Pregnancy Eating Attitudes-Questionnaire (PEA-Q): Exploratory factor analysis and psychometric performance in a...

Pregnancy is characterized by biopsychosocial changes that impact appetite, eating and weight. Understanding pregnant individuals' attitudes toward eating and weight can provide insight into prenatal health behavior. Accordingly, we developed and performed initial psychometric testing of a self-report measure, the Pregnancy Eating Attitudes-Questionnaire (PEA-Q), among individuals with pre-pregnancy BMI≥25. Pregnant participants with pre-pregnancy BMI≥25 (N = 213), who predominantly identified as racially minoritized (51% Black/African American) and lower income (66% ≤$30,000/year), enrolled in a longitudinal study. Participants completed 25 candidate PEA-Q items and eating- and weight-related measures. We conducted exploratory factor analysis to determine PEA-Q factor structure, calculated internal consistency coefficients of the extracted factors, and assessed convergent and discriminant validity. An 11-item, three-factor solution produced excellent model fit. Factors were interpreted as Permissive Eating and Weight Attitudes (e.g., "Pregnancy is a 'free pass' to eat any type of food that I want; " α = .82), Intentional Eating Changes (e.g., "I need to eat more food each day because I am pregnant; " α = .81), and Lack of Worry about Eating and Weight (e.g., "I am not concerned about eating too much now that I am pregnant; " α = .83). Each factor showed small-to-moderate correlations with measures of gestational weight gain and/or dietary intake and was not correlated with eating pathology measures, demonstrating adequate convergent and discriminant validity, respectively. This novel self-report measure seems to adequately capture pregnancy-related attitudes toward eating and weight among pregnant individuals with BMI≥25. Further testing is required to confirm these preliminary findings and determine generalizability.