Parenting self-efficacy instruments for parents of infants and toddlers: A review

Abstract

Background

Parenting Self-Efficacy, a concept first described in Bandura's Social Cognitive Theory, is a parent's belief in their ability to successfully parent their child. The concept of parenting self-efficacy is used by researchers to increase our understanding of parenting abilities and influences on child health and developmental outcomes. Numerous instruments exist for measuring parental self-efficacy; but little is known about the specific topics included in the measures and consistency across instruments. Therefore, this scoping review sought to compare parenting self-efficacy instruments for parents of infants and toddlers, focusing on comparison of parenting topics, scale format, and administration with the goal of providing guidance and recommendations for measurement selection.

Methods

Our sample included 25 instruments and items from every instrument was evaluated and coded using NVIVO Qualitative Software. We reviewed the instruments’ target population, subscales, number of items, response options, scoring range and instructions, theoretical background, and parenting topics across each instrument.

Results

This review found three common factors across all instruments: parent, social and family, and child factors. Parent personal factors were addressed most frequently to evaluate self-efficacy and included topics such as, perception of parenting abilities, emotional reactions, and perceived successes. From our synthesis, we also offer recommendations for instrument selection and provide a conceptual model of parenting self-efficacy.

Conclusions

The findings from this scoping review highlight the presence of key factors (parent, social & family, and child) necessary for the evaluation of parenting self-efficacy in parents of infants and toddlers. Given our results, a meta-analysis is needed to compare parenting self-efficacy scores across studies to better understand the associations between self-efficacy and parent and child outcomes.

1. Introduction

Parenting self-efficacy is described as a parent's belief that they can successfully perform parenting behaviors or tasks to influence their child's health and development (Bandura, 1997; Vance & Brandon, 2017). Self-efficacy is conceptualized as a personal belief that one can achieve what one sets out to do and belief (i.e., confidence) influences mastery of tasks, skills, and psychosocial functioning (Fang et al., 2021). Historically, measurement of this concept is completed via self-reported instruments. Over time many instruments have been developed using Bandura's Social Cognitive Theory as the theoretical foundation, with scale items created to evaluate parenting-self-efficacy, by measuring a parent's perceived capacity or ability based on their personal beliefs, otherwise referred to as parenting self-efficacy (Jones & Prinz, 2005).

Since the concept of parenting self-efficacy was first described by Bandura, there has been a growing interest among researchers in documenting the importance of this concept related to parent and infant health outcomes. Parenting self-efficacy appears to be particularly relevant for outcomes related to infant health status (Anzman-Frasca et al., 2013; Coller et al., 2015), infant/child social-emotional wellbeing (Badr Zahr, 2001; Takacs et al., 2019), and parent mental health (Klawetter et al., 2021; Sevigny & Loutzenhiser, 2010). For example, in one study, mothers, with high self-efficacy scores, or who are confident in their parental role, were found to be generally more sensitive and responsive to their children (Dumka et al., 2010; Law et al., 2019), and demonstrated more positive parenting practices (Fang et al., 2021; Jones & Prinz, 2005). Parents who are highly efficacious (i.e., confident) are more likely to positively influence their child's environment so the child can thrive and obtain optimal health and developmental goals.

Currently, parenting self-efficacy instruments are available for use in many different research and clinical settings. For example, population-specific instruments exist for use with parents of autistic children (Weiss et al., 2016), during early childhood (Holloway et al., 2019), and with parents of prematurely born infants (Pennell et al., 2012). With the growing number of currently available instruments, it is becoming increasingly difficult to discern which instrument may be most appropriate for use in a particular study or setting. Parenting self-efficacy, as a concept, provides a way to increase understanding as well as classify an individual's belief that they are capable of performing parenting skills. Importantly, since parenting self-efficacy is the parent's perceptions or beliefs, it is only measurable via self-report. It is also important to note that not all available measures accurately capture the concept of parenting self-efficacy based on Bandura's theory (Crncec et al., 2010). Thus, there may be instances where the concept of parenting self-efficacy is inaccurately described and measured as competence or perceived competence (Vance & Brandon, 2017). It has also been noted that researchers (and/or clinicians) sometimes use confidence and competence interchangeably, which may not represent the variables of interest accurately in a particular study. Confidence (parenting self-efficacy) is most often a trait a parent can identify about their beliefs, while competence is most often a trait that is demonstrated or observed by others about a parent's abilities (Vance & Brandon, 2017). Our understanding of confidence, as a concept, is dependent on parent's self-report as it is, by definition, an assessment of a parent's beliefs regarding their capacity to be successful in the parenting role, verses competence which can be a direct observation of parenting abilities in particular situations. In selecting an instrument for research purposes, it is important to accurately operationalize the concept of interest, which includes selection of an appropriate instrument and relevant scale items.

To date, there are two systematic reviews of parenting self-efficacy measures (Crncec et al., 2010; Wittkowski et al., 2017) documenting existing self-report instruments for parents of children ages 0 -18. However, these reviews are limited in their scope as they do not provide details about the scale items, language used, or describe specific parenting topics associated with each instrument. Furthermore, the broad nature and differences in parenting skills needed for infants’ verses adolescences does not provide guidance for understanding differences between and within a particular population. Comparing parenting concepts and the research context of these instruments would facilitate evaluation of how different aspects of confidence in the parental role influence outcomes. Several systematic reviews exist focusing on parenting self-efficacy in different cultures (Boruszak-Kiziukiewicz & Kmita, 2020), socio-contextual factors influencing confidence (Fang et. Al., 2021), and health based on parenting self-efficacy (Norman et. al., 2021), however our review solely focuses on infants and toddlers, which has not been previously examined in a systematic way. Understanding how these instruments can be used by health professionals and researchers is key in furthering our understanding on the connections between parenting self-efficacy and parent and infant outcomes.

