Development and Validation of the Breastfeeding Literacy Assessment Instrument (BLAI) for Obstetric Women
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design, Setting, and Participants
2.2. Questionnaire Development and Content Validity
2.3. Psychometric Properties
2.4. Inferential Analysis
3. Results
3.1. BLAI Validation Results
3.2. Descriptive Analysis
3.3. Breastfeeding Literacy Assessment Instrument
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Correction Statement
References
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Content Validity Index | Factors | Communalities | |||||
---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | ω 1 | |||
Access | 0.907 | 0.809 | |||||
Access1 | 1.00 | 0.676 | 0.399 | 0.311 | 0.402 | 0.948 | 0.490 |
Access2 | 1.00 | 0.748 | 0.403 | 0.419 | 0.401 | 0.948 | 0.560 |
Access3 | 1.00 | 0.687 | 0.318 | 0.356 | 0.411 | 0.948 | 0.505 |
Access4 | 1.00 | 0.656 | 0.367 | 0.391 | 0.552 | 0.948 | 0.563 |
Access5 | 0.67 | 0.565 | 0.405 | 0.445 | 0.557 | 0.947 | 0.534 |
Understand | 0.956 | 0.810 | |||||
Understand1 | 1.00 | 0.426 | 0.460 | 0.551 | 0.529 | 0.947 | 0.476 |
Understand2 | 1.00 | 0.645 | 0.520 | 0.552 | 0.602 | 0.946 | 0.615 |
Understand3 | 0.89 | 0.713 | 0.422 | 0.473 | 0.615 | 0.947 | 0.601 |
Understand4 | 0.89 | 0.587 | 0.399 | 0.404 | 0.707 | 0.947 | 0.557 |
Understand5 | 1.00 | 0.494 | 0.485 | 0.480 | 0.725 | 0.947 | 0.526 |
Appraise | 0.856 | 0.912 | |||||
Appraise1 | 0.89 | 0.510 | 0.601 | 0.673 | 0.741 | 0.946 | 0.715 |
Appraise2 | 0.78 | 0.508 | 0.580 | 0.634 | 0.679 | 0.946 | 0.654 |
Appraise3 | 0.78 | 0.340 | 0.665 | 0.696 | 0.676 | 0.946 | 0.608 |
Appraise4 | 1.00 | 0.338 | 0.639 | 0.703 | 0.603 | 0.946 | 0.584 |
Appraise5 | 0.67 | 0.330 | 0.513 | 0.771 | 0.396 | 0.947 | 0.589 |
Appraise7 | 1.00 | 0.394 | 0.549 | 0.801 | 0.525 | 0.947 | 0.654 |
Appraise8 | 0.89 | 0.423 | 0.610 | 0.749 | 0.605 | 0.946 | 0.616 |
Appraise9 | 0.89 | 0.489 | 0.590 | 0.692 | 0.616 | 0.946 | 0.625 |
Appraise10 | 0.78 | 0.371 | 0.708 | 0.729 | 0.555 | 0.946 | 0.653 |
Apply | 0.968 | 0.873 | |||||
Apply1 | 1.00 | 0.380 | 0.706 | 0.618 | 0.645 | 0.946 | 0.611 |
Apply2 | 1.00 | 0.446 | 0.669 | 0.573 | 0.456 | 0.947 | 0.521 |
Apply3 | 1.00 | 0.471 | 0.587 | 0.472 | 0.607 | 0.947 | 0.481 |
Apply4 | 1.00 | 0.410 | 0.852 | 0.625 | 0.510 | 0.946 | 0.691 |
Apply5 | 1.00 | 0.485 | 0.776 | 0.587 | 0.494 | 0.946 | 0.618 |
Apply6 | 0.78 | 0.255 | 0.582 | 0.484 | 0.550 | 0.948 | 0.479 |
Apply7 | 1.00 | 0.335 | 0.692 | 0.482 | 0.537 | 0.947 | 0.534 |
Access | Understand | Appraise | Apply | |
---|---|---|---|---|
Access | 1.000 | |||
Understand | 0.680 | 1.000 | ||
Appraise | 0.546 | 0.707 | 1.000 | |
Apply | 0.535 | 0.662 | 0.761 | 1.000 |
Inadequate BFL | Adequate BFL | p 3 | |||||||
---|---|---|---|---|---|---|---|---|---|
Min | Max | n 1 | % 2 | Min | Max | n | % | ||
Access | 1.8 | 3.00 | 82 | 40.2 | 3.20 | 4.00 | 122 | 59.8 | <0.001 |
Understand | 1.8 | 3.00 | 92 | 45.1 | 3.20 | 4.00 | 112 | 54.9 | <0.001 |
