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Breastfeeding self-efficacy, body image, body acceptance, and partner support: Associations in Israeli postpartum women

Geller S, Levy S, Baruch T, Rinot Y, Swami V

Midwifery, 2024 Apr;131:103937.
PMID: 38306735 DOI: 10.1016/j.midw.2024.103937

PROBLEM: Research suggests that breastfeeding self-efficacy (i.e., a mother's perceived ability and confidence to breastfeed her new-born) is associated with body image experiences and wider psychosocial factors. However, much of this work is focused on negative body image and has relied on samples from predominantly Westernised, industrialised nations.
BACKGROUND: To extend knowledge, we sought to examine the extent to which indices of positive body image (body appreciation), negative body image (body dissatisfaction, breast size dissatisfaction), and psychosocial factors (body acceptance by others, postpartum partner support) are associated with breastfeeding self-efficacy in sample of mothers from Israel.
HYPOTHESIS: We hypothesised that body appreciation, body dissatisfaction, breast size dissatisfaction, body acceptance by others, and postpartum partner support would each be significantly associated with breastfeeding self-efficacy in Israeli mothers.
METHOD: A total of 352 mothers from Israel, with an infant aged six months or younger, were asked to complete an online survey that measured the aforementioned constructs.
FINDINGS: Correlational and linear model analyses indicated that only body appreciation was significantly associated with breastfeeding self-efficacy. Body acceptance by others was significantly associated with breastfeeding self-efficacy in correlational but not regression analyses. These effects were consistent across primiparous and multiparous mothers.
DISCUSSION: In Israeli mothers, at least, a limited set of body image and body image-related indices appear to be associated with breastfeeding self-efficacy.
CONCLUSION: Overall, these findings suggest that positive body image may be associated with breastfeeding self-efficacy in women from Israel, though more research is needed.
An examination of the factor structure and preliminary assessment of the psychometric properties of a Hebrew translation of the Body Appreciation Scale-2 (BAS-2)

Geller S, Handelzalts JE, Levy S, Boxer N, Todd J, Swami V

Body Image, 2020 Sep;34:145-154.
PMID: 32674037 DOI: 10.1016/j.bodyim.2020.05.013

The Body Appreciation Scale-2 (BAS-2) is a widely-used, 10-item measure of a core facet of positive body image. To extend its use internationally, we examined the factor structure and conducted a preliminary assessment of the psychometric properties of a novel Hebrew translation of the BAS-2. A sample of 613 Israeli adults (362 women, 251 men; age M = 29.52, SD = 9.47) completed the BAS-2 alongside demographic items and previously-validated measures of life satisfaction, self-esteem, self-compassion, and body investment. Exploratory factor analyses with a semi-random split-half subsample (n = 377) indicated that BAS-2 scores reduced to a single dimension with all 10 items. This factor structure was equivalent across women and men. Confirmatory factor analysis (CFA) with a second split-half subsample (n = 235) showed the 1-dimensional factor structure had adequate fit following one modification and multi-group CFA showed that the model was invariant across sex. Men had significantly higher BAS-2 scores than women, but the effect size was small (d = 0.22). Evidence of construct validity was demonstrated through positive associations with indices of life satisfaction, self-esteem, self-compassion, and body investment. The availability of a validated BAS-2 Hebrew translation should advance future research of body appreciation in Israel.
Fulltext A relational investigation of Israeli gay fathers' experiences of surrogacy, early parenthood, and mental health in the context of the COVID-19 pandemic

Kelly HK, Geller S, Swami V, Shenkman G, Levy S, Ridge D

PLoS One, 2023;18(2):e0282330.
PMID: 36827339 DOI: 10.1371/journal.pone.0282330

Perinatal distress affects approximately 10% of fathers, but little is known about how gay fathers experience the challenges surrounding childbirth and early parenting of a child. This study explored gay fathers' experiences of having a baby via transnational surrogacy, raising that baby as a gay parent, and the context of the COVID-19 pandemic. In-depth qualitative interviews were conducted with 15 Israeli men to understand their experiences of surrogacy and early parenthood, focusing on the impact on their mental health and the relational factors involved. Secondary narrative analysis revealed that fathers constructed surrogacy as a perilous quest that required strong intentionality to undertake. The first year of parenthood was conceptualised alternately as a joyful experience and/or one that challenged fathers' identities and mental health. A relational framework was applied to better conceptualise the fathers' narratives, revealing that actual connections-and the potentials for links-considerably shaped experiences of surrogacy, perinatal distress and recovery. Implications for research and policy are discussed.
The Breast Size Satisfaction Survey (BSSS): Breast size dissatisfaction and its antecedents and outcomes in women from 40 nations

Swami V, Tran US, Barron D, Afhami R, Aimé A, Almenara CA, et al.

Body Image, 2020 Mar;32:199-217.
PMID: 32032822 DOI: 10.1016/j.bodyim.2020.01.006

The Breast Size Satisfaction Survey (BSSS) was established to assess women's breast size dissatisfaction and breasted experiences from a cross-national perspective. A total of 18,541 women were recruited from 61 research sites across 40 nations and completed measures of current-ideal breast size discrepancy, as well as measures of theorised antecedents (personality, Western and local media exposure, and proxies of socioeconomic status) and outcomes (weight and appearance dissatisfaction, breast awareness, and psychological well-being). In the total dataset, 47.5 % of women wanted larger breasts than they currently had, 23.2 % wanted smaller breasts, and 29.3 % were satisfied with their current breast size. There were significant cross-national differences in mean ideal breast size and absolute breast size dissatisfaction, but effect sizes were small (η2 = .02-.03). The results of multilevel modelling showed that greater Neuroticism, lower Conscientiousness, lower Western media exposure, greater local media exposure, lower financial security, and younger age were associated with greater breast size dissatisfaction across nations. In addition, greater absolute breast size dissatisfaction was associated with greater weight and appearance dissatisfaction, poorer breast awareness, and poorer psychological well-being across nations. These results indicate that breast size dissatisfaction is a global public health concern linked to women's psychological and physical well-being.
Fulltext Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age

Swami V, Tran US, Stieger S, Aavik T, Ranjbar HA, Adebayo SO, et al.

Body Image, 2023 Sep;46:449-466.
PMID: 37582318 DOI: 10.1016/j.bodyim.2023.07.010

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research.