Therefore, our aim in conducting this systematic review was to describe similarities and differences among existing self-report instruments designed to measure the concept of parenting self-efficacy in parents of infants and toddlers. We evaluated the specific items in each instrument to better understand the language used, parenting topics, and compared the formats for each instrument with the goal of providing a critical assessment of each instrument and offer recommendations for instrument selection for use in research or clinical settings.

2. Methods

This systematic review was conducted to identify and map the evidence as well as to evaluate differences and similarities across parenting self-efficacy instruments. We generated a list of instruments using the two existing systematic reviews (Crncec et al., 2010; Wittkowski et al., 2017). From the list of instruments in both reviews, a total of 41 unique instruments were identified after duplicates were removed. Subsequently, 6 instruments were excluded because their intended population was not parents of infants or toddlers (e.g., early childhood, middle school, or adolescence). Next, the full-text psychometric publication for each instrument was located and items (e.g., exact questions and wording) from the instruments were extracted when available. If the scale items were not available in the publication, corresponding authors were contacted with a request to provide a copy of the instrument. An additional 10 instruments were excluded because the specific items (i.e., questions) could not be located by contacting the authors or an additional review of the literature (e.g., locating an additional article with the instrument citation or adaptation to another language).

Thus, our final sample includes 25 instruments. A complimentary search of PubMed and CINAHL using the same search terms in the two existing systematic reviews was conducted to identify any recent or additional parenting self-efficacy instruments, and to validate our sample as systematically obtained. No new instruments were identified through our library search.

Inclusion criteria for this study differed from the two previous reviews in that we sought to examine a homogenous group of measures by targeting measures designed for use in parents of infants or toddlers (birth – 3 years old). We focused on this population given the rapid developmental growth for children during this period and the important impacts of early parenting on subsequent outcomes. To date, no other review has targeted this group for in-depth assessment of these instruments. Information extracted from the psychometric article included: theoretical underpinnings of instrument, exact wording of questions (items), scale format (i.e., number of items, scoring, target population, subscales, response options, score range), and research context of the instrument.

In addition to the information extracted from the articles, we conducted directed content analysis using each of the items from the included parenting self-efficacy instruments using NVIVO qualitative coding software (QSR International Pty Ltd, 2020) for data management and analysis. Every item (question) from the 25 instruments was imported into NVIVO for coding. Coding was completed by two research assistants and the senior author. Coding began with each team member reading through the instruments for familiarity and comprehension, followed by first pass coding to generating codes for both the specific content of the question (e.g., feeding, bath time, sleep) and a broader code to reflect the parenting attribute or concept (e.g., knowledge, behavior, emotion). Second pass coding included merging of similar codes and collapsing into broader categories representing parenting topics and concepts. These broader categories were discussed in multiple meetings to increase inter-rater reliability and ensure all team members came to consensus with shared understanding of the terms. Interrater reliability was established by conducting weekly group meetings where analytic decisions were discussed in detail. We maintained an audit trail using analytic memos of decisions made throughout the coding process. Thus, our final codebook included summary codes about the specific content of each question and the broader parent topic code capturing a particular aspect of the parenting role.

3. Findings

The findings from our analysis are summarized in the following ways: (1) summary of instrument formats and descriptive information (2) comparison of similarities and differences among instruments, and (3) discussion of research use and recommendations.

3.1. Characteristics of instruments

Table 1 provides an overview of the 25 parenting self-efficacy instruments and associated sources. The intended population for most instruments was the period of infancy (birth – 12 months) (n=11, 44%) followed by infancy to toddlerhood (birth – 24 months) (n= 8, 32%). Most instruments were designed for use with parents of healthy infants and toddlers (96%). A few instruments were designed for use in specific populations, such as the Perceived Maternal Parental Self-Efficacy (Barnes & Adamson-Macedo, 2007) and Preterm Parenting Self-Efficacy Checklist (Pennell et al., 2012), that included items related to parents of infants born prematurely or with medical concerns and the Early Intervention Parenting Self-Efficacy Scale (Guimond et al., 2008) for parents who had an infant or toddler with a disability.

Table 1.

