Essential Coaching Postpartum: Evaluating a Parent-focused Postpartum Text Message Program in Nova Scotia

Parenting self-efficacy will be measured using the Karitane Parenting Confidence Scale (KPCS) tool. This 15-item tool was developed to assess perceived self-efficacy of parents of infants birth to twelve months of age and has acceptable internal consistent (Cronbach's alpha = 0.81) and test-retest reliability (r = 0.88). A cut off score of 39 or less (out of a possible 45) was determine to be a clinically low perceived parenting self-efficacy (PPSE).

Postnatal anxiety will be measured using the Postpartum Specific Anxiety Scale (PSAS), a 51-item scale that is a valid and reliable measure to assess anxiety during the first six-months postpartum, with individual factor reliability having a Cronbach's alpha from 0.80 to 0.91 with an overall alpha of 0.95. The optimal cut-off PSAS score for detecting clinical levels of anxiety is 112 with a sensitivity and specificity of 0.75.

Postpartum depression will be measured using the 10-item Edinburgh Postnatal Depression Scale (EPDS).. A score above 9 (out of 30) indicating a possibility of postpartum depression 30 in both birthing and non-birthing parents.

Postpartum stress will be measured using the Postpartum Childcare Stress Checklist, an 18-item scale used to measure parental perceptions of childcare stress in the early postpartum period. Responses are summed to produce a score from 0 to 23, where higher scores indicate a higher level of postpartum childcare stress.

General distress will be measured using the Depression, Anxiety, and Stress Scale, which is a 21-item scale used to measure the emotional states of depression, anxiety, and stress. High postnatal distress is based on percentile scores, with 0-78 classified as 'normal', 78-87 as 'mild', 87-95 as 'moderate', 95-98 as 'severe', and 98-100 as 'extremely severe'.

This will be measured using the PROMIS Short-Form Sleep Related Impairment (4a) and PROMIS Short-Form Sleep Disturbances (4a). Sleep related impairment measures perceptions of alertness, sleepiness, and tiredness during usual waking hours, and the perceived functional impairments during wakefulness associated with sleep problems or impaired alertness. On the other hand, sleep disturbance measures perceptions of sleep quality, sleep depth, and restoration associated with sleep. For the v2.0 adult 4-item form, raw scores range from 4-16, with a corresponding T score. Higher scores indicated higher sleep related impairment and disturbance.

This will be measured using the Couple Satisfaction Index-4, which is a 4-item scale used to measure one's satisfaction in a relationship. The CSI-4 contains 4 questions: the first item is scored on a 7-point Likert scale with values from 0 ("Extremely Unhappy") to 6 ("Perfect"), the second is scored on a 6-point Likert scale with values from 0 ("Not at all True") to 5 ("Completely True"), and items 3 and 4 are scored on a 6-point Likert scale with values from 0 ("Not at all") to 5 ("Completely"). A total score is calculated by summing the item responses and ranges from 0 to 21; higher scores are associated with higher levels of satisfaction in the relationship. Scores below 13.5 are associated with notable relationship dissatisfaction.

This will be measured using the brief Co-parenting Relationship Scale, which a validated 15-item instrument to assess the five coparenting dimensions of agreement, closeness, child exposure to conflict, coparenting undermining, endorsement of partner's parenting, and labour division.35 Scores range from 0 to 60, with high scores indicating greater coparenting.