{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T17:28:49Z","timestamp":1787074129370,"version":"build-2736575974"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n BACKGROUND:<\/jats:title>\n In contemporary societies, delayed childbearing and declining fertility rates have emerged as prominent reproductive behavior patterns globally. This demographic shift has precipitated significant population aging trends, presenting substantial socioeconomic challenges. This study aimed to investigate the effect of positive counseling on childbearing intention and stages of behavior change among women.<\/jats:p>\n <\/jats:sec>\n \n MATERIALS AND METHODS:<\/jats:title>\n \n This study employed a two-arm randomized clinical controlled trial on married women unwilling to conceive within two years following marriage until the next two years. The exclusion criteria encompassed contraindications to pregnancy such as cardiovascular diseases, autoimmune disorders, severe psychiatric conditions, a history of hysterectomy, and similar factors. Initially, one-fifth of 88 health centers across various city districts were selected using simple random sampling to ensure socioeconomic diversity. Then, participants were recruited using convenience sampling method from 88 health centers. The participants were assigned into two groups (\n n<\/jats:italic>\n = 27per group) with a ratio of 1:1 with block size of 6 using Random Allocation Sampling (RAS) software. The intervention group attended seven weekly group counseling based on positive psychology. The childbearing intention and stage of behavior change questionnaires were completed before and 4 weeks after the intervention. To compare the mean scores of outcomes, the ANCOVA statistical test was used. The Chi-square test was used for comparison of stages of behavior change in childbearing.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n The results indicated that after counseling, the overall mean score of childbearing intention [Adjusted Mean Difference (AMD): 8.58, 95% CI: (5.18\u201311.99),\n P<\/jats:italic>\n < 0.001] significantly increased in the intervention group compared to the control group. A statistically significant difference was observed between the two groups in terms of the frequency of the stages of childbearing behavior change after the intervention (\n P<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n This study provides empirical evidence supporting the integration of positive psychology-based counseling into public health interventions aimed at addressing declining fertility rates.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jehp.jehp_663_25","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T08:00:32Z","timestamp":1785484832000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A randomized controlled clinical trial of the effect of positive psychology on childbearing Intention and Stages of behavior change in reproductive age women"],"prefix":"10.4103","volume":"15","author":[{"given":"Tahereh T.","family":"Teymourloei","sequence":"first","affiliation":[{"name":"Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esmat","family":"Mehrabi","sequence":"additional","affiliation":[{"name":"Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roghaiyeh","family":"Nourizadeh","sequence":"additional","affiliation":[{"name":"Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Mortazavi","sequence":"additional","affiliation":[{"name":"Psychology Department, Daman Clinic of Psychology, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7]]},"reference":[{"key":"R1-20260818","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1017\/S0021932016000109","article-title":"Low fertility intention in Tehran, Iran: The role of attitudes, norms and perceived behavioural control","volume":"49","author":"Erfani","year":"2017","journal-title":"J Biosoc Sci"},{"key":"R2-20260818","first-page":"446","article-title":"Factors affecting childbearing intention in women employees in Birjand: Application of the theory of planned behavior","volume":"12","author":"Alizadeh","year":"2023","journal-title":"J Educ Health Promot"},{"key":"R3-20260818","doi-asserted-by":"crossref","first-page":"48","DOI":"10.4103\/jehp.jehp_594_22","article-title":"Childbearing decisions and related factors in the COVID-19 pandemic: A narrative review study","volume":"12","author":"Safdari-Dehcheshmeh","year":"2023","journal-title":"J Educ Health Promot"},{"key":"R4-20260818","doi-asserted-by":"crossref","first-page":"409","DOI":"10.4103\/jehp.jehp_1858_21","article-title":"Investigating the relationship between attitudes toward fertility and childbearing and the value of children with attitudes toward fertility control in married women aged 15-45 in Isfahan","volume":"11","author":"Kohan","year":"2022","journal-title":"J Educ Health Promot"},{"key":"R5-20260818","doi-asserted-by":"crossref","first-page":"183","DOI":"10.4103\/jehp.jehp_505_23","article-title":"The effect of single-child couples\u2019 education based on the theory of planned behavior on their intention to have next child","volume":"13","author":"Sahraei","year":"2024","journal-title":"J Educ Health Promot"},{"key":"R6-20260818","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1002\/nop2.849","article-title":"Childbearing intention and its associated factors: A systematic review","volume":"8","author":"Hashemzadeh","year":"2021","journal-title":"Nurs Open"},{"key":"R7-20260818","first-page":"117","article-title":"The influence of legal supports of working women during pregnancy and lactation period on their desire to have children","volume":"2","author":"Samani","year":"2020","journal-title":"Islam J Women Fam"},{"key":"R8-20260818","doi-asserted-by":"crossref","first-page":"413","DOI":"10.4103\/ijnmr.IJNMR_225_20","article-title":"Principal factors affecting couples\u2019 childbearing policies: A roadmap for policymaking","volume":"27","author":"Hashemzadeh","year":"2022","journal-title":"Iran J Nurs Midwifery Res"},{"key":"R9-20260818","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1007\/s10834-017-9548-1","article-title":"Uncertainty, doubts, and delays: Economic circumstances and childbearing expectations among emerging adults","volume":"39","author":"Brauner-Otto","year":"2018","journal-title":"J Fam Econ Issues"},{"key":"R10-20260818","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1186\/s12884-024-06385-3","article-title":"What factors influence couples\u2019 decisions to have children? 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