Appraise | 1.44 | 2.78 | 70 | 34.3 | 2.89 | 4.00 | 134 | 65.7 | <0.001 |
Apply | 1.29 | 2.71 | 69 | 33.8 | 2.86 | 4.00 | 135 | 66.2 | <0.001 |
n 1 | % 2 | |
---|---|---|
Hospital | ||
H. Universitario de La Ribera | 93 | 45.6 |
H. General Universitario de Castellón | 88 | 43.1 |
H. Lluís Alcanyís de Xàtiva | 23 | 11.3 |
Country of origin | ||
Spain | 171 | 83.8 |
Central and South America | 20 | 9.8 |
Rest of European Union Countries | 9 | 4.4 |
Other | 1 | 0.5 |
Educational level | ||
Primary studies | 33 | 16.2 |
Professional training | 68 | 33.3 |
Degree, bachelor’s degree | 68 | 33.3 |
Master’s degree or Phd | 35 | 17.2 |
Perceived socioeconomic status | ||
Low | 26 | 12.7 |
Middle | 174 | 85.3 |
High | 4 | 2 |
Exclusive Breastfeeding | Mixed Feeding | Formula Feeding | ||||
---|---|---|---|---|---|---|
n 1 | % 2 | n | % | n | % | |
Parity | ||||||
First | 80 | 39.2 | 6 | 2.9 | 24 | 11.8 |
Second | 55 | 27 | 5 | 2.5 | 11 | 5.4 |
Third or more | 16 | 7.8 | 2 | 1.00 | 5 | 2.5 |
Feeding doubts before birth | ||||||
I had no doubts | 135 | 66.2 | 6 | 2.9 | 23 | 11.3 |
I had doubts, but it was my own free will | 15 | 7.4 | 7 | 3.4 | 17 | 8.3 |
I had doubts, I felt pressured | 1 | 0.5 | - | - | - | - |
Previous BF | ||||||
Yes | 70 | 34.3 | 5 | 2.5 | 7 | 3.4 |
No | 81 | 39.7 | 8 | 3.9 | 31 | 15.2 |
General perception of previous breastfeeding experience (n = 82) | ||||||
Very good | 43 | 51.2 | 1 | 1.2 | - | - |
Good | 18 | 21.4 | 2 | 2.4 | 2 | 2.4 |
Regular | 9 | 10.7 | 1 | 1.2 | 3 | 3.6 |
Bad | - | - | 1 | 1.2 | 4 | 4.8 |
Professional support received during previous breastfeeding (n = 82) | ||||||
Supported at all times | 33 | 39.3 | 2 | 2.4 | 3 | 3.6 |
Supported most of the times | 12 | 14.3 | 2 | 2.4 | 2 | 2.4 |
Supported sometimes | 8 | 9.5 | 1 | 1.2 | 1 | 1.2 |
Insufficient support | 17 | 20.2 | - | - | 3 | 3.6 |
Support from family and friends received during previous breastfeeding (n = 82) | ||||||
Supported at all times | 28 | 33.3 | 1 | 1.2 | 4 | 4.8 |
Supported most of the times | 20 | 23.8 | 3 | 3.6 | 3 | 3.6 |
Supported sometimes | 6 | 7.1 | 1 | 1.2 | - | - |
Insufficient support | 16 | 19 | - | - | 2 | 2.4 |
Months exclusively breastfed during previous breastfeeding (n = 82) | ||||||
1 month or less | 4 | 4.8 | 3 | 3.6 | 8 | 9.5 |
2–3 months | 8 | 9.5 | - | - | - | - |
4–5 months | 8 | 9.5 | - | - | 1 | 1.2 |
6 months or more | 50 | 61 | 2 | 2.4 | - | - |
Main reason for abandonment of previous breastfeeding (n = 82) | ||||||
Previous BF has not ended | 6 | 7.1 | - | - | - | - |
Physiological weaning | 31 | 36.9 | - | - | - | - |
Breast problems unrelated to BF | 1 | 1.2 | - | - | 2 | 2.4 |
Breast problems related to BF | 2 | 2.4 | - | - | 2 | 2.4 |
Lack of professional support | 1 | 1.2 | 1 | 1.2 | - | - |
Lack of family support | 1 | 1.2 | - | - | 1 | 1.2 |
Work incorporation | 15 | 17.9 | 2 | 2.4 | - | - |
Perceived lack of breastmilk | 8 | 9.5 | - | - | 4 | 4.8 |
