Psychometric Assessment and Precision Remodeling of the Iowa Infant Feeding Attitude Scale to Improve Clinical Use and Efficacy Among Prenatal Women in Canada

AlKusayer, Nouf Majed; Midodzi, William K.; Newhook, Leigh Anne; Burrage, Lorraine; Gill, Nicole; Halfyard, Beth; Twells, Laurie

doi:10.1177/0890334417741296

Cited by 19 publications

(31 citation statements)

References 27 publications

(42 reference statements)

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“…Many studies have assessed ability of IIFAS to predict intention to breastfeed [16,18,24,42,[45][46][47]. However, in the current study, since all women had intention to breastfeed, we assessed whether IIFAS can predict intention for breastfeeding ≥24 months.…”

Section: Discussionmentioning

confidence: 97%

Adaptation and validation of the Iowa infant feeding attitude scale and the breastfeeding knowledge questionnaire for use in an Ethiopian setting

et al. 2020

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Background: Validated instruments to assess breastfeeding knowledge and attitude are non-existent in Africa including Ethiopia. We aimed to adapt and validate the Breastfeeding Knowledge Questionnaire (BFKQ) and the Iowa Infant Feeding Attitude Scale (IIFAS) for use in Afan Oromo (AO), the most widely spoken language in Ethiopia. Methods: After forward-backward translation into Afan Oromo, the instruments were reviewed for content validity by a panel of a nutritionist and pediatricians, and pretested on a sample of 30 mothers. Then, a cross-sectional study involving 468 pregnant women in their second and third trimester was conducted between May and August 2017 in the Manna district, Southwest Ethiopia, using the final versions of the adapted questionnaires. We used exploratory and confirmatory factor analysis to assess the construct validity, receiver operating characteristic (ROC) curves to determine the predictive validity and Cronbach's alpha coefficients to assess internal consistency. Results: Using exploratory factor analysis (EFA), nine domains containing 34 items were extracted from the BFKQ-AO. A confirmatory factor analysis of the constructs from EFA confirmed construct validity of the instrument (χ2/ df = 2.11, RMSEA = 0.049, CFI = 0.845, TLI = 0.823). In factor analysis of the IIFAS, the first factor explained 19.7% of the total variance and the factor loadings and scree plot test suggested unidimensionality of the tool. Cronbach's alpha was 0.79 for the BFKQ-AO and 0.72 for IIFAS-AO suggesting an acceptable internal consistency of both instruments. For the sensitivity and specificity in predicting intention of breastfeeding for ≥24 months, the area under the curve (AUC) was 82% for IIFAS score and 79% for BFKQ score. Conclusions: Here we present the first study that reported the use of the BFKQ and the IIFAS in Ethiopia. Our results showed that both BFKQ-AO and IIFAS-AO can be reliable and valid tools for measuring maternal breastfeeding knowledge and attitude in the study population, showing the potential for adapting these tools for application in a wider Ethiopian context.

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Section: Discussionmentioning

confidence: 97%

Adaptation and validation of the Iowa infant feeding attitude scale and the breastfeeding knowledge questionnaire for use in an Ethiopian setting

et al. 2020

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“…This location can be explained by the fact that personal experiences and previous experiences count equally besides attitudes when judging the issue. Therefore, this question, in addition to asking a very important point, is less suitable for measuring infant feeding attitudes and predicting behavior in this form, similar to Alkusayer's nding (27). Therefore, we left this item out of the short Hungarian version, as well.…”

Section: Discussionmentioning

confidence: 99%

“…AlKusayer et al (27) were the rst who compared the predictive validity of the 17 items IIFAS with the shortened 13-item version among pregnant women. They found a similar internal consistency of both, the Cronbach's alpha was 0.870 in shorter versions.…”

Section: Shortened Versions Of the Iifasmentioning

confidence: 99%

“…If we use again the rule mentioned earlier, these items have to be deleted and we get a 9-item version of IIFAS. If we compare the items of this version with other shortened forms of IIFAS from different cultures and languages (Canadian 13 item version (27), Iranian 11 item version (29), Spanish 9 item version (26)) we can declare that 8 items are common in these four shortened forms. The additional item of the Hungarian 9-item version includes the statement about overfeeding ("Breast-fed babies are more likely to be overfed than formula-fed babies.").…”

Section: Possible Shortened Forms Of Hungarian Version Of Iifasmentioning

confidence: 99%

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Psychometric Properties of the Hungarian Version of the Iowa Infant Feeding Attitude Scale 

