Pregnancy Eating Attitudes-Questionnaire (PEA-Q): Longitudinal measurement invariance from early to late pregnancy in a community sample

The Pregnancy Eating Attitudes-Questionnaire (PEA-Q) assesses pregnancy-specific eating/weight attitudes that impact birthing individuals. This novel self-report measure, comprising Permissive Eating/Weight Attitudes, Intentional Eating Changes, and Lack of Worry about Eating/Weight factors, demonstrated promising psychometric properties when administered late in pregnancy. To evaluate the PEA-Q's ability to adequately capture pregnancy-specific eating/weight attitudes across pregnancy, we employed longitudinal measurement invariance (MI) testing among a community sample of pregnant individuals with pre-pregnancy body mass index≥25. Participants (N = 312) enrolled in a randomized perinatal health behavior trial completed the PEA-Q at M(SD) = 13.6(2.7) and 36.5(1.3) weeks' gestation. We performed longitudinal MI testing in steps to establish equivalence of the PEA-Q at early and late pregnancy and to compare PEA-Q scores between these timepoints. Models covaried for randomization status. Partial strong invariance was ultimately achieved by freeing the intercepts of one item. Results from latent mean difference testing documented significantly lower scores on Permissive Eating/Weight Attitudes and Lack of Worry about Eating/Weight (p ≤ .01), but not Intentional Eating Changes (p = .08), in early versus late pregnancy. Findings indicate that the PEA-Q adequately captures pregnancy-specific eating/weight attitudes in both early and late pregnancy and, thus, can be used to assess change over this period. In the present sample, changes in PEA-Q scores from early to late pregnancy suggest that pregnant individuals may experience increasingly permissive eating/weight attitudes and less worry about eating/weight as pregnancy progresses. Future research examining the health implications of PEA-Q changes across pregnancy is warranted.