{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T06:27:00Z","timestamp":1786602420576,"version":"build-2736575974"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>It remains a challenge to promote reproductive healthcare behaviors\u2014including preconception care\u2014among emerging adults. To effectively influence behavioral changes among emerging adults, it is necessary to understand their behavior according to their psychological steps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to describe the distribution of preconception care behavioral stages among emerging adults, using the framework of the precaution adoption process model (PAPM), and to examine factors associated with each stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study used an online convenience sample of 929 participants aged 18\u201325 years in South Korea between March and October 2020. Behavioral stages of preconception care were assessed using the PAPM, and participants were classified into three groups (unaware, pre-adoption, and adoption of preconception care behaviors). Separate binary logistic regression models were used to compare each group with the adoption group as a reference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with the adoption group, the unaware group was more likely to be male, to be sexually inexperienced, to use contraception inconsistently, to have no intention of future childbearing, and to report higher self-perceived knowledge of pregnancy-related issues. The pre-adoption group was more likely to be sexually inexperienced and to report lower perceived health status and lower levels of reproductive health-promoting behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study described the behavioral stages of preconception care using the PAPM framework and identified characteristics associated with each stage. The findings may inform the development of future communication strategies; however, further research is required to evaluate their effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1842698","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:32:21Z","timestamp":1786599141000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with preconception care behaviors and behavioral stages among emerging adults: a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Inhae","family":"Cho","sequence":"first","affiliation":[{"name":"College of Nursing, Inje University","place":["Busan, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunjeong","family":"Shin","sequence":"additional","affiliation":[{"name":"College of Nursing, Korea University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songi","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Nursing, Catholic Kwandong University","place":["Gangneung, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"B1","unstructured":"Meeting to Develop a Global Consensus on Preconception Care to Reduce Maternal and Childhood Mortality and Morbidity"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e046311","DOI":"10.1136\/bmjopen-2020-046311","article-title":"Protocol for a randomised trial evaluating a preconception-early childhood telephone-based intervention with tailored e-health resources for women and their partners to optimise growth and development among children in Canada: a healthy life trajectory initiative (HeLTI Canada)","volume":"11","author":"Dennis","year":"2021","journal-title":"BMJ Open."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1853","DOI":"10.1016\/S0140-6736(18)30313-1","article-title":"Intervention strategies to improve nutrition and health behaviours before conception","volume":"391","author":"Barker","year":"2018","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"103244","DOI":"10.1016\/j.midw.2021.103244","article-title":"High-risk health behaviours of pregnancy-planning women and men: is there a need for preconception care?","volume":"106","author":"Dennis","year":"2022","journal-title":"Midwifery."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1830","DOI":"10.1016\/S0140-6736(18)30311-8","article-title":"Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health","volume":"391","author":"Stephenson","year":"2018","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e13235","DOI":"10.1111\/obr.13235","article-title":"Enablers and barriers to women's lifestyle behavior change during the preconception period: a systematic review","volume":"22","author":"Kandel","year":"2021","journal-title":"Obes Rev"},{"key":"B7","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1007\/s10995-010-0663-y","article-title":"Preconception health: awareness, planning, and communication among a sample of US men and women","volume":"16","author":"Mitchell","year":"2012","journal-title":"Matern Child Health J"},{"key":"B8","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1007\/s10995-012-0967-1","article-title":"Pregnancy 101: a call for reproductive and prenatal health education in college","volume":"17","author":"Delgado","year":"2013","journal-title":"Matern Child Health J"},{"key":"B9","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1186\/s12889-025-22332-z","article-title":"User-centered design to enhance university students' sex and menstrual education in South Korea: randomized controlled trial","volume":"25","author":"Kim","year":"2025","journal-title":"BMC Public Health"},{"key":"B10","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1097\/CIN.0000000000000200","article-title":"Development and evaluation of simulation-problem-based learning for sex education","volume":"34","author":"Kim","year":"2016","journal-title":"Comput Inform Nurs"},{"key":"B11","unstructured":"Society at a Glance 2024: OECD Social Indicators"},{"key":"B12","unstructured":"Mean Age of Mother at First Birth, Vital Statistics\n          \n          2025"},{"key":"B13","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1111\/j.1728-4465.2014.00393.x","article-title":"Intended and unintended pregnancies worldwide in 2012 and recent trends","volume":"45","author":"Sedgh","year":"2014","journal-title":"Stud Fam Plann"},{"key":"B14","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1056\/NEJMsa1506575","article-title":"Declines in unintended pregnancy in the United States, 2008\u20132011","volume":"374","author":"Finer","year":"2016","journal-title":"N Engl J Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1037\/0003-066X.55.5.469","article-title":"Emerging adulthood: a theory of development from the late teens through the twenties","volume":"55","author":"Arnett","year":"2000","journal-title":"Am