023-6200","authenticated-orcid":false,"given":"Pimpaporn","family":"Klunklin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1293-9691","authenticated-orcid":false,"given":"Petsunee","family":"Thungjaroenkul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"19163","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"137423","doi-asserted-by":"crossref","unstructured":"Al Shekaili, H. A., Al Hashmi, I., & Al Omari, O. (2024). Gestational weight gain and its association with maternal and neonatal outcomes among pregnant women with normal pre-pregnancy body mass index from a Middle Eastern country. Midwifery, 130, 103929. https:\/\/doi.org\/10.1016\/j.midw.2024.103929","DOI":"10.1016\/j.midw.2024.103929"},{"key":"137424","doi-asserted-by":"crossref","unstructured":"Beyene, G. A., & Kasahun, A. W. (2025). Effects of gestational weight gain on adverse pregnancy outcomes among pregnant women in gurage zone, central Ethiopia: A cohort study. Scientific Reports, 15(1), 6742. https:\/\/doi.org\/10.1038\/s41598-025-91782-7","DOI":"10.1038\/s41598-025-91782-7"},{"key":"137425","doi-asserted-by":"crossref","unstructured":"Bijlholt, M., Van Uytsel, H., Ameye, L., Devlieger, R., & Bogaerts, A. (2020). Eating behaviors in relation to gestational weight gain and postpartum weight retention: A systematic review. Obesity Reviews, 21(10), e13047. https:\/\/doi.org\/10.1111\/obr.13047","DOI":"10.1111\/obr.13047"},{"key":"137426","unstructured":"Bureau of Nutrition of Ministry of Public Health. (2020). Dietary reference intakes for Thais 2020 [in Thai]. https:\/\/nutrition2.anamai.moph.go.th\/th\/dri\/176096"},{"key":"137427","doi-asserted-by":"crossref","unstructured":"Darling, A. M., Wang, D., Perumal, N., Liu, E., Wang, M., Ahmed, T., Christian, P., Dewey, K. G., Kac, G., & Kennedy, S. H. (2023). Risk factors for inadequate and excessive gestational weight gain in 25 low-and middle-income countries: An individual-level participant meta-analysis. PLoS Medicine, 20(7), e1004236. https:\/\/doi.org\/10.1371\/journal.pmed.1004236","DOI":"10.1371\/journal.pmed.1004236"},{"key":"137428","doi-asserted-by":"crossref","unstructured":"Dewidar, O., John, J., Baqar, A., Madani, M. T., Saad, A., Riddle, A., Ota, E., Kung'u, J. K., Arabi, M., & Raut, M. K. (2023). 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Predictive factors of gestational weight gain [in Thai] [Master's thesis, Mahidol University]. https:\/\/doi.nrct.go.th\/ListDoi\/Download\/165229?Resolve_DOI=10.14457\/MU.the.2013.21"},{"key":"137437","unstructured":"Kampan, S., Tulyakul, P., & Saetan, C. (2021). Factors predicting gestational weight gain among overweight pregnancy women [in Thai]. The Southern College Network Journal of Nursing and Public Health, 8(1), 222-223. https:\/\/he01.tci-thaijo.org\/index.php\/scnet\/article\/view\/245135\/167849"},{"key":"137438","unstructured":"Kieudee, S., & Saengrut, B. (2020). Carbohydrate consumption among uncontrolled type 2 diabetes mellitus patients in Diabetic Clinic, Maharaj Nakorn Chiang Mai Hospital [in Thai]. Chiang Mai Medical Journal, 9(4), 227-239. https:\/\/he01.tci-thaijo.org\/index.php\/CMMJ-MedCMJ\/article\/view\/243782\/179018"},{"key":"137439","doi-asserted-by":"crossref","unstructured":"Li, Q., & Li, J. (2025). Behavior change techniques in pregnancy dietary interventions: A systematic review through the lens of the COM-B model. BMC Pregnancy and Childbirth, 25(1), 1-16. https:\/\/doi.org\/10.1186\/s12884-025-07876-7","DOI":"10.1186\/s12884-025-07876-7"},{"key":"137440","doi-asserted-by":"crossref","unstructured":"Li, Q., Piaseu, N., Phumonsakul, S., & Thadakant, S. (2024). Effects of a comprehensive dietary intervention program, promoting nutrition literacy, eating behavior, dietary quality, and gestational weight gain in Chinese urban women with normal body mass index during pregnancy. Nutrients, 16(2), 217. https:\/\/doi.org\/10.3390\/nu16020217","DOI":"10.3390\/nu16020217"},{"key":"137441","doi-asserted-by":"crossref","unstructured":"Mart\u00ednez-Hortelano, J. A., Cavero-Redondo, I., \u00c1lvarez-Bueno, C., Garrido-Miguel, M., Soriano-Cano, A., & Mart\u00ednez-Vizca\u00edno, V. (2020). Monitoring gestational weight gain and prepregnancy BMI using the 2009 IOM guidelines in the global population: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 20(1), 649. https:\/\/doi.org\/10.1186\/s12884-020-03335-7","DOI":"10.1186\/s12884-020-03335-7"},{"key":"137442","doi-asserted-by":"crossref","unstructured":"McClintic, E. E., Ellis, A., Ogutu, E. A., Caruso, B. A., Ventura, S. G., Arriola, K. R. J., Kowalski, A. J., Linabarger, M., Wodnik, B. K., & Muga, R. (2022). Application of the capabilities, opportunities, motivations, and behavior (COM-B) change model to formative research for child nutrition in Western Kenya. Current Developments in Nutrition, 6(7), nzac104. https:\/\/doi.org\/10.1093\/cdn\/nzac104","DOI":"10.1093\/cdn\/nzac104"},{"key":"137443","doi-asserted-by":"crossref","unstructured":"McDonald, S. D., Yu, Z. M., van Blyderveen, S., Schmidt, L., Sword, W., Vanstone, M., Biringer, A., McDonald, H., & Beyene, J. (2020). 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Asia Pacific Journal of Clinical Nutrition, 25(4), 810-817. https:\/\/search.informit.org\/doi\/10.3316\/informit.370123785298482"},{"key":"137448","doi-asserted-by":"crossref","unstructured":"Ruchat, S.-M., Davenport, M. H., Giroux, I., Hillier, M., Batada, A., Sopper, M. M., Hammond, J. M., & Mottola, M. F. (2012). Nutrition and exercise reduce excessive weight gain in normal-weight pregnant women. Medicine and Science in Sports and Exercise, 44(8), 1419-1426. https:\/\/doi.org\/10.1249\/mss.0b013e31825365f1","DOI":"10.1249\/MSS.0b013e31825365f1"},{"key":"137449","doi-asserted-by":"crossref","unstructured":"Saarikko, J., Niela-Vil\u00e9n, H., Rahmani, A. M., & Axelin, A. (2021). Identifying target behaviors for weight management interventions for women who are overweight during pregnancy and the postpartum period: A qualitative study informed by the Behaviour Change Wheel. 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