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Development of a questionnaire to assess maternal attitudes towards infant growth and milk feeding practices
Rajalakshmi R Lakshman1, Jill R Landsbaugh, Annie Schiff
1MRC Epidemiology Unit, Cambridge, UK. rl284@mrc-epid.cam.ac.uk
Insights
This study developed a questionnaire to assess maternal attitudes and infant feeding practices, crucial for preventing childhood obesity. The tool showed good reliability and validity, aiding in understanding feeding behaviors.
Area of Science:
- Public Health
- Pediatrics
- Behavioral Science
Background:
- Childhood obesity prevention requires early intervention targeting maternal attitudes and infant feeding.
- A validated tool is needed to assess these factors.
Purpose of the Study:
- To develop and preliminarily validate a questionnaire assessing maternal attitudes toward infant growth and milk feeding practices.
- To identify key determinants of infant feeding behaviors for obesity prevention strategies.
Main Methods:
- A 57-item questionnaire was developed covering milk feeding, attitudes, and beliefs.
- Test-retest reliability and criterion validity were assessed with 40 mothers via questionnaire and interviews.
- Statistical analyses included percentage agreement, Cohen's Kappas, Spearman's correlations, and Cronbach's alpha.
Main Results:
- The questionnaire demonstrated good test-retest reliability (89% of items >70% agreement).
- Criterion validity was acceptable, with 68% of items showing >66% agreement.
- Internal consistency for self-efficacy, outcome expectancy, and intention were 0.51, 0.79, and 0.90, respectively.
Conclusions:
- The developed questionnaire is a potentially valuable tool for research on infant feeding.
- It can help elucidate the 'causal mechanisms' influencing infant feeding practices.
- Findings support its use in interventions aimed at preventing early childhood obesity.
Background:
There is increasing recognition that public health strategies to prevent childhood obesity need to start early in life. Any behavioural interventions need to target maternal attitudes and infant feeding practices, This paper describes the development and preliminary validation of a questionnaire to assess maternal attitudes towards infant growth and milk feeding practices.
Methods:
We designed a 57-item (19 questions), self-administered questionnaire to measure the following four domains- 1) type of milk feeding, decision making and sources of advice; 2) frequency and quantity of milk feeds; 3) attitudes to infant feeding and growth; and 4) theory-based beliefs about following infant feeding recommendations. Forty mothers completed the questionnaire on two occasions six days apart (to assess test-retest reliability) and then participated in a semi-structured, open-ended telephone interview covering the same domains (to assess criterion validity). Percentage agreement, Cohen's Kappas (for categorical variables) and Spearman's correlation coefficients (for continuous variables) were used to quantify reliability and validity. Internal consistency between theory-based constructs (self-efficacy, outcome expectancy and intention) was quantified by Chronbach's alpha.
Results:
Of the 57 questionnaire items 51 (89%) had percentage agreement above 70% indicating good test-retest reliability, and the remaining 6 items had moderate or substantial levels of agreement (kappa 0.41-0.68). Comparing questionnaire with interview coding (validity), percentage agreement was above 66% for 39/57 items (68%). Of the 16 items with percentage agreement below 66%, only five had kappa values below 0.20 (two items had insufficient interview responses). Internal consistency was 0.51, 0.79 and 0.90 for self-efficacy, outcome expectancy and intention respectively.
Conclusions:
This questionnaire could be a useful tool in understanding the determinants of infant feeding and the 'causal mechanism' of interventions that target infant feeding practices to prevent early obesity.
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