适应和验证爱荷华婴儿喂养态度量表和母乳喂养知识问卷，以用于埃塞俄比亚环境。
Adaptation and validation of the Iowa infant feeding attitude scale and the breastfeeding knowledge questionnaire for use in an Ethiopian setting.
机构信息
Department of Population and Family Health, Jimma University, Jimma, Ethiopia.
Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway.
出版信息
Int Breastfeed J. 2020 Apr 9;15(1):24. doi: 10.1186/s13006-020-00269-w.
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.
背景
在包括埃塞俄比亚在内的非洲，目前还没有经过验证的评估母乳喂养知识和态度的工具。我们旨在将母乳喂养知识问卷（BFKQ）和爱荷华婴儿喂养态度量表（IIFAS）翻译成奥罗莫语（Afan Oromo）并进行验证，奥罗莫语是埃塞俄比亚使用最广泛的语言。
方法
经过奥罗莫语的正向和反向翻译，该工具由营养学家和儿科医生组成的小组进行了内容有效性审查，并对 30 名母亲进行了预测试。然后，在 2017 年 5 月至 8 月期间，在埃塞俄比亚西南部的曼纳区进行了一项涉及 468 名处于第二和第三个孕期的孕妇的横断面研究，使用的是经过改编的问卷的最终版本。我们使用探索性和验证性因子分析来评估结构效度，使用受试者工作特征（ROC）曲线来确定预测效度，使用克朗巴赫 α系数来评估内部一致性。
结果
使用探索性因子分析（EFA），从 BFKQ-AO 中提取了包含 34 个项目的九个领域。EFA 构建的验证性因子分析证实了该工具的结构效度（χ2/df=2.11，RMSEA=0.049，CFI=0.845，TLI=0.823）。在 IIFAS 的因子分析中，第一个因子解释了总方差的 19.7%，因子负荷和碎石图测试表明该工具具有单维性。BFKQ-AO 的克朗巴赫 α 系数为 0.79，IIFAS-AO 的克朗巴赫 α 系数为 0.72，这表明两个工具的内部一致性都可以接受。在预测母乳喂养意愿≥24 个月的敏感性和特异性方面，IIFAS 评分的曲线下面积（AUC）为 82%，BFKQ 评分的 AUC 为 79%。
结论
在这里，我们首次报道了在埃塞俄比亚使用 BFKQ 和 IIFAS 的研究。我们的结果表明，BFKQ-AO 和 IIFAS-AO 均可作为衡量研究人群中产妇母乳喂养知识和态度的可靠和有效的工具，表明这些工具有可能在更广泛的埃塞俄比亚背景下应用。
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