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Article ; Online: Breastfeeding Duration and the Theory of Planned Behavior and Breastfeeding Self-Efficacy Framework: A Systematic Review of Observational Studies.

Lau, Christine Y K / Lok, Kris Y W / Tarrant, Marie

2018 Volume 22, Issue 3, Page(s) 327–342

Abstract: Introduction Numerous studies have shown that the constructs of the Theory of Reasoned Action (TRA), Theory of Planned Behavior (TPB) and Breastfeeding Self-Efficacy (BSE) Framework can effectively identify relationships between maternal psychosocial ... ...

Abstract	Introduction Numerous studies have shown that the constructs of the Theory of Reasoned Action (TRA), Theory of Planned Behavior (TPB) and Breastfeeding Self-Efficacy (BSE) Framework can effectively identify relationships between maternal psychosocial factors and breastfeeding initiation. However, the ability of these theories to predict breastfeeding duration has not been adequately analyzed. The aim of the review was to examine the utility of the constructs of TRA/TPB and BSE to predict breastfeeding duration. Methods We conducted a literature search using Pubmed (1980-May 2015), Medline (1966-May 2015), CINAHL (1980-May 2015), EMBASE (1980-May 2015) and PsycINFO (1980-May 2015). We selected studies that were observational studies without randomization or blinding, using TRA, TPB or BSE as the framework for analysis. Only studies reporting on breastfeeding duration were included. Results Thirty studies were selected, which include four using TRA, 10 using TPB, 15 using BSE and one using a combination of TPB and BSE. Maternal intention and breastfeeding self-efficacy were found to be important predictors of breastfeeding duration. Inconsistent findings were found in assessing the relationship between maternal attitudes, subjective norms, perceived behavior control and breastfeeding duration. Discussion The inadequacy of these constructs in explaining breastfeeding duration indicates a need to further explore the role of maternal self-determination in breastfeeding behavior.
MeSH term(s)	Breast Feeding/psychology ; Female ; Health Behavior ; Health Knowledge, Attitudes, Practice ; Humans ; Intention ; Observational Studies as Topic ; Psychological Theory ; Self Efficacy
Language	English
Publishing date	2018-02-09
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	1339905-6
ISSN	1573-6628 ; 1092-7875
ISSN (online)	1573-6628
ISSN	1092-7875
DOI	10.1007/s10995-018-2453-x
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Article ; Online: Psychometric Evaluation of a Fear of COVID-19 Scale in China: Cross-sectional Study.

Choi, Edmond P H / Duan, Wenjie / Fong, Daniel Y T / Lok, Kris Y W / Ho, Mandy / Wong, Janet Y H / Lin, Chia-Chin

JMIR formative research

2022 Volume 6, Issue 3, Page(s) e31992

Abstract: Background: At the very beginning of the COVID-19 pandemic, information about fear of COVID-19 was very limited in Chinese populations, and there was no standardized and validated scale to measure the fear associated with the pandemic.: Objective: ... ...

Abstract	Background: At the very beginning of the COVID-19 pandemic, information about fear of COVID-19 was very limited in Chinese populations, and there was no standardized and validated scale to measure the fear associated with the pandemic. Objective: This cross-sectional study aimed to adapt and validate a fear scale to determine the levels of fear of COVID-19 among the general population in mainland China and Hong Kong. Methods: A web-based questionnaire platform was developed for data collection; the study instruments were an adapted version of the 8-item Breast Cancer Fear Scale ("Fear Scale") and the 4-item Patient Health Questionnaire. The internal construct validity, convergent validity, known group validity, and reliability of the adapted Fear Scale were assessed, and descriptive statistics were used to summarize the participants' fear levels. Results: A total of 2822 study participants aged 18 years or older were included in the analysis. The reliability of the adapted scale was satisfactory, with a Cronbach α coefficient of .93. The item-total correlations corrected for overlap were >0.4, confirming their internal construct validity. Regarding convergent validity, a small-to-moderate correlation between the Fear Scale and the 4-item Patient Health Questionnaire scores was found. Regarding known group validity, we found that the study participants who were recruited from Hong Kong had a higher level of fear than the study participants from mainland China. Older adults had a higher level of fear compared with younger adults. Furthermore, having hypertension, liver disease, heart disease, cancer, anxiety, and insomnia were associated with a higher fear level. The descriptive analysis found that more than 40% of the study participants reported that the thought of COVID-19 scared them. About one-third of the study participants reported that when they thought about COVID-19, they felt nervous, uneasy, and depressed. Conclusions: The psychometric properties of the adapted Fear Scale are acceptable to measure the fear of COVID-19 among Chinese people. Our study stresses the need for more psychosocial support and care to help this population cope with their fears during the pandemic.
Language	English
Publishing date	2022-03-02
Publishing country	Canada
Document type	Journal Article
ISSN	2561-326X
ISSN (online)	2561-326X
DOI	10.2196/31992
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Article ; Online: Evaluating the diagnostic properties of the Whooley questionnaire as a case-finding instrument for depression among Chinese women during and after pregnancy.

