A video-based intervention to overcome pregnancy smoking stigma among healthcare students: a randomised controlled trial.

OBJECTIVES: This study tests a video intervention to reduce pregnancy smoking stigma among French healthcare students. DESIGN: The participants were randomly selected to watch online either an experimental video (presenting educational content regarding stigma and contact with pregnant smokers) or a control video (presenting standard educational content about the risks of smoking). The students completed scales assessing stigma, intention to address smoking cessation and self-efficacy to do so, before the intervention (T0, n = 252), one week after the intervention (T1, n = 187), and one month after the intervention (T2, n = 131). RESULTS: Compared to the medical students, especially men, the midwifery students reported lower derogative cognitions (η2p = .18), negative behaviours (η2p = .07) and personal distress (η2p = .06). However, the midwifery students also reported lower levels of intention to address smoking (η2p = .02) than the medical students. The experimental video decreased derogative cognitions to a greater extent than the control video (η2p = .23) in both the short and medium term. This study is the first intervention designed to reduce the stigmatisation of pregnant smokers by healthcare students. We recommend that the issue of stigma should receive more attention in the medical curriculum.

The Pregnant Smoker Stigma Scale - Self Stigma (P3S-SS): development and validation in pregnant smoking women in France.

Pregnancy smoking self-stigma may be associated with mental health and smoking cessation. This study aims to validate the Pregnant Smoker Stigma Scale - Self-Stigma (P3S-SS) assessing perceived and internalized stigma. Between May 2021 and May 2022, French pregnant smokers recruited online (n = 143) took the P3S-SS and other scales assessing depressive symptoms (EPDS), social inclusion (SIS), dissimulation, dependence (CDS-5), cessation self-efficacy (SEQ), and intention. The two versions of the scale include four dimensions: derogatory cognitions ("People think/I feel I am selfish"), negative emotions and behaviors ("People make me feel/smoking makes me feel guilty"), personal distress ("People/I feel sorry for me/myself"), and information provision ("People tell me/I think about the risks of smoking"). Confirmatory factor analyses and multiple regressions have been computed. Model fit was good for perceived stigma and internalized stigma (X2/df = 3.06, RMSEA = .124, AGFI = .982, SRMR = .068, CFI = .986, NNFI = .985; X2/df = 3.31, RMSEA = .14, AGFI = .977, SRMR = .087, CFI = .981, NNFI = .979). Controlling for dependence, cessation intention was positively predicted by perceived and internalized personal distress and negatively predicted by perceived negative emotions and behaviors (Adj R2 = .143, F(8,115) = 3.567, p = .001). Controlling for dependence, dissimulation was positively predicted by internalized negative cognitions and perceived personal distress and negatively predicted by internalized personal distress (Adj R2 = .19, F(9,98) = 3.785, p = .000). The P3S-SS opens up exciting avenues for further research. Stigma does not motivate women to stop smoking but increases distress and dissimulation.

Validity of the Measure of Intensive Mothering Ideology (MIMI).

OBJECTIVE: The aim of this study was to test the validity of the Measure of Intensive Mothering Ideology (MIMI), a French scale assessing beliefs about mothering and childcare. METHOD: The MIMI was submitted online to Mothers/mothers-to-be (n=249) and Childless women (n=231). To test structural validity, confirmatory factor analyses were conducted in both groups. Then, to test known-groups validity, means comparisons were conducted according to parity (mothers/mothers-to-be and childless women) and employment status (full-time, part-time and housewives). It was also hypothesized that MIMI scores would be negatively correlated with education. RESULTS: Model fit was satisfactory for Mothers/mothers-to-be (X2/df=2.52, AGFI=.957, NFI=.937 RMR=.087) and, to a lesser extent, for Childless women (X2/df=3.31, AGFI=.948, NFI=.907, RMR=.104). In both groups, most dimensions were moderately correlated (.22-.70). As hypothesized, Mothers/mothers-to-be and Housewives had higher score than Childless women and Employed women. MIMI scores were also negatively and moderately correlated with education. CONCLUSION: The MIMI shows good structural validity and known-groups validity. This scale offers interesting research avenues notably regarding perinatal parental adaptation.

Should we use the Parental Stress Index-Short Form in parents of children with ASD? A French validation study.