Instrument (abbreviation)	First Author (Year)Country1	Target Population	Scale Items	Response Options (score values)	Score Range	Unit of Analysisa, b, c	Score Threshold	Subscale Name(# Items)
Infancy
Infant Care Questionnaire	Secco (2002) Canada	0 – 6 weeks	22	5-point (1-5)	1-5	Averagea	Scores < 3.99 indicate ‘acquiring competence’	1. Mom and baby (5) 2. Emotionality (9) 3. Responsiveness (8)
Infant Care Survey	Froman (1989) United States	0 – 12 months	51	5-point (A-E)	1-5	Averagea	No	None
Karitane Parenting Confidence Scale	Crnec (2008) Australia	0 – 12 months	15	4-point (0-3)	0-45	Total scorea	Scores < 39 indicate clinical risk of low confidence	None
Maternal Confidence Questionnaire	Bahr (2005) United States	0 – 12 months	14	5-point (1-5)	14-70	Total scorea	No	None
Maternal Self-Efficacy Questionnaire	Teti (1991) United States	0 – 12 months	10	4-point (1-4)	10-40	Total scorea	No	None
Parental Conducts and Cognitions Towards Infants Scale	Boivin (2005) Canada	0 – 5 months	23	11-point (0-10)	0-10	Averagea	No	1. Self-efficacy (6) 2. Parental impact (5) 3. Parental hostile-reactive behaviors (7) 4. Parental overprotection (5)
Perceived Competence Scale	Rutledge (1987) United States	0 – 6 weeks	68	6-point (1-6)	1-6	Averagea	No	None
Perceived Maternal Parental Self-Efficacy	Barnes (2007) United Kingdom	0 – 6 months	20	4-point (1-4)	20-80	Total scorea	No	1. Care taking procedures (4) 2. Evoking behavior (7) 3. Reading behavior (6) 4. Situational beliefs (3)
Postpartum Self-Evaluation Questionnaire	Lederman (1981) United States	0 – 6 weeks	81	4-point (1-4)	1. 13-52 2. 11-44 3. 10-40 4. 10-40 5. 13-52 6. 13-52 7. 6-24 8. 5-20	Total score (each scale)b	No	1. Quality of the relationship with the husband (13) 2. Mother's perception of the father's participation in care (11) 3. Mother's gratification from her labor and delivery experience (10) 4. Mother's satisfaction with her life circumstances (10) 5. Mother's confidence in her ability to cope with the tasks of motherhood (13) 6. Mother's satisfaction with motherhood and infant care (13) 7. Support for the maternal role from parents (6) 8. Support for the maternal role from friends and other family members (5)
Self-Efficacy in the Nurturing Role Scale postnatal	Pedersen (1989) United States	Perinatal – 3 months	16	7-point (1-7)	16-112	Total scorea	No	None
What Being a Parent of a Baby is Like	Pridham (1989) United States	0 – 3 months	25	9-point (1-9)	25-225	Averagec	No	1. Evaluation (11) 2. Centrality (8) 3. Life change (6)
Infancy – Toddlerhood
Assessment of Parenting Tool	Moran (2016) United States	0 – 24 months	12	5-point (1-5)	1-5	Averagea	No	Subscale items available depending on age of child (birth – 2 months, 3 – 5 months, 6 – 9 months, 10 – 12 months, 13 – 18 months, and 19 – 24 months)
Begin a Mother	Matthey (2011) Australia	0 – 3 years	13	4-point (0-3)	0-39	Total scoreb	Scores > 9 indicate some distress; items endorsed with 2 or 3 suggest a negative response	None
Comfort with Parenting Performance	Ballenski (1982) United States	0 – 12 months	8	6-point (1-6)	1 – 6	Averageb	No	None
Early Intervention Parenting Self-Efficacy Scale	Guimond (2008) United States	3 – 34 months	20	7-point (1-7)	1 – 7	Averagea	No	None
Fathering Self-Efficacy Scale	Sevigny (2016) Canada	1 – 4 years	20	9-point (1-9)	20-180	Total scorea	No	None
Me As a Parent	Hamilton (2014) Australia	6 months – 15 years	16	5-point (1-5)	16-80	Total scorec	No	1. Self-efficacy (4) 2. Personal agency (4) 3. Self-sufficiency (4) 4. Self-management (4)
Preterm Parenting Self-Efficacy Checklist	Pennell (2012) Australia	Preterm – 24 months	36	7-point (1-7)	36-252	Total scorea	No	1. Self-efficacy (12) 2. Importance of tasks (12) 3. Self-perceived parental competence (12)
Self-Efficacy for Parenting Tasks Index	Coleman (2003) United States	19 – 25 months	36	6-point (1-6)	1 – 6	Averagea	No	1. Discipline (8) 2. Achievement (7) 3. Recreation (7) 4. Nurturance (7) 5. Health (7)
Toddlerhood & Early Childhood
Kansas Parental Satisfaction Scale	James (1985) United States	Not stated	3	5-point (1-5)	3-15	Total scorec	No	None
Child Adjustment and Parent Efficacy Scale	Morawska (2014) Australia	2 – 12 years	19	10-point (1-10)	19-190	Total scorea	No	1. Behavioral regulation (24) 2. Emotional adjustment (3) 3. Self-efficacy (19)
Parental Self-Agency Measure	Dumka (1996) United States	3 – 12 years*	10	7-point (1-7)	10-70	Averagea	No	None
Perceived Sense of Competence Scale	Johnston (1989) Canada	4 – 12 years*	17	6-point (1-6)	17-102	Total scorea	No	1. Efficacy (8) 2. Satisfaction (9)
Parenting Tasks Checklist	Sanders (2005) Australia	2 – 8 years	28	101-point (0-100)	0-100	Averagea	No	1. Behavior self-efficacy (14)2. Setting self-efficacy (14)
Toddler Care Questionnaire	Gross (1988) United States	1 – 3 years	37	5-point (1-5)	37-185	Total scorea	No	None

¹Country where instrument was originally developed and validated.

^⁎Frequently used in studies for infants and toddlers.

^aHigher scores indicate greater self-efficacy

^bHigher scores indicate less satisfaction or lower confidence in the parenting role

^cScores indicate greater satisfaction or self-regulation in the parenting role.

The average number of scale items was 24; the Kansas Parenting Satisfaction Scale (James et al., 1985) had the lowest number (3 items), and the Perceived Competence Scale (Rutledge & Pridham, 1987) had the most (68 items). Response options ranged from 4-point to 11-point Likert scales and one instrument, Parenting Tasks Checklist (Sanders & Woolley, 2005) asking for responses from 0-100 for each item. Of the 25 scales, 14 (56%) generated total scores, with higher scores reflecting greater parenting self-efficacy (i.e., better confidence in the parenting role) and three instruments, Postpartum Self-Evaluation Questionnaire (Lederman et al., 1981), Being a Mother (Matthey, 2011), Comfort with Parenting Performance (Ballenski & Cook, 1982), generated total scores where higher scores reflected worse confidence or satisfaction with the parenting role. Only six instruments (24%) were developed in the last 10 years: Assessment of Parenting Tool (Moran et al., 2016), Being a Mother (Matthey, 2011), Father Self-Efficacy Scale (Sevigny et al., 2016), Child Adjustment and Parent Efficacy Scale (Morawska et al., 2014), Me as a Parent (Hamilton et al., 2015), and Preterm Parenting Self-Efficacy Checklist (Pennell et al., 2012). One instrument, Father Self-Efficacy Scale was developed specifically for use with fathers of infants. Most instruments used neutral language such as ‘parent’ or ‘caregiver’ for assessing confidence in the maternal or paternal role. Ten instruments included subscales to investigate more specific aspects of parenting self-efficacy, such as: nurturing, empathy, emotional availably, responsiveness, and support system. Only three instruments were designed and tested to have a score threshold or cut-off value to better distinguish high vs. low parent confidence (e.g., Karitane Parenting Confidence Scale (Crncec et al., 2008) scores < 39 indicate risk for clinically low confidence) (see Table 1 for more details).