Lok, Kris Y W / Chow, Charlotte L Y / Tan, Shirley Waner / Smith, Robert / Lin, Jingxia / Kong, Choi Wah / Fong, Daniel Y T

Journal of psychosomatic obstetrics and gynaecology

2022 Volume 44, Issue 1, Page(s) 2132930

Abstract: Purpose: ...

Abstract	Purpose:
MeSH term(s)	Pregnancy ; Female ; Humans ; East Asian People ; Hong Kong/epidemiology
Language	English
Publishing date	2022-10-14
Publishing country	England
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604816-x
ISSN	1743-8942 ; 0167-482X
ISSN (online)	1743-8942
ISSN	0167-482X
DOI	10.1080/0167482X.2022.2132930
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Article ; Online: Using the Revised Health Care System Distrust Scale to evaluate healthcare distrust among Chinese men in Hong Kong: An analysis from a prostate cancer screening behaviours survey.

Choi, Edmond P H / Hui, Bryant P H / Wan, Eric Y F / Kwok, Jojo Y Y / Lok, Kris Y W / Lee, Jung Jae

Health & social care in the community

2022 Volume 30, Issue 6, Page(s) e4694–e4704

Abstract: Information about the level of distrust in healthcare systems is very limited in Chinese populations, and no validated instrument has been developed to measure this distrust. Therefore, to begin addressing this research gap, this study evaluated the ... ...

Abstract	Information about the level of distrust in healthcare systems is very limited in Chinese populations, and no validated instrument has been developed to measure this distrust. Therefore, to begin addressing this research gap, this study evaluated the psychometric properties of a traditional Chinese version of the Revised Health Care System Distrust Scale and used it to assess the level of distrust in a healthcare system. The study involved a community-based personal interview survey of individuals in Hong Kong. A total of 340 men were randomly recruited. In addition to the distrust instrument, the two-item Trust in Physician Scale and the Patient Health Questionnaire-9 were used. The two-factor structure of the distrust scale was confirmed. The item-total correlations corrected for overlap were >0.4 for both the Competence and Values Distrust subscales, confirming the internal construct validity of the scale. The Cronbach's alpha coefficient was 0.77 for both subscales. The scores of both the Competence and Values subscales were moderately negatively correlated with the total score of the Trust in Physician Scale, providing support for convergent validity. Regarding known-group validity, the scale could differentiate people according to marital status, monthly personal income and severity of depressive symptoms. Moreover, we found that men who had previously undergone prostate cancer screening had higher Values Distrust scores than those who had not. The descriptive analysis showed that only about half of the participants reported that they received high-quality medical care and that the healthcare system provided excellent medical care, suggesting that more effort is needed to improve the quality of care and people's satisfaction with healthcare in Hong Kong. In summary, the translated traditional Chinese version of the Revised Health Care System Distrust Scale used in this study is a valid and reliable scale for assessing the level of distrust in a healthcare system.
MeSH term(s)	Male ; Humans ; Early Detection of Cancer ; Hong Kong ; East Asian People ; Prostatic Neoplasms/diagnosis ; Prostate-Specific Antigen ; Surveys and Questionnaires ; Psychometrics ; Delivery of Health Care ; Reproducibility of Results
Chemical Substances	Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2022-06-14
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1155902-0
ISSN	1365-2524 ; 0966-0410
ISSN (online)	1365-2524
ISSN	0966-0410
DOI	10.1111/hsc.13875
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Article ; Online: Meta-analysis of diagnostic properties of the Whooley questions to identify depression in perinatal women.

Smith, Robert D / Shing, Jeffrey S Y / Lin, Jessie / Bosanquet, Kate / Fong, Daniel Y T / Lok, Kris Y W

Journal of affective disorders

2022 Volume 315, Page(s) 148–155

Abstract: Background: This study's objective was to assess the diagnostic properties of the Whooley questions in identifying depression among perinatal women according to previously published studies. We conducted a systematic review and meta-analysis of studies ... ...

