title: Reliability and validity of the Romanian version of a scale to measure infant feeding attitudes and knowledge.
abstract: OBJECTIVE
  To describe the development and testing of the Romanian version of the Iowa Infant Feeding Attitude Scale (IIFAS-R). The original instrument has well-established psychometrics for use in English-speaking countries.
  
  
  METHODS
  Questionnaires including demographics and items about prior pregnancy and opinions about breastfeeding in public were administered to women in Cluj-Napoca, Romania, attending antenatal clinic (n = 336) and to a separate cohort of mothers within 24 h of delivery (n = 276). Postpartum follow-up was conducted with a sample of maternity cohort subjects who initiated breastfeeding in the hospital (n = 52).
  
  
  RESULTS
  Internal consistency was adequate in both cohorts (antenatal alpha= 0.50; maternity alpha= 0.63), with improved reliability for antenatal multigravid (alpha= 0.60) and university-educated women (alpha= 0.57). Score distributions were comparable and item means were approximately central across cohorts. Among pregnant women, higher scores (more positive towards breastfeeding) were associated with longer planned maternity leave (chi2= 17.8; p = 0.02). Higher maternity cohort scores were associated with age (r = 0.31, p = 0.003), urban residence (chi2= 10.2, p = 0.04), breastfeeding a prior infant for at least 6 weeks (chi2= 6.4, p = 0.04), and with intending to breastfeed for at least 6 weeks (chi2= 4.7, p = 0.03). Postpartum women still breastfeeding at follow-up also scored higher (chi2= 9.3, p = 0.009).
  
  
  CONCLUSIONS
  This is the first study to report on use of the IIFAS in Eastern Europe. The IIFAS-R is easy to administer, reliable and valid in Romania. The IIFAS-R can support data collection to promote and assess breastfeeding initiatives consistent with World Health Organization recommendations.
authors.affiliation: Department of Epidemiology and Community & Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA, USA. anne-wallis@uiowa.edu
authors.forename: Anne Baber
authors.initials: AB
authors.lastname: Wallis
authors.forename: Alexandra
authors.initials: A
authors.lastname: Brînzaniuc
authors.forename: Razvan
authors.initials: R
authors.lastname: Cherecheş
authors.forename: Florin
authors.initials: F
authors.lastname: Oprescu
authors.forename: Emanuela
authors.initials: E
authors.lastname: Sirlincan
authors.forename: Ioana
authors.initials: I
authors.lastname: David
authors.forename: Ioana Andreea
authors.initials: IA
authors.lastname: Dîrle
authors.forename: Claibourne I
authors.initials: CI
authors.lastname: Dungy
mesh_terms: D000328:Adult; D001942:Breast Feeding; D015331:Cohort Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009035:Mothers; D011247:Pregnancy; D011594:Psychometrics; D015203:Reproducibility of Results; D012383:Romania; D011795:Surveys and Questionnaires