The Beliefs About Breastfeeding Questionnaire (BAB-Q): A Psychometric Validation Study

Philippa Davie; Debra Bick; Joseph Chilcot

doi:10.1111/bjhp.12498

The Beliefs About Breastfeeding Questionnaire (BAB-Q): A Psychometric Validation Study

Philippa Davie, Debra Bick, Joseph Chilcot

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Abstract

Objectives: Questionnaires used to assess women’s beliefs as a predictor of breastfeeding behaviour are not theoretically informed or tested for psychometric validity and reliability. This study conducted a psychometric evaluation of the Beliefs About Breastfeeding Questionnaire (BAB-Q). Design: A two-phase evaluation in an online cross-sectional questionnaire study (N = 278) and cohort study sample (N = 264). A ten-item questionnaire was proposed to assess women’s beliefs about the benefits and efforts of breastfeeding. Methods: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed construct validity and reliability. Multivariate regression analyses assessed validity in predicting breastfeeding behaviour and experiences. Results: EFA found a shortened 8-item, 2-factor model had good fit (χ ² = 23.3, df = 13, p <.040; CFI =.99, TLI =.99, RMSEA =.05), with significant factor loadings. Factor 1 (benefit beliefs) and factor 2 (effort beliefs) accounted for 47 and 19.4% of the explained variance and correlated moderately (r = −.40). CFA confirmed the solution in the cohort sample (χ ² = 49.6 df = 19, p <.010; CFI =.97, TLI =.96, and RMSEA =.078). Adjusted regression analyses found beliefs did not reliably predict infant feeding practices. Women’s beliefs significantly predicted the likelihood that women experienced breastfeeding as ‘much more’ positive and negative than they expected. Conclusions: The eight-item questionnaire showed good model fit with acceptable loadings, and good reliability for all subscales. The utility of the BAB-Q at predicting breastfeeding behaviour remains unclear and unsupported by empirical evidence. Further assessments of the predictive validity of the questionnaire in longitudinal studies with diverse beliefs and infant feeding practices are required.

Original language	English
Pages (from-to)	482-504
Number of pages	23
Journal	British Journal of Health Psychology
Volume	26
Issue number	2
Early online date	19 Dec 2020
DOIs	https://doi.org/10.1111/bjhp.12498
Publication status	Published - May 2021

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@article{36bb53d4b1d344749e25be4900d48a25,

title = "The Beliefs About Breastfeeding Questionnaire (BAB-Q): A Psychometric Validation Study",

abstract = "Objectives: Questionnaires used to assess women{\textquoteright}s beliefs as a predictor of breastfeeding behaviour are not theoretically informed or tested for psychometric validity and reliability. This study conducted a psychometric evaluation of the Beliefs About Breastfeeding Questionnaire (BAB-Q). Design: A two-phase evaluation in an online cross-sectional questionnaire study (N = 278) and cohort study sample (N = 264). A ten-item questionnaire was proposed to assess women{\textquoteright}s beliefs about the benefits and efforts of breastfeeding. Methods: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed construct validity and reliability. Multivariate regression analyses assessed validity in predicting breastfeeding behaviour and experiences. Results: EFA found a shortened 8-item, 2-factor model had good fit (χ 2 = 23.3, df = 13, p <.040; CFI =.99, TLI =.99, RMSEA =.05), with significant factor loadings. Factor 1 (benefit beliefs) and factor 2 (effort beliefs) accounted for 47 and 19.4% of the explained variance and correlated moderately (r = −.40). CFA confirmed the solution in the cohort sample (χ 2 = 49.6 df = 19, p <.010; CFI =.97, TLI =.96, and RMSEA =.078). Adjusted regression analyses found beliefs did not reliably predict infant feeding practices. Women{\textquoteright}s beliefs significantly predicted the likelihood that women experienced breastfeeding as {\textquoteleft}much more{\textquoteright} positive and negative than they expected. Conclusions: The eight-item questionnaire showed good model fit with acceptable loadings, and good reliability for all subscales. The utility of the BAB-Q at predicting breastfeeding behaviour remains unclear and unsupported by empirical evidence. Further assessments of the predictive validity of the questionnaire in longitudinal studies with diverse beliefs and infant feeding practices are required. ",

author = "Philippa Davie and Debra Bick and Joseph Chilcot",

note = "Funding Information: This article is the author(s) original work. This article has not received prior publication and is not under consideration for publication elsewhere. All authors have seen and approved the manuscript being submitted. This research study was funded as part of a PhD studentship stipend awarded to Philippa Davie (King{\textquoteright}s College London Institute of Psychiatry, Psychology and Neuroscience (IoPPN) Studentship Prize 2016/17) and funding awarded to the PIPINS Study (Ref: 18/LO/0740) from Guy{\textquoteright}s and St Thomas{\textquoteright} Charity, London, UK (Grant Reference EIC181002). Guy{\textquoteright}s Charity and St Thomas{\textquoteright} Charity do not have any permissions or influence over study design, methodology (including data collection), data analysis, or manuscript preparation. The authors wish to extend their thanks and gratitude to all the women enrolled in the online study and PIPINS cohort study for their time and contribution to this research. PD conceptualized the article with the guidance of DB and JC. JC and PD conducted statistical analyses. All members of the study team contributed significantly towards the preparation of the manuscript. JC is the guarantor. Publisher Copyright: {\textcopyright} 2020 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltdon behalf of British Psychological Society Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = may,

doi = "10.1111/bjhp.12498",

language = "English",

volume = "26",

pages = "482--504",

journal = "British Journal of Health Psychology",

issn = "1359-107X",

publisher = "Wiley-Blackwell",

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T1 - The Beliefs About Breastfeeding Questionnaire (BAB-Q): A Psychometric Validation Study