Abstract	Background: This study's objective was to assess the diagnostic properties of the Whooley questions in identifying depression among perinatal women according to previously published studies. We conducted a systematic review and meta-analysis of studies investigating the diagnostic accuracy of the Whooley questions in perinatal women. Methods: Nine databases were searched in October 2021. All primary studies evaluated the diagnostic properties of the Whooley questions compared with a diagnostic gold standard in women during the perinatal period or, if not identified as being in the perinatal stage within the study, women between 20 weeks' gestation to 4 weeks post-delivery. A bivariate mixed-effects meta-analysis was performed to estimate pooled diagnostic properties and measure heterogeneity. Meta-regression was conducted to evaluate factors contributing to heterogeneity. Results: Six studies were included in the review; five were used in the meta-analysis. The pooled sensitivity (95 % confidence interval) was 0.95 (0.81-0.99), pooled specificity was 0.60 (0.44-0.74), pooled positive likelihood ratio was 2.4 (1.6-3.4), pooled negative likelihood ratio was 0.09 (0.02-0.32), and pooled diagnostic odds ratio was 27 (7-106); heterogeneity was substantial (I Conclusions: The Whooley questions have high sensitivity but moderate specificity for perinatal women. The Whooley questions are a short and acceptable tool for identifying depression in perinatal women. However, a potential risk exists of incorrectly identifying a high proportion of women as positive. Using the Whooley questions followed by a secondary case-finding tool could reduce the misdiagnosis risk.
MeSH term(s)	Depression/diagnosis ; Depression, Postpartum/diagnosis ; Female ; Humans ; Parturition ; Pregnancy ; Sensitivity and Specificity
Language	English
Publishing date	2022-08-02
Publishing country	Netherlands
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2022.07.026
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Article ; Online: Correction to: The Effect of Maternal Self‑Regulated Motivation on Breastfeeding Continuation.

Lau, Christine Y K / Fong, Daniel Y T / Chan, Vincci H S / Lok, Kris Y W / Ng, Judy W Y / Sing, Chu / Tarrant, Marie

Maternal and child health journal

2022 Volume 26, Issue 2, Page(s) 449

Language	English
Publishing date	2022-01-04
Publishing country	United States
Document type	Published Erratum
ZDB-ID	1339905-6
ISSN	1573-6628 ; 1092-7875
ISSN (online)	1573-6628
ISSN	1092-7875
DOI	10.1007/s10995-021-03347-5
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Article ; Online: Exposure to baby-friendly hospital practices and mothers' achievement of their planned duration of breastfeeding.

Lok, Kris Y W / Chow, Charlotte L Y / Fan, Heidi S L / Chan, Vincci H S / Tarrant, Marie

BMC pregnancy and childbirth

2020 Volume 20, Issue 1, Page(s) 261

Abstract: Background: Both breastfeeding intentions and exposure to baby-friendly hospital practices were found to be associated with a longer duration of breastfeeding. This study aims to examine the effect of exposure to baby-friendly hospital practices on ... ...

Abstract	Background: Both breastfeeding intentions and exposure to baby-friendly hospital practices were found to be associated with a longer duration of breastfeeding. This study aims to examine the effect of exposure to baby-friendly hospital practices on mothers' achievement of their planned duration of breastfeeding. Methods: A total of 1011 mother-newborn pairs from the postnatal units of four public hospitals in Hong Kong were recruited. Sociodemographic data and breastfeeding intention data were collected via self-report questionnaires during the postnatal hospitalization and exposure to Baby-Friendly hospital practices were assessed through hospital records and maternal self-report. Breastfeeding status after hospital discharge was assessed through telephone follow-up for up to 12 months postnatal, or until participants were no longer breastfeeding. Results: Only 55% (n = 552) of study participants achieved their intended duration of breastfeeding. Participants with higher socioeconomic status, previous breastfeeding experience, and those who had lived in Hong Kong for less than 5 years, were more likely to achieve their planned duration of breastfeeding. Among baby-friendly hospital practices, feeding only breast milk during the hospitalization and providing information about breastfeeding support on discharge were associated with participants' achieving their individual breastfeeding intentions. After adjustment, when compared with women who experienced onebaby-friendly practice, participants who experienced six baby-friendly hospital practices were significantly more likely to achieve their planned duration of breastfeeding (adjusted odds ratio = 8.45, 95% confidence interval 3.03-23.6). Conclusions: Nearly half of participants did not achieve their planned breastfeeding duration. Exposure to baby-friendly hospital practices, especially in-hospital exclusive breastfeeding and providing breastfeeding support information upon hospital discharge may help more mothers to achieve their individual breastfeeding goals.
MeSH term(s)	Adolescent ; Adult ; Breast Feeding/statistics & numerical data ; Female ; Health Promotion/methods ; Hong Kong ; Hospitals, Public ; Humans ; Infant, Newborn ; Intention ; Postnatal Care ; Surveys and Questionnaires ; Time Factors ; Young Adult
Language	English
Publishing date	2020-05-01
Publishing country	England
Document type	Journal Article
ISSN	1471-2393
ISSN (online)	1471-2393
DOI	10.1186/s12884-020-02904-0
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Article ; Online: The Effect of Maternal Self-Regulated Motivation on Breastfeeding Continuation.