Psychol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"2205","DOI":"10.1038\/oby.2008.365","article-title":"Emerging adulthood and college-aged youth: an overlooked age for weight-related behavior change","volume":"16","author":"Nelson","year":"2008","journal-title":"Obesity"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.1016\/S0140-6736(12)60072-5","article-title":"Adolescence: a foundation for future health","volume":"379","author":"Sawyer","year":"2012","journal-title":"Lancet"},{"key":"B18","doi-asserted-by":"publisher","first-page":"465","DOI":"10.5534\/wjmh.210012","article-title":"Changing trends in sexual debut age in the Korean Internet Sexuality Survey","volume":"40","author":"Park","year":"2022","journal-title":"World J Mens Health"},{"key":"B19","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1037\/\/0278-6133.11.3.170","article-title":"A model of the precaution adoption process: evidence from home radon testing","volume":"11","author":"Weinstein","year":"1992","journal-title":"Health Psychol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1704","DOI":"10.1002\/nop2.1425","article-title":"The effectiveness of a tailored programme to promote reproductive health-promoting behaviour in young women based on the precaution adoption process model: a randomized controlled trial","volume":"10","author":"Cho","year":"2023","journal-title":"Nurs Open"},{"key":"B21","author":"Glanz","year":"2008","journal-title":"Health Behavior and Health Education: Theory, Research, and Practice"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1093\/ije\/dyw070","article-title":"Data resource profile: the Korea youth risk behavior web-based survey (KYRBS)","volume":"45","author":"Kim","year":"2016","journal-title":"Int J Epidemiol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e1077","DOI":"10.1016\/S2214-109X(18)30357-7","article-title":"Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1\u00b79 million participants","volume":"6","author":"Guthold","year":"2018","journal-title":"Lancet Glob Health"},{"key":"B24","unstructured":"Drinking Levels Defined"},{"key":"B25","unstructured":"\u201cDevelopment of nutrition-dietary life diagnosis program for nutrition counseling,\u201d\n          \n          \n            \n              Sohn\n              C\n            \n          \n          Korea\n          Ministry of Food and Drug Safety\n          Government Printing Office\n          \n          2014"},{"key":"B26","doi-asserted-by":"publisher","first-page":"29","DOI":"10.14367\/kjhep.2014.31.5.29","article-title":"Development of a scale to measure reproductive health promoting behavior of undergraduates","volume":"31","author":"Jo","year":"2014","journal-title":"Korean J Health Educ Promot."},{"key":"B27","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1007\/s10995-007-0300-6","article-title":"Undergraduate student awareness of issues related to preconception health and pregnancy","volume":"12","author":"Delgado","year":"2008","journal-title":"Matern Child Health J"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1016\/S0895-4356(96)00236-3","article-title":"A simulation study of the number of events per variable in logistic regression analysis","volume":"49","author":"Peduzzi","year":"1996","journal-title":"J Clin Epidemiol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1186\/s12884-020-02973-1","article-title":"Defining preconception: exploring the concept of a preconception population","volume":"20","author":"Hill","year":"2020","journal-title":"BMC Pregnancy Childbirth."},{"key":"B30","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1186\/s12884-025-07176-0","article-title":"Preconception health policy, health promotion, and health services to achieve health in current and future generations: a narrative review","volume":"25","author":"Steel","year":"2025","journal-title":"BMC Pregnancy Childbirth."},{"key":"B31","doi-asserted-by":"publisher","first-page":"e76","DOI":"10.1016\/S2468-2667(22)00254-7","article-title":"Addressing reproductive health needs across the life course: an integrated, community-based model combining contraception and preconception care","volume":"8","author":"Hall","year":"2023","journal-title":"Lancet Public Health."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1037\/0022-3514.77.6.1121","article-title":"Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments","volume":"77","author":"Kruger","year":"1999","journal-title":"J Pers Soc Psychol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"S117","DOI":"10.1016\/j.whi.2008.09.003","article-title":"The effect of preconception counselling on lifestyle and other behaviour before and during pregnancy","volume":"18","author":"Elsinga","year":"2008","journal-title":"Womens Health Issues."},{"key":"B34","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1080\/03009734.2019.1653407","article-title":"An intervention in contraceptive counseling increased the knowledge about fertility and awareness of preconception health-a randomized controlled trial","volume":"124","author":"Skogsdal","year":"2019","journal-title":"Ups J Med Sci."},{"key":"B35","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/S0968-8080(13)41686-5","article-title":"\u201cIt would be weird to have that on Facebook\u201d: young people's use of social media and the risk of sharing sexual health information","volume":"21","author":"Byron","year":"2013","journal-title":"Reprod Health Matters."},{"key":"B36","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1186\/s12889-019-7046-0","article-title":"Sex education in Poland: a cross-sectional study evaluating over 20,000 Polish women's knowledge of reproductive health issues and contraceptive methods","volume":"19","author":"Warzecha","year":"2019","journal-title":"BMC Public Health"},{"key":"B37","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1186\/s12884-015-0774-y","article-title":"Knowledge on preconceptional folic acid supplementation and intention to seek for preconception care among men and women in an urban city: a population-based cross-sectional study","volume":"15","author":"Temel","year":"2015","journal-title":"BMC Pregnancy Childbirth"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1842698\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:32:23Z","timestamp":1786599143000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1842698\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":37,"alternative-id":["10.3389\/fpubh.2026.1842698"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1842698","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"article-number":"1842698"}}