Psychometric properties of the Prenatal Health Behavior Scale in mid- and late pregnancy

Abstract

Introduction: Psychometrically sound self-report measures are important tools to advance research on health behaviors in pregnancy. The Prenatal Health Behavior Scale (PHBS) has been used in prior studies to quantify health behaviors and examine their associations with relevant variables, but its psychometric properties have not been carefully investigated.

Methods: In a sample of low-risk women, we examined the factor structure, reliability, and validity of the PHBS at mid- (N = 138) and late (N = 102) pregnancy.

Results: In confirmatory factor analysis, items on the PHBS loaded onto a single reliable factor, but separating health-promoting and health-impairing behavior into two factors had better model fit. The scales defined by these two factors had good internal consistency in mid- and late pregnancy, were only moderately correlated, and were predicted by somewhat different sets of sociodemographic and psychological variables. Pregnancy-specific stress was a robust predictor of health-promoting and health-impairing behavior across time.

Discussion: Results bolster confidence in the reliability and validity of the PHBS and its appropriateness as a self-report tool for investigation of health behaviors among pregnant women. This study is one of the first investigations to examine patterns and predictors of health behavior practices at two time periods of pregnancy.

Keywords:

• Birth outcomes
• health behaviors
• perceived control
• pregnancy
• prenatal stress

Acknowledgements

The authors are grateful to Todd Griffin, Elizabeth Roemer, Elsa Singh, Ellie Sotomayer, and all of the midwives and study participants who made this research possible.

Disclosure statement

The authors report no conflicts of interest. The authors alone were responsible for the content and writing of the paper. This research was supported by a grant from the Society for the Psychological Study of Social Issues.

Current knowledge on this subject

• Prenatal maternal stress is associated with poorer birth outcomes.

• Health-impairing behaviors during pregnancy such as smoking and poor nutrition are well-documented contributors to adverse birth outcomes.

• Psychometrically sound, self-report measures are important tools to advance research on health behaviors in pregnancy.

What this study adds

• The Prenatal Health Behavior Scale is a reliable and valid self-report tool for investigation of health behaviors in pregnancy.

• Health-promoting and health-impairing behaviors in pregnancy are distinguishable constructs.

• Pregnancy-specific stress is a potent predictor of health-promoting and health-impairing behavior in mid- and late pregnancy even after controlling for sociodemographic factors that are also associated with health behavior practices.

Additional information

Funding

Society for the Psychological Study of Social Issues [#64239 Project #1109640].