School of Public Health, Mekelle University, College of Health Sciences, Mekelle, Ethiopia.
Graduate School of Public Health, San Diego State University, San Diego, USA.
Reprod Health. 2020 Aug 14;17(1):123. doi: 10.1186/s12978-020-00976-x.
Pastoralist community, Afar, women felt that they are embedded in strong cultural and religious perspectives which promotes a high number of children, and discourages family planning (FP) use. They are multifaced factors which hinder women not to use FP and it is time to develop a context-based tool to understand the situation at the ground. However, we have a dearth of evidence on a reliable and valid tool. Therefore, this study aims in developing a reliable and valid tool that considers the women's knowledge, male involvement, attitude, and belief about whether most people approve or disapprove of the behavior to use or not use of FP.
A total of 891 married women participated in the study. Reviewing the literature, piloting, pretesting, and collecting the actual data were the steps we used to develop a reliable and valid tool. We used the integrated behavioral model (IBM) as a conceptual framework for developing the tool. The developing tool consists of 1) knowledge 2) perceived male involvement and 3) constructs of integrated behavioral model (IBM); expressional and instrumental attitude, subjective norm, self-efficacy, perceived control and intention to use of FP. The IBM items composed of direct and indirect measurement. In the analysis of the data, exploratory and confirmatory factor analysis was done. Independent t. test with cohen's d was used to calculate the effect size. The correlation coefficient was carried between the direct and indirect measurements of the items of the integrated behavioral model (IBM).
A total of 891 pastoralist married women were included in the analysis of the reliability and validity of the tool. The mean age of the participants was 26.74(±6.45). The KMO value for all items was greater than 0.83 with a Bartlett test of sphericity of (p < 0.00). Thirteen items were used to measure the knowledge of the respondent towards FP use. The tool had 64.92 variances explained and Cronbach alpha of 0.85. Acceptable values of the fitness indices were obtained in the confirmatory factor analysis (CFA) The items of knowledge towards FP had normed chi-square of 4.5, RMSEA with 90% CI of 0.064(0.056,.0.071), SRMR of 0.039, CFI of 0.969 and TLI of 0961. All the developed items had a Cohen's d ranges from 0.5 to 2. Moreover, the correlation test of the IBM ranges from 0.6 to 0.7 which shows a higher correlation between the measurement direct and indirect items.
The pastoralist community version of the FP questionnaire is a valid and reliable tool and can be used to measure future family planning use. The indirect measurement of the IBM constructs was a good item to measure FP. However, as a limitation of the study respondents may face difficulty in realizing the difference one item to another especially when items on the scale look so similar to her.
在非洲之角的牧民社区，女性认为自己深受强烈的文化和宗教观念的影响，这些观念促使她们生育众多子女，并阻碍了计划生育（FP）的使用。有许多因素阻碍了女性使用 FP，现在是时候开发一种基于背景的工具来了解当地的实际情况了。然而，我们缺乏可靠和有效的工具的证据。因此，本研究旨在开发一种可靠和有效的工具，该工具考虑了女性对 FP 使用或不使用的知识、男性参与程度、态度以及对大多数人是否赞成或反对该行为的信念。
共有 891 名已婚女性参与了这项研究。我们采用了文献回顾、预试验、预测试和收集实际数据的方法来开发可靠和有效的工具。我们使用综合行为模型（IBM）作为开发工具的概念框架。该工具包括 1）知识，2）感知到的男性参与度，3）综合行为模型（IBM）的构建模块；表达和工具性态度、主观规范、自我效能感、对 FP 使用的感知控制和意图。IBM 项目由直接和间接测量组成。在数据分析中，我们进行了探索性和验证性因素分析。使用独立 t 检验和 Cohen's d 计算效应大小。IBM 项目的直接和间接测量之间的相关性。
共有 891 名牧民已婚女性参与了工具的可靠性和有效性分析。参与者的平均年龄为 26.74（±6.45）岁。所有项目的 KMO 值均大于 0.83，巴特利特球形检验（p<0.00）。13 个项目用于衡量受访者对 FP 使用的知识。该工具解释了 64.92%的方差，Cronbach's alpha 为 0.85。在验证性因素分析（CFA）中获得了可接受的拟合指数值。知识方面的项目具有规范的卡方值为 4.5，90%置信区间的 RMSEA 为 0.064（0.056，0.071），SRMR 为 0.039，CFI 为 0.969，TLI 为 0.961。所有开发的项目的 Cohen's d 值范围为 0.5 至 2。此外，IBM 结构的相关性测试范围为 0.6 至 0.7，这表明直接和间接测量项目之间存在更高的相关性。
牧民社区的 FP 问卷是一种有效且可靠的工具，可用于衡量未来的计划生育使用情况。IBM 结构的间接测量是衡量 FP 的一个很好的项目。然而，作为研究的一个限制，受访者可能难以意识到一个项目与另一个项目之间的区别，特别是当量表上的项目看起来如此相似时。