3.2. Comparison of instrument items

Three categories emerged from the coding of the instrument items: parent factors, social and family factors, and child factors. To better describe these three categories, the remaining codes were summarized into sub-categories and codes. This information is outlined in detail in Table 2, which highlights the three categories, sub-categories, codes, definitions, and exemplars. Additionally, to visually represent the findings, we developed a parenting self-efficacy model to summarize our overall findings and serve as a visual aid for identifying relationships between coded topics in the instruments and broader parenting factors (see Fig. 1).

Table 2.

Parenting Self-Efficacy Framework Categories, Codes, and Exemplars

Parent Factors
Sub-category	Codes	Definition	Example Item
Affective	Attentiveness	Being responsive to infant cues and other non-observable abilities (patience, attentive, sensitive).	I am sensitive to my infants' needs.1 I am unsure just how much attention I should give my baby.2
	Emotions	Reactions and feelings because of being a parent (e.g., joyful, grateful, sad, disappointed, overwhelmed).	I have found it hard to cope when my baby cries.3 I often feel helpless about my child's behavior.4
	Satisfaction	Feeling a sense of gratification or fulfilment about being a parent.	How satisfied are you with the relationship with your children?5 I am satisfied with my role as a parent.6
Behavior	Routines	Relating to behaviors which are the same every day, setting priorities, organizing, and scheduling daily life.	I have been successful in getting my child to eat on a fairly regular schedule.7 Knowing schedule for physical exams.8
	Skills	Perceived ability of performance with specific parenting tasks (feeding, bathing, discipline).	How well prepared do you think you are to deal with infant feeding?25 I honestly believe I have all the skills necessary to be a good mother/father to my child.9
	Teaching	Helping a child learn new skills and concepts.	Helping my child learn colors, names of objects, etc. is not one of my strongest points.7 When my child does better than expected, many times it is because I tried a little harder to help.10
Cognitive	Comfort	The ease felt with regards to parenting task (e.g., easy, or difficult).	I feel comfortable and natural using baby-talk.2 How comfortable do you feel in setting limits?11 Comfortable in showing affection to your child.23
	Confidence	Overall sense of trust in oneself to be a good parent or perform a certain task.	I am confident about feeding my baby.12 How confident are you at settling your baby?13
	Intuition	Relating to a felt sense that are built into the psyche of all parents.	I trust my feelings and intuitions about taking care of my baby.2 I can tell what my baby needs by the sound of the cry.14
	Knowledge	Gathering information and having awareness of one's child's needs; understanding child's individual needs.	How good are you at knowing what activities your baby will enjoy?15 I know what makes my baby happy.6
	Perceived Success	Parents’ belief in their ability to perform in their role as a parent, perceived accomplishments related to influencing child's development.	My behavior has little effect on the intellectual development of my baby.16 I believe that my baby responds well to me.17
	Problem Solving	Addresses ability to deal with conflict and/or trouble.	I can find out what's needed to resolve any problems my child has.4 The problems of taking care of a child are easy to solve once you know how your actions affect your child, an understanding I have acquired.9
Social and Family Factors
Sub-category	Codes	Code Definition	Example Item
Environment	Home Setting	The ability to manage a household to adequately provide for the needs of the family, including, finances, safety, necessities, work-life balance.	I can provide financially for my family in the long term.18 Providing a safe, hazard-free environment for my child is very difficult for me.7 We need more things than we can afford to buy.24
	Support Systems	Community, partner, and/or family resources to assist the parent in emotional, behavioral and/or skills associated with parenthood (e.g., parent to parent, mother to father, etc.)	No matter how hard I try, it seems that I just cannot find a way to get the services that my child and family needs.10 I feel sure that my partner will be there for me when I need support.12
Role Identity	Expectations	How one imagined parenting to be (in comparison to one's actual experience) or how life has changed since having a child; adjustment to role as a parent.	How well are you meeting your expectations for yourself as a parent of a new baby?19 I worry I am not as good as other mothers.3
	Parenting Style	The constellation of parents’ attitudes and behaviors toward children and an emotional climate in which the parents’ behaviors are expressed; values and goals of parents related to child rearing.	My disciplinary skills are at least as good as an average parent.7 When something goes wrong between me and my child, there is little I can do to correct it.20
Child Factors
Sub-category	Codes	Code Definition	Example Item
Needs	Basic Care	Perceived ability in performing basic care tasks associated with having an infant or toddler (e.g., feeding, bathing)	I am good at feeding my baby.17 My baby sleeps the amount I expected.14
	Health	The ability of a parent to manage the physical health of a child (e.g., doctor visits, medications); medical awareness	Knowing expected weight gain patterns for an infant.8 How confident were you at caring for your baby's health and medical needs (e.g., giving medication, keeping appointments)?13
Development	Attachment	The reciprocal interactions of the parent-child relationship; bonding.	I have felt close to my baby/toddler.3 I believe that my baby and I have a good interaction with each other.17
	Emotional Reactiveness	Response of parent to child expressions and/or ability to foster emotional regulation.	My baby relaxes when I talk soothingly.14 I can help my child cope with his or her feelings.18
	Temperament	How a child acts/expresses themselves; personality and disposition of the child.	Acts defiant when asked to do something.21 How confident are you in handling your child's behavior when your child throws a tantrum?22

¹Assessment of Parenting Tool

²Self-Efficacy in the Nurturing Role Scale

³Being a Mother

⁴Me As a Parent

⁵Kansas Parental Satisfaction Scale

⁶Maternal Confidence Questionnaire

⁷Self-Efficacy for Parenting Tasks Index-Toddler

⁸Infant Care Survey

⁹Perceived Sense of Competence Scale

¹⁰Early Intervention Parenting Self-Efficacy

¹¹Comfort with Parenting Performance

¹²Karitane Parenting Confidence Scale

¹³Preterm Parenting Self-Efficacy Checklist

¹⁴Infant Care Questionnaire

¹⁵Maternal Self-Efficacy Questionnaire

¹⁶Parental Conducts and Cognitions Towards Infants Scale

¹⁷Perceived Maternal Parental Self-Efficacy

¹⁸Fathering Self-Efficacy Scale

¹⁹What Being a Parent of a Baby is Like

²⁰Parental Self-Agency Measure

²¹Child Adjustment and Parent Efficacy Scale

²²Parenting Tasks Checklist

²³Toddler Care Questionnaire

²⁴Postpartum Self-Evaluation Questionnaire

²⁵Percieved Competence Scale

Fig. 1.

