Introduction
The Health Practices in Pregnancy Questionnaire–II (HPQ-II) is a 34-item self-report instrument that measures health practices important to pregnancy outcomes, giving a global assessment of pregnant women's health practices. Kelly Lindgren developed it and published its validation in 2005, and it has received more than 100 citations.
The HPQ-II was developed mainly for research use. This guide explains its content, scoring, versions and evidence.
Key Features of the Health Practices in Pregnancy Questionnaire–II (HPQ-II)
Purpose and Use
The HPQ-II assesses health practices among pregnant women, focusing on behaviors that matter for pregnancy outcomes.
Target Population
The HPQ-II is intended for adult pregnant women.
Structure
The HPQ-II has 34 items that reflect six areas of health practice:
Balancing rest and exerciseTaking recommended measures to prevent illness and injuryFollowing recommended nutrition and diet guidelinesAvoiding substances that may be harmful in pregnancyObtaining health careGetting information and knowledge about pregnancy and childbirthItems cover topics such as sleep and exercise, safety, caffeine and substance use, risky sexual practices, communication with health care providers, medicines, supplements and herbal remedies, douching, toxin exposure, hot baths, prenatal vitamins and nutrition, smoking and alcohol, prenatal and dental care, childbirth education and classes, relaxation, weight gain, fluid intake and toxoplasmosis prevention.
Scoring Method
Each item is rated on a 5-point scale from 1 (never) to 5 (always).
Reverse scoring: 11 of the 34 items are negatively worded and reverse coded.Total score: the sum of all items, from 34 to 170.Higher scores indicate more desirable health practices. No cut-off scores are reported.
Administration Format
The HPQ-II is a self-report questionnaire that takes about 10 minutes.
Applications of the Health Practices in Pregnancy Questionnaire–II (HPQ-II)
The HPQ-II supports several uses:
Research: measuring health practices in pregnancy.Prenatal care comparisons: for example, comparing health practices in group and traditional prenatal care.Maternal health studies: examining health behaviors linked to pregnancy outcomes.Languages and availability
A Chinese short form has been tested for psychometric properties, and a modified Korean 30-item version exists. The HPQ-II items are included in a University of Liverpool thesis. The original article is available from the Journal of Obstetric, Gynecologic, & Neonatal Nursing.
Reliability and Validity
The original development study showed satisfactory internal consistency (Cronbach's alpha = 0.81) and evidence of content and construct validity.
Validation studies:
Testing the Health Practices in Pregnancy Questionnaire–II (2005): study linkPsychometric properties of the short form of the HPQ-II (Chinese, 2019): study linkFurther study using the HPQ-II (University of the Western Cape): study linkLimitations and Considerations
Keep these points in mind:
Homogeneous sample: the validation sample was relatively homogeneous, and the authors recommended testing in more diverse populations.Predictive validity: the link between scores and pregnancy outcomes still needs evaluation.No cut-offs: scores are interpreted continuously.Other Versions And Related Questionnaires
Other versions include a Chinese short form and a modified Korean version (30 items).
These questionnaires are related:
Health-Promoting Lifestyle Profile II (HPLP-II); see the ResRef HPLP-II guideHealthy Habits questionnaireAttitudes to Pregnancy and the Baby scaleAdditional Resources
The original article: linkCentering Pregnancy and traditional prenatal care: a comparison of health practices: linkFor inquiries, contact Kelly Lindgren, PhD, RN, CNM, WHNP, University of Wisconsin–Madison, School of Nursing, at kjlindgren@facstaff.wisc.edu.Browse more obstetrics and gynecology questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Health Practices in Pregnancy Questionnaire measure?The HPQ-II measures health practices that matter for pregnancy outcomes, such as rest and exercise, nutrition, avoiding harmful substances, prenatal care and learning about pregnancy and childbirth.
How is the HPQ-II scored?Each of the 34 items is rated from 1 (never) to 5 (always), with 11 negatively worded items reverse coded. The items are summed for a total of 34 to 170.
What does a high HPQ-II score mean?A higher score indicates more desirable health practices during pregnancy. No cut-off scores are reported, so scores are interpreted continuously.
How long does the HPQ-II take?The HPQ-II takes about 10 minutes to complete. It is a self-report questionnaire designed for adult pregnant women.
A Word from ResRef About the Health Practices in Pregnancy Questionnaire–II (HPQ-II)
The HPQ-II is a comprehensive self-report instrument for assessing health practices among pregnant women and was developed primarily for research use. It demonstrated satisfactory internal consistency (α = 0.81) and evidence of content and construct validity in the original development study. Its validation sample was relatively homogeneous, and the authors recommended further testing in more diverse populations and evaluation of predictive validity with pregnancy outcomes.
References
Lindgren, K. (2005). Testing the Health Practices in Pregnancy Questionnaire–II. Journal of Obstetric, Gynecologic & Neonatal Nursing, 34(4), 465–472. https://doi.org/10.1177/0884217505276308Wang, L., Chang, Y., Chou, H., Doerzbacher, M., & Lin, H. (2019). Psychometric Properties of the Short Form of the Health Practices Questionnaire–II Chinese Version. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(2), 205–215. https://doi.org/10.1016/j.jogn.2018.12.006