Reliability and validity of the reduced Spanish version of the Prenatal Breastfeeding Self‐Efficacy Scale

Abstract

Breastfeeding self‐efficacy is a relevant predictor of exclusive breastfeeding during the first six months of life. The Prenatal Breastfeeding Self‐Efficacy Scale (PBSES) is a 20‐item tool developed to determine breastfeeding self‐efficacy during pregnancy. Our study aimed to assess the structural validity and psychometric characteristics of the PBSES and to explore item reduction according to the statistical criteria for parsimony and incremental validity. In this study, conducted in six hospitals in eastern Spain, we recruited 1183 women with healthy, full‐term, single‐birth newborns. Data on sociodemographic, breastfeeding‐related variables, and the PBSES, were obtained from self‐administered questionnaires during the third trimester of pregnancy, at postpartum discharge, and 5 months postpartum, and from a phone survey 12 months postpartum. Item reduction was conducted after revising the PBSES item floor and ceiling effects, interitem correlations, and item–score relationships with breastfeeding‐status variables during follow‐up. The factorial structure of the short form of the PBSES (PBSES‐SF) was tested using both exploratory and confirmatory approaches. After item reduction, the confirmatory factor analysis of the 12 remaining items of the PBSES‐SF revealed adequate fit statistics for a three‐factor structure and a second‐order factor. Internal consistency was measured using the Cronbach's α coefficient of the PBSES‐SF (0.86). We provided evidence on the discriminant validity of the PBSES‐SF by comparing its scores between known groups, convergent validity by examining its correlations with other variables, and predictive validity by assessing the association of PBSES‐SF scores with breastfeeding behavior at critical points in time during the first postpartum year.

Breastfeeding Self-Efficacy: A Systematic Review of Psychometric Properties Using COSMIN

“…The PBSES, developed to measure women’s perceptions of breastfeeding self-efficacy before delivery, has been validated in three languages (Aydın & Pasinlioğlu, 2018; Hazar & Akça, 2018; Pineiro-Albero et al, 2013; Wells et al, 2006). The short form of PBSES (PBSES-SF) has been developed in Spanish (Silva-Tubio et al, 2021). Recently, McKinley et al (2019) developed the PREPBS, a comprehensive self-report tool for measuring a woman’s perceived self-efficacy to engage in breastfeeding behaviors after giving birth.…”

“…The tool consists of 19–20 items on a 5-point Likert scale (Aydın & Pasinlioğlu, 2018; Hazar & Akça, 2018; Pineiro-Albero et al, 2013; Wells et al, 2006). The PBSES-SF has a second-order factor with three latent dimensions and 12 items (Silva-Tubio et al, 2021). The Prenatal Rating of Efficacy in Preparation to Breastfeed Scale (PREPBS) features a four-factor solution with 39 items on a 10-point response scale (Mckinley et al, 2019).…”

An exploration of prenatal breastfeeding self-efficacy: a scoping review protocol

“…Confidence and belief in the ability to breastfeed starts well before birth and Araban et al reiterate the importance of there being an antenatal focus, stating that prenatal preparation was key to increasing self-efficacy 25 . Silva-Tubio et al also outline the role of prenatal breastfeeding self-efficacy in both determining groups at-risk for early cessation and in evaluating programmes that promote breastfeeding 26 . However, much of the focus on improving self-efficacy is in the postnatal period and less attention has been paid to the prenatal one.…”

An exploration of prenatal breastfeeding self-efficacy: a scoping review protocol

“…Confidence and belief in the ability to breastfeed starts well before birth and Araban et al reiterate the importance of there being an antenatal focus, stating that prenatal preparation was key to increasing self-efficacy 22 . Silva-Tubio et al also outline the role of prenatal breastfeeding self-efficacy in both determining groups at-risk for early cessation and in evaluating programmes that promote breastfeeding 23 . However, much of the focus on improving self-efficacy is in the postnatal period and less attention has been paid to the prenatal one.…”