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

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          Abstract

          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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          Most cited references38

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          The Iowa Infant Feeding Attitude Scale: Analysis of Reliability and Validity1

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            Cross-cultural adaptation of the Health Education Impact Questionnaire: experimental study showed expert committee, not back-translation, added value.

            To assess the contribution of back-translation and expert committee to the content and psychometric properties of a translated multidimensional questionnaire.
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              Cross-Cultural Translation: Methodology and Validation

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                Author and article information

                Contributors
                misra_ab@yahoo.com
                Journal
                Int Breastfeed J
                Int Breastfeed J
                International Breastfeeding Journal
                BioMed Central (London )
                1746-4358
                9 April 2020
                9 April 2020
                2020
                : 15
                : 24
                Affiliations
                [1 ]GRID grid.411903.e, ISNI 0000 0001 2034 9160, Department of Population and Family Health, , Jimma University, ; Jimma, Ethiopia
                [2 ]GRID grid.5510.1, ISNI 0000 0004 1936 8921, Department of Community Medicine and Global Health, , University of Oslo, ; Oslo, Norway
                [3 ]GRID grid.418193.6, ISNI 0000 0001 1541 4204, Norwegian Institute of Public Health, ; Oslo, Norway
                [4 ]GRID grid.5342.0, ISNI 0000 0001 2069 7798, Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, , Ghent University, ; Ghent, Belgium
                [5 ]GRID grid.5510.1, ISNI 0000 0004 1936 8921, Faculty of Medicine, , University of Oslo, ; Oslo, Norway
                [6 ]GRID grid.265219.b, ISNI 0000 0001 2217 8588, Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, ; New Orleans, USA
                Article
                269
                10.1186/s13006-020-00269-w
                7144343
                32272963
                e541cfd7-b8ce-4e6e-b943-71395bb24a81
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 7 October 2019
                : 31 March 2020
                Funding
                Funded by: NORAD (Norwegian Agency for Development Cooperation) under the NORHED-Program
                Award ID: ETH-13/0024
                Categories
                Research
                Custom metadata
                © The Author(s) 2020

                Obstetrics & Gynecology
                optimal breastfeeding,knowledge,attitude,iifas,reliability,validity,developing country,ethiopia

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