Psychosocial correlates of venous thromboembolism-preventive practices among pregnant and postpartum women in China: a cross-sectional structural equation modeling study.

BACKGROUND

Venous thromboembolism (VTE) is a major preventable cause of maternal morbidity. Preventive practices may be related to knowledge, attitudes, perceived support, family function, and confidence in performing recommended behaviors. This study examined the psychosocial correlates and prespecified indirect statistical pathways associated with VTE-preventive practices among pregnant and postpartum women in China.

METHODS

This hospital-based cross-sectional study was conducted from January to October 2023 among 1,384 pregnant and postpartum women at a tertiary women's and children's hospital in Chengdu, China. Participants completed questionnaires assessing venous thromboembolism knowledge, attitudes, preventive practices, self-efficacy, family function, and social support. A latent-variable structural equation modeling, guided primarily by the Information-Motivation-Behavioral Skills (IMB) model, was estimated using 5,000 bootstrap resamples. Multigroup and covariate-adjusted sensitivity analyses were conducted to assess robustness.

RESULTS

Attitude was the strongest correlate of preventive practices (β = 0.522, 95% CI 0.463 ~ 0.574). Knowledge (β = 0.236, 95% CI 0.166 ~ 0.303), family function (β = 0.162, 95% CI 0.091 ~ 0.232), and social support (β = 0.185, 95% CI 0.105 ~ 0.258) were positively associated with attitude. The standardized indirect association of knowledge with practice through attitude was β = 0.123; the corresponding unstandardized estimate was B = 0.481. Self-efficacy had a small association with practice (β = 0.065). The model explained 16.4% of the variance in attitude, 3.9% in self-efficacy, and 29.0% in practice. Equality constraints on the structural paths did not worsen model fit between pregnant and postpartum participants (p = 0.195), and covariate-adjusted estimates were similar.

CONCLUSION

Attitude was the strongest psychosocial correlate of self-reported VTE-preventive practices in this sample. Knowledge, family function, and social support showed smaller indirect statistical associations through attitude. These cross-sectional findings do not establish temporal or causal mediation, but they support prospective evaluation of culturally sensitive, attitude-focused educational interventions that also involve family and social support.