Renata

Ittzés

Bóné

et al. 2020

Preprint

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Background: The Iowa Infant Feeding Attitude Scale (IIFAS) is a widely used tool to assess attitudes toward infant feeding methods. Attitudes toward breastfeeding are one of the main influencing factors of feeding choice and breastfeeding duration. Adaptation of IIFAS to Hungarian provides an opportunity for cross-cultural comparisons and helps targeting breastfeeding support interventions.Methods: The original IIFAS was translated into Hungarian and back-translated to English. A cross-sectional study was conducted among 553 mothers whose latest child’s age was between 6 and 36 months. In addition to the Hungarian IIFAS, infant feeding status and socioeconomic properties were self-reported in the online survey. Psychometric properties, validity and internal consistency were determined and compared with international results.Results: The 17 item IIFAS-H showed good psychometric properties with that of Cronbach alpha=0.733. Further analyses proved that two shortened versions of the IIFAS-17 consisting of 11 and 9 items also showed good properties (Cronbach’s alpha=0.789, 0.787). After comparing our results to the international short versions of IIFAS, we found that they share 8 identical items. These common 8 items have similar good properties with the Cronbach’s alpha=0.763.Conclusions: The benefits of possible use of international comparisons of the 8-item version outweigh its slightly lower reliability compared to the 9 or 11-item versions. Based on our analyses, we suggest the use of the 8-item-long, shortened version (IIFAS-H8) of the scale.

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“…however, both studies were small and focused on Indigenous populations [ [13][14][15], and neither study . Per-person healthcare spending is even higher for infants, in 2014 the percapita cost of medical services for infants in their first year of life was $10,800 [ 18 ].…”

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confidence: 99%

Infant Feeding Mode Predicts the Costs of Healthcare Services in One Region of Canada: a Data Linkage Study

Taylor

Chowdhury

Gao

et al. 2019

Preprint

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Background Few studies have examined the association between infant feeding mode (IFM) and costs related to healthcare service use (HSU) in Canada. The aim of this study is to evaluate differences in HSU and its associated costs by IFM, in an infant’s first year of life in one region of Newfoundland and Labrador, Canada.Methods Data from a prospective cohort study were linked to administrative databases to examine HSU during an infant’s first year of life. The cohort study collected information on peri- and postnatal variables, including IFM during three stages that covered pregnancy through the first year postnatally. Consenting mothers provided their infants health insurance number for a data linkage to examine HSU by the infant. Outcomes included: hospital admissions, emergency room, family doctor and specialist visits. IFM was categorized as exclusively breastfed, mixed fed and exclusively formula fed. Descriptive statistics and multivariate analysis were performed to examine the relationship between IFM, maternal and child characteristics and costs associated with HSU.Results The sample included 160 mother infant dyads who consented to the data linkage. Mothers were Caucasian (95.6%), 26 years or older (95%), partnered (97.5%), living in a household with income greater than $30,000 CAN (98.1%) with a post-secondary education (97.5%). At one month 67% were exclusively breastfeeding, 20% were mixed feeding, and 13% were exclusively formula feeding. Overall $315,235 was spent on healthcare service use for the sample of healthy full-term infants during their first year of life. Generalized linear modelling was performed to assess the effect of IFM on costs associated with HSU adjusting for confounders. When compared to exclusive breastfeeding, exclusive formula and mixed feeding were found to be significant predictors of the total costs associated with HSU during the first year of life (p <0.05), driven by costs of hospital admissions.Conclusions Due to the human and economic burden associated with not breastfeeding, policies and programs that support and encourage breastfeeding should be a priority for governments and regional health authorities.

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Psychometric Assessment and Precision Remodeling of the Iowa Infant Feeding Attitude Scale to Improve Clinical Use and Efficacy Among Prenatal Women in Canada

Abstract: The reduced 13-item version of the IIFAS is a psychometrically sound instrument that maintains its accuracy and validity when measuring maternal feeding attitudes during pregnancy and can be more time efficient in clinical settings compared with the 17-item IIFAS.

Cited by 19 publications

References 27 publications

Adaptation and validation of the Iowa infant feeding attitude scale and the breastfeeding knowledge questionnaire for use in an Ethiopian setting

Adaptation and validation of the Iowa infant feeding attitude scale and the breastfeeding knowledge questionnaire for use in an Ethiopian setting

Psychometric Properties of the Hungarian Version of the Iowa Infant Feeding Attitude Scale

Infant Feeding Mode Predicts the Costs of Healthcare Services in One Region of Canada: a Data Linkage Study

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Psychometric Assessment and Precision Remodeling of the Iowa Infant Feeding Attitude Scale to Improve Clinical Use and Efficacy Among Prenatal Women in Canada

Abstract: The reduced 13-item version of the IIFAS is a psychometrically sound instrument that maintains its accuracy and validity when measuring maternal feeding attitudes during pregnancy and can be more time efficient in clinical settings compared with the 17-item IIFAS.

Cited by 19 publications

References 27 publications

Adaptation and validation of the Iowa infant feeding attitude scale and the breastfeeding knowledge questionnaire for use in an Ethiopian setting

Adaptation and validation of the Iowa infant feeding attitude scale and the breastfeeding knowledge questionnaire for use in an Ethiopian setting

Psychometric Properties of the Hungarian Version of the Iowa Infant Feeding Attitude Scale&nbsp;

Infant Feeding Mode Predicts the Costs of Healthcare Services in One Region of Canada: a Data Linkage Study

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Psychometric Properties of the Hungarian Version of the Iowa Infant Feeding Attitude Scale