Lau, Christine Y K / Fong, Daniel Y T / Chan, Vincci H S / Lok, Kris Y W / Ng, Judy W Y / Sing, Chu / Tarrant, Marrie

Maternal and child health journal

2021 Volume 26, Issue 2, Page(s) 441–448

Abstract: Objective: Women frequently report breastfeeding problems in the early postpartum period. Women who have self-endorsed beliefs that breastfeeding benefits their babies and themselves are more likely to continue breastfeeding despite breastfeeding ... ...

Abstract	Objective: Women frequently report breastfeeding problems in the early postpartum period. Women who have self-endorsed beliefs that breastfeeding benefits their babies and themselves are more likely to continue breastfeeding despite breastfeeding barriers. Maternal self-endorsed beliefs is a key component of maternal self-regulated motivation. The present study examined the association between maternal self-regulated motivation, breastfeeding duration and exclusivity in Chinese women. Methods: This was a prospective cohort study, of which we recruited participants in postnatal maternity units of publicly funded hospitals in Hong Kong. Postpartum women were asked to fill in the validated breastfeeding self-regulation questionnaire (BSRQ) before hospital discharge and their breastfeeding status was assessed by telephone follow-ups at 6 and 12 weeks postpartum. Multiple logistic regression was used to study the relationship between breastfeeding self-regulated motivation and the duration of breastfeeding at follow-up. Results: At 6 and 12 weeks postpartum, women who breastfed exclusively scored significantly higher in self-regulated motivation than those who formula-fed. The self-regulated motivation was associated with higher odds of exclusive breastfeeding at 6 weeks and any breastfeeding at 12 weeks postpartum. Conclusions for practice: The study found that self-regulated motivation was positively related to breastfeeding duration. Maternal self-regulated motivation toward breastfeeding could be enhanced by the availability of social support and breastfeeding-friendly facilities, resulting in longer breastfeeding duration.
MeSH term(s)	Breast Feeding ; Female ; Humans ; Infant ; Motivation ; Postpartum Period ; Pregnancy ; Prospective Studies ; Surveys and Questionnaires
Language	English
Publishing date	2021-10-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	1339905-6
ISSN	1573-6628 ; 1092-7875
ISSN (online)	1573-6628
ISSN	1092-7875
DOI	10.1007/s10995-021-03274-5
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Article ; Online: Interventions to increase the uptake of seasonal influenza vaccination among pregnant women: A systematic review.

Wong, Valerie W Y / Lok, Kris Y W / Tarrant, Marie

Vaccine

2016 Volume 34, Issue 1, Page(s) 20–32

Abstract: Background: Pregnant women and their infants under 6 months of age infected with influenza have a high risk of serious morbidity and mortality. Influenza vaccine during pregnancy offers 3-for-1 benefits to pregnant women, fetuses and newborn infants. ... ...

