Reliability and validity of an instrument to measure maternal health beliefs.

Noncompliance with recommended preventive pediatric care continues to be a major problem, especially in inner-city pediatric clinics. There has been little evaluation of the maternal beliefs that are associated with such noncompliance, perhaps because there are no instruments which have been assessed for reliability and validity. To evaluate the internal consistency and construct validity of a maternal health belief instrument, we interviewed 500 mothers of healthy full-term newborns postpartum. Forty-eight items measured the maternal health beliefs, according to Health Belief Model constructs (perceived susceptibility, perceived severity, perceived benefits of medical care, perceived barriers, and health motivation). Construct validity was assessed by principal components factor analysis. Eight internally consistent indices emerged, including illnesses having high and low perceived susceptibility, and low and moderate perceived benefit. Logistical access barriers and economic access barriers were also distinct. Perceived severity and health motivation formed single indices. This maternal health belief instrument was internally consistent in the study sample and showed evidence of construct validity. These indices may make important independent contributions to understanding variation in preventive well-child care utilization.