AU - Davie, Philippa

AU - Bick, Debra

AU - Chilcot, Joseph

N1 - Funding Information: This article is the author(s) original work. This article has not received prior publication and is not under consideration for publication elsewhere. All authors have seen and approved the manuscript being submitted. This research study was funded as part of a PhD studentship stipend awarded to Philippa Davie (King’s College London Institute of Psychiatry, Psychology and Neuroscience (IoPPN) Studentship Prize 2016/17) and funding awarded to the PIPINS Study (Ref: 18/LO/0740) from Guy’s and St Thomas’ Charity, London, UK (Grant Reference EIC181002). Guy’s Charity and St Thomas’ Charity do not have any permissions or influence over study design, methodology (including data collection), data analysis, or manuscript preparation. The authors wish to extend their thanks and gratitude to all the women enrolled in the online study and PIPINS cohort study for their time and contribution to this research. PD conceptualized the article with the guidance of DB and JC. JC and PD conducted statistical analyses. All members of the study team contributed significantly towards the preparation of the manuscript. JC is the guarantor. Publisher Copyright: © 2020 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltdon behalf of British Psychological Society Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/5

Y1 - 2021/5

N2 - Objectives: Questionnaires used to assess women’s beliefs as a predictor of breastfeeding behaviour are not theoretically informed or tested for psychometric validity and reliability. This study conducted a psychometric evaluation of the Beliefs About Breastfeeding Questionnaire (BAB-Q). Design: A two-phase evaluation in an online cross-sectional questionnaire study (N = 278) and cohort study sample (N = 264). A ten-item questionnaire was proposed to assess women’s beliefs about the benefits and efforts of breastfeeding. Methods: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed construct validity and reliability. Multivariate regression analyses assessed validity in predicting breastfeeding behaviour and experiences. Results: EFA found a shortened 8-item, 2-factor model had good fit (χ 2 = 23.3, df = 13, p <.040; CFI =.99, TLI =.99, RMSEA =.05), with significant factor loadings. Factor 1 (benefit beliefs) and factor 2 (effort beliefs) accounted for 47 and 19.4% of the explained variance and correlated moderately (r = −.40). CFA confirmed the solution in the cohort sample (χ 2 = 49.6 df = 19, p <.010; CFI =.97, TLI =.96, and RMSEA =.078). Adjusted regression analyses found beliefs did not reliably predict infant feeding practices. Women’s beliefs significantly predicted the likelihood that women experienced breastfeeding as ‘much more’ positive and negative than they expected. Conclusions: The eight-item questionnaire showed good model fit with acceptable loadings, and good reliability for all subscales. The utility of the BAB-Q at predicting breastfeeding behaviour remains unclear and unsupported by empirical evidence. Further assessments of the predictive validity of the questionnaire in longitudinal studies with diverse beliefs and infant feeding practices are required.

AB - Objectives: Questionnaires used to assess women’s beliefs as a predictor of breastfeeding behaviour are not theoretically informed or tested for psychometric validity and reliability. This study conducted a psychometric evaluation of the Beliefs About Breastfeeding Questionnaire (BAB-Q). Design: A two-phase evaluation in an online cross-sectional questionnaire study (N = 278) and cohort study sample (N = 264). A ten-item questionnaire was proposed to assess women’s beliefs about the benefits and efforts of breastfeeding. Methods: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed construct validity and reliability. Multivariate regression analyses assessed validity in predicting breastfeeding behaviour and experiences. Results: EFA found a shortened 8-item, 2-factor model had good fit (χ 2 = 23.3, df = 13, p <.040; CFI =.99, TLI =.99, RMSEA =.05), with significant factor loadings. Factor 1 (benefit beliefs) and factor 2 (effort beliefs) accounted for 47 and 19.4% of the explained variance and correlated moderately (r = −.40). CFA confirmed the solution in the cohort sample (χ 2 = 49.6 df = 19, p <.010; CFI =.97, TLI =.96, and RMSEA =.078). Adjusted regression analyses found beliefs did not reliably predict infant feeding practices. Women’s beliefs significantly predicted the likelihood that women experienced breastfeeding as ‘much more’ positive and negative than they expected. Conclusions: The eight-item questionnaire showed good model fit with acceptable loadings, and good reliability for all subscales. The utility of the BAB-Q at predicting breastfeeding behaviour remains unclear and unsupported by empirical evidence. Further assessments of the predictive validity of the questionnaire in longitudinal studies with diverse beliefs and infant feeding practices are required.

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U2 - 10.1111/bjhp.12498

DO - 10.1111/bjhp.12498

M3 - Article

SN - 1359-107X

VL - 26

SP - 482

EP - 504

JO - British Journal of Health Psychology

JF - British Journal of Health Psychology

IS - 2

ER -

The Beliefs About Breastfeeding Questionnaire (BAB-Q): A Psychometric Validation Study

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