Abstract	Background: Pregnant women and their infants under 6 months of age infected with influenza have a high risk of serious morbidity and mortality. Influenza vaccine during pregnancy offers 3-for-1 benefits to pregnant women, fetuses and newborn infants. Current vaccination uptake rates during pregnancy, however, are often lower than other high-risk groups and the general population. Methods: We systematically reviewed evidence on the effectiveness of interventions to improve influenza vaccination coverage in pregnant women. Risk differences (RDs) were calculated from the included studies. Results: Eleven studies were included in the review, of which four were randomized controlled trials (RCTs). Three cohort studies assessed provider-focused interventions while four RCTs and one cohort study evaluated pregnant women-focused interventions. Two cohort studies and a prospective intervention study assessed the effectiveness of bundled interventions. No study solely assessed the effectiveness of interventions to enhance access to influenza vaccination. One moderate quality RCT showed that an influenza pamphlet, with or without a verbalized benefit statement, improved the vaccination rate (RD=0.26; RD=0.39). The other reviewed RCTs showed discordant results, with RDs ranging from -0.15 to 0.03. Although all observational studies significantly improved vaccination rates (RDs ranged from 0.03 to 0.44), the quality of the evidence varied. Conclusions: There is a lack of effective interventions to increase the influenza vaccination rate in pregnant women. Based on the existing research, we recommend that clinicians provide influenza pamphlets to pregnant women with a verbalized statement about the benefits of influenza vaccine to newborns. Further high-quality RCTs are needed to develop successful maternal influenza vaccination programs. Increased clarity in reporting the content of interventions would help to improve the comparability and generalizability of the published studies.
MeSH term(s)	Adolescent ; Adult ; Behavior Therapy/methods ; Female ; Humans ; Influenza Vaccines/administration & dosage ; Influenza, Human/prevention & control ; Middle Aged ; Patient Acceptance of Health Care ; Pregnancy ; Pregnancy Complications, Infectious/prevention & control ; Prospective Studies ; Vaccination/psychology ; Vaccination/utilization ; Young Adult
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2016-01-02
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2015.11.020
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Article ; Online: Validating the use of the revised childbirth experience questionnaire in Hong Kong.

Lok, Kris Y W / Fan, Heidi S L / Ko, Rachel W T / Kwok, Jojo Y Y / Wong, Janet Y H / Fong, Daniel Y T / Shek, Noel W M / Ngan, Hextan Y S / Choi, Edmond P H

BMC pregnancy and childbirth

2022 Volume 22, Issue 1, Page(s) 126

Abstract: Objective: To evaluate the psychometric properties of the traditional Chinese version of the Childbirth Experience Questionnaire (CEQ 2.0) and assess the childbirth experiences of Chinese women.: Methods: A cross-sectional survey was conducted in ... ...

Abstract	Objective: To evaluate the psychometric properties of the traditional Chinese version of the Childbirth Experience Questionnaire (CEQ 2.0) and assess the childbirth experiences of Chinese women. Methods: A cross-sectional survey was conducted in Hong Kong from July 2020 to February 2021. In total, 975 mothers, who could read traditional Chinese and gave birth in 2020 or 2021, were included in the analysis. Data were fitted into the model proposed by the original developers using the confirmatory factor analysis. The data were then randomly split into training and validation sets for exploratory and confirmatory factor analyses. Childbirth experiences were assessed. Factor structure, internal construct validity, internal consistency, and known-group validity were assessed. Results: The originally proposed CEQ2.0 model showed a poor fit. An exploratory factor analysis identified a revised four-factor model (CEQ2.0-R) on a randomly split sample, which showed a satisfactory fit (CFI=0.912; TLI=0.884; SRMR=.053; RMSEA=0.072) on the other split sample. The revised scale comprised 13 items and four domains: (1)"Own capacity" (6 items), (2) "General support" (3 items), (3) "Perceived safety" (2 items), and (4) "Professional support" (2 items). CEQ2.0-R showed high internal construct validity and reliability. It can differentiate between participants with different characteristics, including parity, oxytocin augmentation, and companionship during labour. The childbirth experiences of the participants were merely positive, and participants reported that more support from midwives is needed. Conclusions: CEQ2.0-R can adequately describe the childbirth experiences of women in Hong Kong. The questionnaire is easy to be administer and can be used to assess several domains of the childbirth experiences. It may be useful to evaluate the aspects of support needed during childbirth.
MeSH term(s)	Adult ; Asians ; Factor Analysis, Statistical ; Female ; Hong Kong ; Humans ; Parturition/psychology ; Psychometrics/instrumentation ; Reproducibility of Results ; Surveys and Questionnaires ; Translations
Language	English
Publishing date	2022-02-15
Publishing country	England
Document type	Journal Article ; Validation Study
ZDB-ID	2059869-5
ISSN	1471-2393 ; 1471-2393
ISSN (online)	1471-2393
ISSN	1471-2393
DOI	10.1186/s12884-022-04456-x
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