The Role of Climate Change Education on Awareness, Concern, and Hope in Pregnant Women: A Randomized Controlled Trial

Climate change can negatively impact women's health at different stages of life through environmental risks such as extreme temperatures, vector-borne diseases, and air pollution. Particularly during pregnancy, a period of intense physiological and psychosocial changes, climate change is reported to be associated with adverse maternal and infant outcomes such as spontaneous abortion, preterm birth, low birth weight, intrauterine growth retardation, and neonatal mortality. Therefore, identifying climate change-related risks during pregnancy, raising awareness of these risks, and developing preventative approaches are crucial for protecting maternal and fetal health.

This study aims to evaluate the impact of a "Pregnancy and Climate Change" education program developed for pregnant women on their climate change awareness levels, anxiety levels regarding climate change, and hope levels for preventing climate change. The effectiveness of the education program will be determined by comparing the pre-test and post-test scores of the intervention and control groups.

The research is designed as a randomized controlled experimental study with experimental and control groups in a pre-test-post-test configuration. The study population consists of all pregnant women who applied to the antenatal outpatient clinic of Zeynep Kamil Women and Children's Diseases Training and Research Hospital. The sample will consist of pregnant women who are 18 years of age and older, have a gestational age of 32 weeks or less, can speak and understand Turkish, and volunteer to participate in the study. Pregnant women with a history of psychiatric illness, systemic disease before or during pregnancy, or who experienced pregnancy complications such as preeclampsia and gestational diabetes will be excluded from the study.

The sample size was calculated using the G*Power 3.1 program based on the independent samples t-test. A moderate effect size (Cohen's d = 0.50), a 95% confidence level, and 80% statistical power were used. The analysis determined that a total of 128 pregnant women were needed, with at least 64 participants in each group. Considering possible sample losses, a 20% increase was made, and the study was planned with a total of 154 pregnant women, with 77 pregnant women in each group. Participants will be assigned to intervention (n=77) and control (n=77) groups using computer-assisted block randomization.

The intervention group will receive approximately 60 minutes of face-to-face training on "Pregnancy and Climate Change" following a pre-test. The training will cover environmental risk factors, their effects on pregnancy, individual contraceptive approaches, and information aimed at raising awareness. Informative brochures will be distributed to participants after the training. Post-test data for the intervention group will be collected four weeks after the training. The control group will receive only a pre-test and a post-test four weeks later, without any training.

Data will be collected through face-to-face interviews using a Personal Information Form, the Climate Change Anxiety Scale, the Climate Change Awareness Scale, and the Hope Scale for Preventing Climate Change. Data analysis will be performed using SPSS 25.0 software; descriptive statistics, t-test, ANOVA, chi-square test, and normal distribution analysis will be utilized.