Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding
Abstract Background Increasing the prevalence of optimal breastfeeding practices, including exclusive breastfeeding for 6 months, could prevent an estimated 823,000 child deaths annually. Self-efficacy is an important determinant of breastfeeding behaviors. However, existing measures do not specific...
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doaj-314a85bdcabd4a2cb28de02382abeb7e2020-11-25T03:48:43ZengBMCBMC Pregnancy and Childbirth1471-23932019-02-0119111410.1186/s12884-019-2217-7Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeedingGodfred O. Boateng0Stephanie L. Martin1Emily L. Tuthill2Shalean M. Collins3Cindy-Lee Dennis4Barnabas K. Natamba5Sera L. Young6Department of Anthropology & Global Health, Northwestern UniversityDepartment of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel HillDepartment of Community Health Systems, University of California San FranciscoDepartment of Anthropology & Global Health, Northwestern UniversityLawrence S. Bloomberg Faculty of Nursing, University of Toronto and St. Michael’s HospitalNoncommunicable Diseases Theme, MRC/UVRI and LSHTM Uganda Research UnitDepartment of Anthropology & Global Health, Northwestern UniversityAbstract Background Increasing the prevalence of optimal breastfeeding practices, including exclusive breastfeeding for 6 months, could prevent an estimated 823,000 child deaths annually. Self-efficacy is an important determinant of breastfeeding behaviors. However, existing measures do not specifically assess exclusive breastfeeding self-efficacy, but rather self-efficacy for any breastfeeding. Hence, we sought to adapt and validate an instrument to measure exclusive breastfeeding self-efficacy. Methods We modified and added items from Dennis’ Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). It was then implemented in an observational cohort in Gulu, Uganda at 1 (n = 239) and 3 (n = 238) months postpartum (clinicaltrials.gov NCT02925429). We performed inter-item and adjusted item-test correlations, as well as exploratory factor analysis and parallel analysis at 1 month postpartum to remove redundant items and determine their latent factor structure. We further applied confirmatory factor analysis to test dimensionality of the scale at 3 months postpartum. We then assessed the reliability of the scale and conducted tests of predictive and discriminant validity. Known group comparisons were made by primiparous status and correct breastfeeding knowledge. Results The modification of the original BSES-SF to target exclusive breastfeeding produced 19 items, which were reduced to 9 based on item correlations and factor loadings. Two dimensions of the adapted scale, the Breastfeeding Self-Efficacy Scale to Measure Exclusive Breastfeeding BSES-EBF emerged: Cognitive and Functional subscales, with alpha coefficients of 0.85 and 0.79 at 3 months postpartum. Predictive and discriminant validity and known group comparisons assessments supported its validity. Conclusions This version of the Breastfeeding Self-Efficacy scale, the BSES-EBF Scale, is valid and reliable for measuring exclusive breastfeeding self-efficacy in northern Uganda, and ready for adaptation and validation for clinical and programmatic use elsewhere.http://link.springer.com/article/10.1186/s12884-019-2217-7Scale developmentExclusive breastfeeding; human milkSelf-efficacyReliabilityValidityPsychometric evaluation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Godfred O. Boateng Stephanie L. Martin Emily L. Tuthill Shalean M. Collins Cindy-Lee Dennis Barnabas K. Natamba Sera L. Young |
spellingShingle |
Godfred O. Boateng Stephanie L. Martin Emily L. Tuthill Shalean M. Collins Cindy-Lee Dennis Barnabas K. Natamba Sera L. Young Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding BMC Pregnancy and Childbirth Scale development Exclusive breastfeeding; human milk Self-efficacy Reliability Validity Psychometric evaluation |
author_facet |
Godfred O. Boateng Stephanie L. Martin Emily L. Tuthill Shalean M. Collins Cindy-Lee Dennis Barnabas K. Natamba Sera L. Young |
author_sort |
Godfred O. Boateng |
title |
Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding |
title_short |
Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding |
title_full |
Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding |
title_fullStr |
Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding |
title_full_unstemmed |
Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding |
title_sort |
adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2019-02-01 |
description |
Abstract Background Increasing the prevalence of optimal breastfeeding practices, including exclusive breastfeeding for 6 months, could prevent an estimated 823,000 child deaths annually. Self-efficacy is an important determinant of breastfeeding behaviors. However, existing measures do not specifically assess exclusive breastfeeding self-efficacy, but rather self-efficacy for any breastfeeding. Hence, we sought to adapt and validate an instrument to measure exclusive breastfeeding self-efficacy. Methods We modified and added items from Dennis’ Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). It was then implemented in an observational cohort in Gulu, Uganda at 1 (n = 239) and 3 (n = 238) months postpartum (clinicaltrials.gov NCT02925429). We performed inter-item and adjusted item-test correlations, as well as exploratory factor analysis and parallel analysis at 1 month postpartum to remove redundant items and determine their latent factor structure. We further applied confirmatory factor analysis to test dimensionality of the scale at 3 months postpartum. We then assessed the reliability of the scale and conducted tests of predictive and discriminant validity. Known group comparisons were made by primiparous status and correct breastfeeding knowledge. Results The modification of the original BSES-SF to target exclusive breastfeeding produced 19 items, which were reduced to 9 based on item correlations and factor loadings. Two dimensions of the adapted scale, the Breastfeeding Self-Efficacy Scale to Measure Exclusive Breastfeeding BSES-EBF emerged: Cognitive and Functional subscales, with alpha coefficients of 0.85 and 0.79 at 3 months postpartum. Predictive and discriminant validity and known group comparisons assessments supported its validity. Conclusions This version of the Breastfeeding Self-Efficacy scale, the BSES-EBF Scale, is valid and reliable for measuring exclusive breastfeeding self-efficacy in northern Uganda, and ready for adaptation and validation for clinical and programmatic use elsewhere. |
topic |
Scale development Exclusive breastfeeding; human milk Self-efficacy Reliability Validity Psychometric evaluation |
url |
http://link.springer.com/article/10.1186/s12884-019-2217-7 |
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