Mother-infant bonding screening in a sample of postpartum women: comparison between online vs offline format

Abstract

Aims: The use of the internet to assess mother-infant bonding (MIB) has not been extensively examined. The main aim of this study was to compare offline (paper-and-pencil) and online MIB screening in a sample of n=1,269 women. We tested the reliability and factorial structure of the Postpartum Bonding Questionnaire (PBQ) and also compared clinical, obstetrical, reproductive, and psychopathological variables related to poor MIB. Methods: A cross-sectional study was conducted on 1,269 mothers. The offline group included 812 women who attended a 40-day postpartum clinical appointment. The online group consisted of 457 women recruited during admission for delivery who volunteered to carry out the online protocol 40 days postpartum. All the participants individually completed the PBQ, the Edinburg Postnatal Depression Scale (EPDS) and a questionnaire on other clinical and sociodemographic variables.Results: The 4-factor solution proposed in the PBQ and its Spanish validation showed good model fit for both the offline and the online sample. Women assessed through the online format reported higher levels of stress, depressive symptoms, and poor bonding, specifically on PBQ scores and the Rejection and Anger subscales. The offline and online assessments obtained the same results regarding the type of statistical associations between PBQ and sociodemographic, reproductive, obstetric and psychological outcomes.Conclusion: Online assessment may be an appropriate option for detecting possible alterations in MIB due to the reduction of desirability bias, the increased perception of anonymity, and being a more cost-effective method.

Pregnancy-Specific Stress during the First Lockdown of the COVID-19 Pandemic: Assessing Face-to-Face versus Online Recruitment

“…Women recruited online reported more previous miscarriages than those in the face-to-face group. We hypothesize that this finding could be associated with the intimacy and sense of security that the online method offers to answer an uncomfortable question anonymously, as pointed out by other authors [ 40 ]. In this sense, online recruitment would show an advantage over the face-to-face recruitment of participants by ensuring anonymity.…”

Anxious Attachment Mediates the Associations Between Early Recollections of Mother's Own Parental Bonding and Mother–Infant Bonding: A 2-Month Path Analysis Model

“…This difference in assessments is a result of following up on a fairly large sample. Recent research of offline vs. online assessment of the PBQ found no difference between assessment modalities in terms of associations with sociodemographic, reproductive, obstetric, and psychological outcomes ( 61 ). Lastly, our participants were mostly Jewish, sampled from one health center only, and this may impair our ability to generalize our findings, as parenting practices may be different across cultures.…”

The acceptability of implementing patient‐reported measures in routine maternity care: A systematic review

“…Seventeen studies observed women's actions and behaviors in responding to PRMs questionnaires in routine maternity care, including participation, response, completion, and compliance to follow-up support or care 20,24,[26][27][28][29][30][31][32][33][34][36][37][38][39][40]44 (see Table 2).…”

“…According to eight studies 26,30,[32][33][34]36,37,39 26 Kim et al, 30 Kingston et al, 32 La Porte et al, 33 Lasheras et al, 34 Lawson et al, 36 Marcano-Belisario et al, 37 Matthey et al 39 Average of participation rates: 85.01% (considering sample size of each study) Range of participation rates: 67.00%-98.50% Participation (average) in different geographical areas: Europe, 93.07%; Australia, 80.00%; North America, 76.43%; Others, Japan and Kenya, no relevant data Participation (average) for different data collection tools and platforms: Paper, 98.42%; web, 94.69%; app, 84.06%; SMS or automated voice messaging, 67.78% Other key points • The main reasons of women's refusal to participate included a lack of interest, a lack of time, technical barriers and worry about missing appointments while answering PRMs questions during waiting time at clinic sites (Kim et al, 30 La Porte et al, 33 Marcano-Belisario et al 37 )…”

“…Response (response rate: the number of respondents who answered and submitted PRMs questionnaires/the number of women who participated) Studies (n = 11) Al-Shammari et al, 21 Depla et al, 24 Kim et al, 30 Kim et al, 31 Kingston et al, 32 La Porte et al, 33 Lasheras et al, 34 Lawson et al, 36 Marcano-Belisario et al, 37 Martínez-Borba et al, 38 Nishizono-Maher et al 34 • Response rate online was 98.36% and 99.4% offline (Kingston et al) 32 • All missing responses in digital form were found in questionnaires that had been filled out on paper. Women replied with a free comment in the margins (of paper) that the question was not applicable to their situation (Depla et al) 24 • Response rate was lower among women in app (53.1%) than those from web (70.7%) (Martínez-Borba et al) 38 • The percentage of women who responded to all assessments across the pathway was higher in app (app 9.1% vs. web 4.6%), indicating a higher fidelity and attractiveness to app platform for repeated measurement (Martínez-Borba et al) 38 The relations between responses and women's characteristics were different • Those who responded were more likely to have at least a high school education, be employed and have food secure households (Kim et al) 31 • Women's participation (i.e., calling into screen system) was not associated with race, ethnicity, age, parity, or previous history of depression (Kim et al) 31 • Privately insured women were significantly more likely to respond than publicly insured women based on Pearson's chi-squared tests (La Porte et al) 33 • Married women were significantly more likely to respond than unpartnered women (La Porte et al) 33 • Response did not vary by race or ethnicity.…”