Table 3 provides a summary of parenting topics for each instrument and alignment with our conceptual model (Fig. 1). We identified 6 instruments focused solely on parent factors affecting confidence, 4 focused on both parent and child factors, 7 focused on parent factors and social and family factors, 7 focused on all three factors, and only 1 instrument focused on child factors. Several factors (i.e., emotions, home setting, intuition, perceived successes) appeared more frequently across the instruments, whereas other subjects like attachment, attentiveness, or teaching, only appeared in a few instruments. Parent factors included questions about parental beliefs and perceived ability in their parenting role such as their emotions, skills, and successes. Social and family factors included questions about the home environment such as safety and finances and role identity, which includes expectations and parenting style. Lastly, child factors included questions focused on the child's development and basic needs.

Table 3.

Summary of Parenting Topics and Alignment with Conceptual Model

	Coded Topic	Conceptual Model
Infancy
Infant Care Questionnaire	Skills, Intuition, Expectations, Basic Care, Temperament	Parent Factors, Social & Family Factors, Child Factors
Infant Care Survey	Routines, Skills, Knowledge, Basic Care	Parent Factors, Child Factors
Karitane Parenting Confidence Scale	Confidence, Skills, Support Systems	Parent Factors, Social & Family Factors
Maternal Confidence Questionnaire	Emotion, Skills, Satisfaction	Parent Factors
Maternal Self-Efficacy Questionnaire	Knowledge, Perceived Success	Parent Factors
Parental Conducts and Cognitions Towards Infants Scale	Skills, Emotions, Perceived Success	Parent Factors
Perceived Competence Scale	Skills, Knowledge	Parent Factors
Perceived Maternal Parental Self-Efficacy	Skills, Confidence, Knowledge, Perceived Success, Basic Care, Attachment	Parent Factors, Child Factors
Postpartum Self-Evaluation Questionnaire	Confidence, Intuition Home Setting, Support Systems, Expectations	Parent Factors, Social & Family Factors
Self-Efficacy in the Nurturing Role Scale	Attentiveness, Emotion, Intuition, Comfort	Parent Factors
What Being a Parent of a Baby is Like	Intuition, Satisfaction, Expectations, Attachment	Parent Factors, Social & Family Factors
Infancy - Toddlerhood
Assessment of Parenting Tool	Attentiveness, Emotion, Parenting Style	Parent Factors, Social & Family Factors
Being a Mother	Attachment, Confidence, Emotion, Expectations	Parent Factors, Social & Family Factors, Child Factors
Comfort with Parenting Performance	Comfort, Home Setting, Expectations, Basic Care	Parent Factors, Social & Family Factors, Child Factors
Early Intervention Parenting Self-Efficacy	Perceived Success, Support Systems, Teaching	Parent Factors, Social & Family Factors
Fathering Self-Efficacy Scale	Skills, Comfort, Home Setting, Emotional Reactiveness	Parent Factors, Social & Family Factors, Child Factors
Me As a Parent	Emotions, Confidence, Perceived Successes, Problem Solving, Expectations	Parent Factors, Social & Family Factors
Preterm Parenting Self-Efficacy Checklist	Skills, Confidence, Perceived Success, Basic Care, Health	Parent Factors, Social & Family Factors, Child Factors
Self-Efficacy for Parenting Tasks Index – Toddler	Routines, Teaching, Perceived Success, Expectations, Home Setting, Parenting	Parent Factors, Social & Family Factors, Child Factors
Toddlerhood & Early Childhood
Kansas Parental Satisfaction Scale	Satisfaction	Parent Factors
Child Adjustment and Parent Efficacy Scale	Basic Needs, Emotional Reactiveness, Temperament	Child Factors
Parental Self-Agency Measure	Problem Solving, Parenting Style, Attachment	Parent Factors, Social & Family Factors, Child Factors
Perceived Sense of Competence Scale	Satisfaction, Confidence, Problem Solving, Parenting Style	Parent Factors, Social & Family Factors
Parenting Tasks Checklist	Skills, Basic Care, Temperament	Parent Factors, Child Factors
Toddler Care Questionnaire	Skills, Comfort, Knowledge Intuition, Emotional Reactiveness	Parent Factors, Child Factors

3.3. Parent Factors

Parent factors affecting confidence were most common across the instruments, which also included three subcategories: (1) affective, (2) behavior, and (3) cognitive. Affective skills refer to a parent's perception of their ability to be sensitive or responsive towards their infant's cues. Behavior refers to a parent's perception of their ability or proficiently to perform practices involved in parenting, like feeding one's child, for example. Cognitive items refer to a parent's beliefs about their knowledge or understanding of how to care for their child at a particular stage of development.

3.4. Social and Family Factors

Social and family factors were the second category identified, which included subcategories of role identity and environment (Fig. 1). Role identity encompasses a parent's perception of their functioning in the role as a parent and how their parent identity fits into their social and family environment and potential changes to their role during the transition to parenthood. The topic of "expectations" was one of the more frequent questions across instruments, highlighting a desire to understand how individuals have transitioned their identity in parenthood and in their role as a parent. For example, questions about expectations are as follows: “It is boring for me to care for the baby and do the same things over and over.” (Postpartum Self-Evaluation Questionnaire) or “I have missed the life I had before I had this baby.” (Being a Mother) or “I meet my expectations for providing emotional support for my child” (Me as a Parent). Interestingly, there were a few questions about being a role model for other parents or not living up to expectations as a parent, “I would be a good person for another parent to learn from” (Assessment of Parenting), “I know things about being a mother/father that would be helpful to other parents” (Parent Self-Agency Measure), or “I worry I am not as good as other mothers” (Being a Mother), “My mother/father was better prepared to be a good mother/father than I am” (Parenting Sense of Competence).