Reduced infant weight gain | 5 | 6 | 2 | 2.4 | - | - |
Inadequate BFL | Adequate BFL | p-Value | |||
---|---|---|---|---|---|
n 1 | % 2 | n | % | ||
Access | |||||
Socioeconomic status | 0.016 3 | ||||
Low | 16 | 61.5 | 10 | 38.5 | |
Middle | 66 | 37.9 | 108 | 62.1 | |
High | - | - | 4 | 100 | |
Understand | |||||
Lactation type | 0.023 4 | ||||
Exclusive Breastfeeding | 61 | 40.4 | 90 | 59.6 | |
Mixed Feeding | 10 | 76.9 | 3 | 23.1 | |
Formula feeding | 21 | 52.5 | 19 | 47.5 | |
Appraise | |||||
Previous Breastfeeding | 0.022 4 | ||||
Previous Breastfeeding | 22 | 26.8 | 60 | 73.2 | |
No previous Breastfeeding | 12 | 27.3 | 32 | 72.7 | |
Is my first pregnancy | 35 | 46.1 | 41 | 53.9 | |
Parity | 0.011 4 | ||||
First | 47 | 42.7 | 63 | 57.3 | |
Second | 15 | 21.1 | 56 | 78.9 | |
Third or more | 8 | 34.8 | 15 | 65.2 | |
Apply | |||||
Parity | 0.042 4 | ||||
First | 43 | 39.1 | 67 | 60.9 | |
Second | 16 | 22.5 | 55 | 77.5 | |
Third or more | 10 | 43.5 | 13 | 56.5 | |
Lactation type | 0.026 4 | ||||
Exclusive Breastfeeding | 44 | 29.1 | 107 | 70.9 | |
Mixed Feeding | 8 | 61.5 | 5 | 38.5 | |
Bottle feeding | 17 | 42.5 | 23 | 57.5 |
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Valero-Chillerón, M.J.; Vila-Candel, R.; Mena-Tudela, D.; Soriano-Vidal, F.J.; González-Chordá, V.M.; Andreu-Pejo, L.; Antolí-Forner, A.; Durán-García, L.; Vicent-Ferrandis, M.; Andrés-Alegre, M.E.; et al. Development and Validation of the Breastfeeding Literacy Assessment Instrument (BLAI) for Obstetric Women. Int. J. Environ. Res. Public Health 2023, 20, 3808. https://doi.org/10.3390/ijerph20053808
Valero-Chillerón MJ, Vila-Candel R, Mena-Tudela D, Soriano-Vidal FJ, González-Chordá VM, Andreu-Pejo L, Antolí-Forner A, Durán-García L, Vicent-Ferrandis M, Andrés-Alegre ME, et al. Development and Validation of the Breastfeeding Literacy Assessment Instrument (BLAI) for Obstetric Women. International Journal of Environmental Research and Public Health. 2023; 20(5):3808. https://doi.org/10.3390/ijerph20053808
Chicago/Turabian StyleValero-Chillerón, María Jesús, Rafael Vila-Candel, Desirée Mena-Tudela, Francisco Javier Soriano-Vidal, Víctor M. González-Chordá, Laura Andreu-Pejo, Aloma Antolí-Forner, Lledó Durán-García, Miryam Vicent-Ferrandis, María Eugenia Andrés-Alegre, and et al. 2023. "Development and Validation of the Breastfeeding Literacy Assessment Instrument (BLAI) for Obstetric Women" International Journal of Environmental Research and Public Health 20, no. 5: 3808. https://doi.org/10.3390/ijerph20053808
APA StyleValero-Chillerón, M. J., Vila-Candel, R., Mena-Tudela, D., Soriano-Vidal, F. J., González-Chordá, V. M., Andreu-Pejo, L., Antolí-Forner, A., Durán-García, L., Vicent-Ferrandis, M., Andrés-Alegre, M. E., & Cervera-Gasch, Á. (2023). Development and Validation of the Breastfeeding Literacy Assessment Instrument (BLAI) for Obstetric Women. International Journal of Environmental Research and Public Health, 20(5), 3808. https://doi.org/10.3390/ijerph20053808