BACKGROUND: Parents of children with Autism Spectrum Disorder (ASD) exhibit higher levels of parental stress than parents of typically developing children. The most frequently used tools to assess parental stress is the Parenting Stress Index (PSI) or its Short Form (PSI-SF). AIMS: This study was designed to test the validity of the PSI-SF in French parents of children with ASD (N = 370). METHODS AND PROCEDURES: First, a confirmatory factor analysis was conducted to test the initial 3-factor structure (36 items) which indicate a poor model fit. Then, an exploratory factor analysis was performed and convergent validity was assessed. OUTCOMES AND RESULTS: A 3-factor structure (21 items) explaining 44 % of the variance was observed. Dimensions were moderately correlated and exhibited good internal consistency. Convergent validity was checked through the PSI-SF association with anxiety and depression (HADS), quality of life (WHOQOL-Brief) and appraisal of being a parent of a child with ASD (ALES). CONCLUSIONS AND IMPLICATIONS: Future research should use the full version of the PSI-SF and examine its factor structure. More studies on the factor structure of the PSI-SF are needed to find out if it is a suitable tool for measuring stress in parents of children with ASD in France.

Screening Beyond Postpartum Depression: Occluded Anxiety Component in the EPDS (EPDS-3A) in French Mothers.

INTRODUCTION: According to many studies, anxiety in the perinatal period is widespread and has many detrimental effects. Thus, screening measures should not be limited to assessing depression symptoms. The widely used Edinburgh Postnatal Depression Scale (EPDS) might assess depression but also anxiety symptoms. This study explores whether an anxiety dimension (EPDS-3A) was found and valid in French women during pregnancy and the postpartum period. METHODS: French women were followed-up at late pregnancy and 2 and 4 months postpartum (N = 144, 138 and 129). They completed the EPDS and the Hospital Anxiety and Depression Scale (HADS-A). Exploratory factor analyses were performed. Then to test its validity, the EPDS-3A was correlated with anxiety (HADS-A) and depression (EPDS-D) scores. Finally, prevalence estimates were computed according to recommended cut off. RESULTS: The anxiety dimension assessed through the EPDS-3A was observed during the postpartum period but not during pregnancy. A two-factor structure (depression and anxiety) increases the variance explained at 2 and 4 months postpartum (respectively 6 and 12%). The EPDS-3A shows good internal consistency (≥ .70) and was more strongly associated with anxiety scores (HADS-A) (.48-.57) than with depression scores (EPDS-D) (.30-.39). Nearly 28% of mothers had scores that exceeded the EPDS-3A cut off (≥ 4) but not the full EPDS cut off (≥ 13 or more). DISCUSSION: The EPDS contains an anxiety component (EPDS-3A) that can be found in French women during the postnatal period but not during pregnancy. It shows signs of internal consistency and validity. The EPDS-3A could be considered when screening for postpartum anxiety.

Intensive mothering ideology in France: A pilot study.

OBJECTIVE: The aim of this pilot study was to adapt the intensive mothering ideology concept in a French sample and to get an assessment tool. METHOD: First, the Intensive Parenting Attitudes Questionnaire (IPAQ), a U.S. scale comprising 25 items, was translated and submitted online to French mothers and mothers-to-be (n=250). Structural validity was tested through confirmatory factor analysis with poor results. Secondly, to increase the cultural validity of a new tool, new items were derived from French women speech. French mothers and mothers-to-be (n=22) were asked about their views regarding motherhood and childcare (semi-structured interviews). A thematic content analysis was performed with good inter-judge agreement (0.53-0.86) and 27 items were created. Finally, the total set of 52 items was submitted online to French mothers and mothers-to-be (n=474). The structure was tested through exploratory factor analysis. RESULTS: A new tool called the Measure of Intensive Mothering Ideology (MIMI) was obtained. This 21 items scale with 6 dimensions (Essentialism, Consuming Fulfillment, Child-centrism, Challenge, Sacrifice and Stimulation) explains 59.75% of variance. Internal consistencies were satisfactory (0.61-0.83) and most dimensions were positively and moderately correlated (0.17-0.38). CONCLUSION: The MIMI is the first French-language scale assessing IMI and offers interesting research avenues notably regarding perinatal parental adaptation.