Environment refers to the parent perceptions or beliefs about the cultural and socioeconomic backgrounds of the person or family in which they parent, such as the home setting and support systems for parents. Several questions related to the home included creating a safe environment, managing responsibilities, and balancing multiple demands (i.e., work, or other children). Of note, a few instruments asked specifically about finances, “I worry about how we will manage our present income” (Postpartum Self-Evaluation Questionnaire) or “I am able to provide financially for my family in the long term” (Fathering Self-Efficacy Scale). Items about income for finances were asked in instruments meant for both mothers and fathers.

3.5. Child Factors

Child factors was the third category, which included items about infant basic care needs and development. When considering child factors, there were two types of items; those emphasizing, the parent's perception of their own behavior or those that were perceptions of their child's behavior. There were items about feeding, diapering, soothing, or consoling, which are child-focused, but the wording of the questions evaluated a parent's perception of their ability to perform these tasks. In contrast, the items that were more child focused, included language specifically asking about the parent's perceptions of their infant's needs or temperament. For instance, questions such as “I have been annoyed or irritated with my baby/toddler (Being a Mother) or “I believe that my baby responds well to me” (Perceived Maternal Parenting Self-Efficacy) are more about an infant's behavior or reaction and the ability of the parent to respond. The Child Adjustment and Parent Efficacy Scale, and Parenting Task Checklist, focus an infant or child's difficult behavior (i.e., tantrums, refusing to eat, attention seeking).

4. Discussion

The findings from this systematic review highlight the presence of key aspects necessary for evaluation of parenting self-efficacy in parents of infants and toddlers. The three main categories (e.g., parent factors, social and family factors, and child factors) identified in our analysis are consistent with those in Belsky's model of parenting (e.g., personal psychological resources, support and stress in the family or environment, and characteristics of the child) and was useful in helping to confirm our findings (Belsky, 1984; Belsky & Jaffee, 2015). Belsky argues that determinates such as a parent's personality, child characteristics, and the broader social context in which the parent-child interacts with each other directly influence parenting behaviors. In other words, these determinates help explain why some parents perform well or poorly in their role (Belsky & Jaffee, 2015). This would provide support for why measures of parenting self-efficacy are predictive or representative of parenting behaviors. Our parenting self-efficacy model highlights the relationships between topics identified in the instruments and broader parenting factors that influence parenting self-efficacy (Fig. 1).

In this analysis, we observed most of the instruments focused on parent personal factors, which aligns with the theoretical assumptions that parenting self-efficacy is an intrapersonal psychological resource. Given the self-report nature of measuring parenting self-efficacy, it is understandable that parent factors are likely the most relevant for determining ones’ level of confidence rather than social, family factors, or child factors. Given the attention to parent factors as they are related to parenting self-efficacy, further research could focus on elucidating how social, family, or child factors contribute to the development of self-efficacy.

4.1. Recommendations for Selection of a Parenting Self-Efficacy Instrument

With the number of available instruments, it is difficult for researchers and clinicians to choose between instruments. For example, why would a researcher choose one instrument over another to answer their research question? There are several factors to consider in instrument selection such as: particular instrument focus; whether the instrument has been used in select or diverse populations; whether the instrument is easy to use or not; whether the instrument uses neutral language so it can be used with all types of parents, given the diversity of family structures; as well as whether setting matters and if change over time is important to the research question of interest. We developed Table 4 to summarize attributes of the instruments as a means of facilitating instrument selection. Using the right instrument has the potential to increase the significance of the study findings as well as provide more information for intervention and predicting outcomes.

Table 4.

Attributes for instrument selection

	Instrument Focus1	Use in Diverse Samples			Ease of Use	Neutral Language	Setting2		Reliable Change Index
Infancy
Infant Care Questionnaire	C					✓	O
Infant Care Survey	C					✓	O
Karitane Parenting Confidence Scale	P		✓	✓		✓	B	✓
Maternal Confidence Questionnaire	P		✓	✓			B
Maternal Self-Efficacy Questionnaire	P		✓				O
Parental Conducts and Cognitions Towards Infants Scale	C		✓				O
Perceived Competence Scale	C					✓	O
Perceived Maternal Parental Self-Efficacy	P		✓	✓		✓	I
Postpartum Self-Evaluation Questionnaire	P					✓	B
Self-Efficacy in the Nurturing Role Scale	C		✓			✓	B
What Being a Parent of a Baby is Like	C		✓				O
Infancy - Toddlerhood
Assessment of Parenting Tool	P		✓	✓		✓	O
Being a Mother	P		✓			✓	B	✓
Comfort with Parenting Performance	P			✓			O
Early Intervention Parenting Self-Efficacy	P		✓				O
Fathering Self-Efficacy Scale	P		✓	✓			B
Me As a Parent	P					✓	O
Preterm Parenting Self-Efficacy Checklist	P		✓			✓	O
Self-Efficacy for Parenting Tasks Index	P					✓	O
Toddlerhood & Early Childhood
Kansas Parental Satisfaction Scale	P		✓			✓	O
Child Adjustment and Parent Efficacy Scale	C		✓			✓	O
Parental Self-Agency Measure	P		✓			✓	O
Perceived Sense of Competence Scale	P		✓	✓			O
Parenting Tasks Checklist	C		✓			✓	O
Toddler Care Questionnaire	C					✓	O

¹P indicates items are focused on parent beliefs, behaviors, or ability in the parental role, and C indicates items are focused more on tasks concerning care of the child

²I indicates usefulness for inpatient (hospital) settings and O indicates usefulness in outpatient (home) settings and B is for both settings.

