Development and Validation of a Questionnaire on Breastfeeding Behavior, Attitudes and Knowledge of a Sample of Croatian Health Worker

Abstract

The aim of this study was to create a questionnaire that will enable the quantification of procedures, attitudes and knowledge of healthcare professionals on breastfeeding. The research was conducted on 370 healthcare workers (37 male and 333 female) who, in the period from 15/12/2020 until 15/03/2021, completed the online working version of the questionnaire. Statistical procedures of particle reduction and extraction of the main factors and calculation of construct validity (indicate the degree to which an instrument measures the trait or theoretical construct that it is intended to measure) resulted in a questionnaire on behavior, attitudes and knowledge of health workers about breastfeeding (BBAKQ prof). The questionnaire consists of a scale of behavior (9 items), attitudes (19 items) and knowledge (20 items). The behavior scale shows satisfactory internal consistency (Cronbach's Alpha = 0.70), and the factorial solution with three factors (Breastfeeding Support, Breastfeeding Cessation, and Wrong advice) explains 67.16% of the variance (Kaiser-Meyer-Olkin test = 0.69, Bartlett's test < 0.000). The extracted values of the average variance extracted for each latent variable are greater than 0.5 (0.55/0.63/0.72) which indicates good convergent validity. Heterotrait-monotrait (HTMT) ratio correlations (0.11/0.19/0.56) confirm good discriminant validity. The attitude scale has a high Cronbach's Alpha (0.94), and the factorial solution with two factors (Positive attitudes on breastfeeding, Negative attitudes on breastfeeding) explains 61.65% of the variance (Kaiser-Meyer-Olkin test = 0.93, Bartlett's test < 0.000). The average variance extracted values for each latent variable are greater than 0.5 (0.53/0.67), and the HTMT correlation ratio is 0.63, indicating good convergent and discriminant validity. The internal consistency of knowledge scale items on the BBAKQ prof. questionnaire is very good (KR20 = 0.81). The questionnaire could be used as an aid in research of contribution of healthcare workers to successful breastfeeding, it is free and available at the link provided in the text.