Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
Department of Maternal and Child Health Nursing, University of Jordan, Amman, Jordan.
BMJ Open. 2022 Feb 25;12(2):e052118. doi: 10.1136/bmjopen-2021-052118.
The aim of this study is to develop and validate a scale to measure provider attitudes towards provision of youth-friendly sexual and reproductive health (SRH) services in a conservative setting in the Middle East.
Cross-sectional, psychometric validation study.
Public health facilities in Amman, Irbid, Mafraq and Zarqa in Jordan.
552 healthcare providers were recruited by convenience. Providers were eligible if they were a practising midwife, nurse or physician in one of the selected health facilities.
An initial pool of 52 items was generated using theory and local expert input. We evaluated the psychometric properties of the scale using factor analysis. We assessed internal consistency reliability by calculating Cronbach's alpha and convergent construct validity using linear regression to assess the association between a provider's score on the scale and whether they had ever received training on SRH issues.
Our final scale consisted of 3 dimensions and 29 items corresponding to the constructs of: (1) Attitudes towards Information and Services Offered to Youth (11 items) (2) norms and personal beliefs (10 items) and (3) attitudes towards the service delivery environment (8 items). Cronbach's alpha was estimated at 0.72 for the full scale, and between 0.70 and 0.73 for each subscale. The scale demonstrated high construct validity. The results of the linear regression analysis suggest that respondents who had received SRH training had a mean score that was 16% higher (0.64 points; 95% CI 0.2 to 11.2; p<0.01) on the full attitudes scale compared with those who did not.
This paper describes a study to formally develop and validate a scale to measure healthcare provider attitudes in support of youth-friendly SRH services, thus providing an important tool to identify areas for improvement of youth SRH programmes in the Middle East and globally.
本研究旨在开发和验证一种衡量在中东保守环境下提供青少年友好型性与生殖健康（SRH）服务的提供者态度的量表。
横断面，心理测量验证研究。
约旦安曼、伊尔比德、马弗拉克和扎尔卡的公共卫生设施。
通过方便抽样招募了 552 名医疗保健提供者。如果他们是选定的卫生设施之一的执业助产士、护士或医生，则有资格参加。
使用理论和当地专家的意见生成了一个初始的 52 项条目池。我们通过因子分析评估了量表的心理测量特性。我们通过计算 Cronbach's alpha 来评估内部一致性信度，并通过线性回归评估量表得分与提供者是否接受过 SRH 问题培训之间的相关性来评估聚合结构效度。
我们的最终量表由 3 个维度和 29 个条目组成，分别对应于以下结构：（1）对青少年提供的信息和服务的态度（11 个条目）；（2）规范和个人信念（10 个条目）；（3）对服务提供环境的态度（8 个条目）。全量表的 Cronbach's alpha 估计值为 0.72，各分量表的 Cronbach's alpha 估计值在 0.70 到 0.73 之间。该量表具有较高的结构效度。线性回归分析的结果表明，接受过 SRH 培训的受访者在全态度量表上的平均得分比未接受培训的受访者高 16%（0.64 分；95%CI 0.2 至 11.2；p<0.01）。
本文描述了一项正式开发和验证一种衡量医疗保健提供者支持青少年友好型 SRH 服务态度的量表的研究，从而为识别中东和全球青少年 SRH 方案的改进领域提供了重要工具。
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