4.1.1. Instrument Focus

It is important to consider the specific items in each instrument, depending on the research or clinical setting. For example, several instruments have questions solely focused on a parent's expectations and ability to function in their parental role,“A difficult job in being a parent is not knowing whether you are doing a good job or a bad one” from Parenting Sense of Competence Scale verses instruments that ask about specific tasks related to the care of an infant or child,“How confident were you at coping with your baby's fussing and crying?” from Preterm Parenting Self-Efficacy Checklist. Yet, there are instruments that include questions related to both the care of a child and personal beliefs about parenting. For instance, the Karitane Parenting Confidence Scale includes the two following questions: “I can soothe my baby when he/she is distressed” and “Being a mother/father is very stressful for me.” Matching the instrument to the setting or intended use is necessary for accurate measurement and to make accurate associations.

4.1.2. Use in Diverse Samples

There has been some interest in creating scales for use with diverse samples or those specifically designed to better understand parents with unique needs such as parents who have a child with disabilities Early Intervention Parenting Self-Efficacy Scale (EIPSES) or parent of prematurely born infants, Maternal Efficacy Questionnaire, Perceived Maternal Parental Self-Efficacy, Preterm Parenting Self-Efficacy Checklist, What being a Parent to a Baby is Like. Unfortunately, most instruments were validated using samples of women (i.e., mothers) of healthy, term born infants who identify as Caucasian. Thus, these scales may not be as useful in understanding the parenting perspectives of parents of color. The only instrument to focus specifically on fathers was the Fathering Self-Efficacy Scale and yet only one question references fathers (e.g., “I do less childcare than most fathers I know). The other questions would be appropriate for use with either parent figure in a child's life. This instrument was also one of a few to ask specific questions about finances and balancing work and family demands. Thus, if the word ‘father’ was replaced with ‘parents’ then the instrument becomes applicable for all parents as the items are not specific to fatherhood, rather parenthood.

Little information about the validity of parenting self-efficacy instruments from a cross-cultural perspective is available. There are known differences in parenting practices across racial, cultural, religious, and ethnic groups where the current parenting self-efficacy instruments may not be applicable. It would be important to assess any cultural norms that may be present in a particular setting that could inform selection of an appropriate measure. More information is needed about whether parenting self-efficacy differs in any significant way across cultural groups and the consistency of it as a concept in the presence of diverse parenting practices.

4.1.3. Ease of Use

In selecting an instrument, the ease of use in a research or clinical setting is an important consideration. The number of items, the readability, and interpretability of the scores will aid understanding of parenting self-efficacy as an important intrapersonal resource. Total scores may be more easily interpreted, especially when higher scores indicate a greater level of confidence. However, not all instruments use or compute a total score. Instruments with multiple sub-scales and reverse-scores (i.e., lower scores indicating better adaptation or satisfaction) such as Comfort with Parenting Performance, Being a Mother, and Postpartum Self-Evaluation Questionnaire, are likely to be more difficult to interpret and may not be generally acceptable to parents. Furthermore, if the instruments provide scoring benchmarks to identify significant differences between high and low scores (i.e., better, or worse confidence), then interpretability is more manageable and comparison of scores across samples can be more robust. Three instruments offer scoring thresholds (Being a Mother, Infant Care Questionnaire, and Karitane Parenting Confidence Scale) (see Table 1). The Karitane Parenting Confidence Scale is the one instrument to offer both a scoring threshold and total scores, with higher scores representing better confidence. Even so, we recognize that scoring thresholds, whether achieving high or low confidence, may not accurately reflect parenting behavior, and these scores should be used as a starting point to assess parental beliefs about their parenting practices.

Given the diversity of family structures and demands on parents’ time, instruments with neutral language and less than 20-items are more likely to be easily administered and acceptable across various settings. The most difficult instruments to administer would likely be the Comfort with Parenting Performance, Infant Care Survey, and Parenting Tasks Checklist, because the two former do not provide items formatted as questions (rather a statement at the beginning of a list “How comfortable do you feel with the following” and “How much confidence do you have about doing each of the behaviors listed below?”) and the Parenting Tasks Checklist asks for responses options from 0 – 100, and the Infant Care Survey lists 51 behaviors, which may be cumbersome for parents and decrease consistency across participants Additionally, instruments with repetitive or similar questions, such as the Preterm Parenting Self-Efficacy Checklist, may decrease ease of use and acceptability. This instrument includes 36-items and includes items about confidence (i.e., “how confident are you at bathing your baby?”) and then repeats the same question for the level of importance and perceived success (i.e., “how important do you feel this skill was for you to be a good parent to your baby?” and “how successful do you feel you were at bathing your baby?”). The authors note the importance questions were all deemed ‘important’ or ‘very important’ by participations; thus, the relevance for inclusion of these questions in future studies is unclear. In sum, the 36-item instrument could potentially be paired down to a 12-item measure to enhance administration decrease repetitiveness and focus specifically on the concept of self-efficacy (i.e., confidence).

4.1.4. Neutral language

The use of neutral or inclusive language such as parent, or partner, instead of gendered terms such as mother and father, has the potential to enhance research efforts to recruit parents from diverse and often under-represented backgrounds. The following scales offer inclusive and neutral language: Fathering Self-Efficacy Scale, Infant Care Questionnaire, Karitane Parenting Confidence Scale, Preterm Parenting Self-Efficacy Checklist, Parenting Sense of Competence Scale. Even so, selecting an instrument with inclusive language may not be sufficient depending on other considerations such as theoretical framework or administration.

