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Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding

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 ass...

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Autores principales: Boateng, Godfred O., Martin, Stephanie L., Tuthill, Emily L., Collins, Shalean M., Dennis, Cindy-Lee, Natamba, Barnabas K., Young, Sera L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380059/
https://www.ncbi.nlm.nih.gov/pubmed/30777020
http://dx.doi.org/10.1186/s12884-019-2217-7
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author Boateng, Godfred O.
Martin, Stephanie L.
Tuthill, Emily L.
Collins, Shalean M.
Dennis, Cindy-Lee
Natamba, Barnabas K.
Young, Sera L.
author_facet Boateng, Godfred O.
Martin, Stephanie L.
Tuthill, Emily L.
Collins, Shalean M.
Dennis, Cindy-Lee
Natamba, Barnabas K.
Young, Sera L.
author_sort Boateng, Godfred O.
collection PubMed
description 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12884-019-2217-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-63800592019-02-28 Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding Boateng, Godfred O. Martin, Stephanie L. Tuthill, Emily L. Collins, Shalean M. Dennis, Cindy-Lee Natamba, Barnabas K. Young, Sera L. BMC Pregnancy Childbirth Research Article 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12884-019-2217-7) contains supplementary material, which is available to authorized users. BioMed Central 2019-02-18 /pmc/articles/PMC6380059/ /pubmed/30777020 http://dx.doi.org/10.1186/s12884-019-2217-7 Text en © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Boateng, Godfred O.
Martin, Stephanie L.
Tuthill, Emily L.
Collins, Shalean M.
Dennis, Cindy-Lee
Natamba, Barnabas K.
Young, Sera L.
Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding
title 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_short 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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380059/
https://www.ncbi.nlm.nih.gov/pubmed/30777020
http://dx.doi.org/10.1186/s12884-019-2217-7
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