4.1.5. Concepts and theoretical framework

A majority (80%) of the parenting self-efficacy instruments assessed in this review had clear theoretical ties to Social Cognitive Theory and the concept of parenting self-efficacy as described by Bandura. Instruments that did not provide a theoretical framework were more aligned with the concept of satisfaction in the parental role (Being a Mother, Comfort with Parenting Performance, Kansas Parenting Satisfaction Scale, Postpartum Self-Evaluation Questionnaire, Parenting Sense of Competence, and What being a Parent to a Baby is Like). Although satisfaction as a concept may be closely aligned with confidence because both are personal judgments about their role as a parent, satisfaction is an emotional response or feeling of pleasure resulting from fulfillment of needs or expectations (Clinton & Wellington, 2013). The concept of feeling comfortable in the parenting role may be similar to confidence as some parents describe confidence as feeling comfortable in the parenting role (Vance et al., 2021). Yet, as we continue to evaluate the concept of parenting self-efficacy, it is distinct from satisfaction, in that parenting self-efficacy assesses an individual's belief in their abilities whereas satisfaction is an assessment of one's own contentment or fulfilment of expectations in the parenting role. Satisfaction is an affective response of feeling pleased with a situation, achievements, or a role and focused on the past whereas, self-efficacy, or confidence, is a personal judgment about current or future capabilities to attain success (e.g., a happy, healthy infant). These instruments were included in this review because they were discussed as relevant parenting self-efficacy instruments in the former systematic reviews, but upon further analysis, they do not truly fit within the framework of parenting self-efficacy or Social Cognitive Theory. Thus, if one wants to appropriately measure parenting self-efficacy, a measure with a clear theoretical framework should be prioritized, such as Karitane Parent Confidence Scale or Preterm Parenting Self-Efficacy Checklist. Of note, the topics addressed in the preterm checklist are non-specific to whether an infant was born term or preterm, meaning the questions align with other infant instruments that cover general topics (e.g., bathing, feeding, diapering, support from partner). In sum, there are no specific items or language in the Preterm Parenting Self-Efficacy Checklist to distinguish it for use in parents with a high-risk infant or those born prematurely.

4.2. Limitations

We note a few limitations in this review. Our sample was purposely limited to instruments validated to measure parenting self-efficacy in parents of infants and toddlers, specifically aged 0-3 years. However, there are instruments measuring parenting self-efficacy in other contexts and ages. A few examples include confidence in the parenting role for children with obesity, asthma, diabetes, elementary and middle-school aged children, and adolescents. Even in the focus of the review, the recommendations for understanding the instrument's theoretical framework, cultural relevance, target population, and administration format are all useful elements to consider in the selection of an instrument. We were also limited to some extent in making recommendations given the various formats of each scale (e.g., number of items, response options, scale format). For example, comparing the acceptability or interpretability of a 4- or 6- Likert scale response option, or a non-traditional response format of 0-100, leave some considerations up to researcher preferences. It is unclear if the number of items within an instrument relates to a more precise evaluation of the concept. What is needed are benchmarks for each unit of analysis (e.g., total score or mean value) to better understand whether scores in an individual study accurately reflect the concept and for comparison across outcomes. More standardization and consistent use of instruments would help facilitate meaningful interpretations across studies. Additionally, determining a core set of parenting topics and/or parent factors could be important for further refinement of the instruments, along with benchmarking studies for individual scales could provide more robust results for comparing high vs. low confidence and their association outcomes. Lastly, most instruments were developed by English-speaking researchers over 20 years ago (1980s & 1990s). It was not within the scope of this review to assess which instruments were created or translated into other languages. More adaptation of instruments into foreign languages with attention to cultural norms and parenting practices is recommended. Additionally, in the time since the development of many of these instruments, the cultural evaluation of parenthood and confidence may have changed. With changes in societal norms, it may influence how we interpret confidence. Even so, the development of an instrument like Karitane Parenting Confidence Scale in the last decade and validated in a diverse population, continue to offer a strong indication that parental assessment of their confidence remains constant and mirrors Bandura's self-efficacy theory and Belsky's Multiple Determinates of Parenting framework.

5. Conclusion

This review compared and contrasted parenting self-efficacy instruments to summarize factors associated with confidence (i.e.,parenting self-efficacy). Parenting self-efficacy is a valuable concept for understanding the connections between parenting and infant health and developmental outcomes. We also recognize that Bandura's Self-Efficacy and Belsky's Parenting Model may seem dated and not reflect current thinking about parenting from a neuroscience or socio-political context. Even so, these are seminal parenting and self-efficacy theories that continue to impact the body of knowledge about parenthood and self-efficacy beliefs, thus relevant to this study. This review provides information about relevant parent, social, and child factors associated with parenting self-efficacy and recommendations regarding selection of parenting self-efficacy instruments. Future work is needed, such as a meta-analysis of parenting self-efficacy scores across studies and instruments. A meta-analysis would provide a means to compare scores from multiple studies and disciplines to evaluate the effects of parenting self-efficacy as an important predictor of parenting success and infant developmental outcomes. There is also a clear need for more longitudinal studies to assess the stability and effect of scores. This would allow researchers to understand of how timing of measurement, situations, factors, or developmental periods potentially contribute to higher verses lower confidence. Understanding this information will ensure instruments are relevant and applied appropriately to support meaningful conclusions across studies of parenting self-efficacy as well as the impact on outcomes.

Contributors’ Statement

Drs Vance and McGrath conceptualized and designed the study. Dr. Vance coordinated and supervised data collection and conducted data analysis. Ms. Seetharaman and Ms. Benjamin conducted data analysis and drafted the initial manuscript. All authors reviewed and interpreted findings, and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Parenting self-efficacy instruments for parents of infants and toddlers: A review

What is already known

• •Parenting self-efficacy is an important concept for describing parent capacity and ability.
• •High parenting self-efficacy beliefs influence positive parenting practices and child outcomes.

What this paper adds

• •This review demonstrates that parenting self-efficacy instruments include questions on parent, social & family factors, and child factors to varying degrees.
• •Item questions related to parent factors were the most frequently addressed, whereas social and child factors were less commonly addressed.

Funding/Support

No funding was secured for this study.

Conflicts of Interest Disclosure

The authors have no conflicts of interest relevant to this article to disclose.