title: Psychometric Properties of the Iowa Infant Feeding Attitude Scale among a Multiethnic Population during Pregnancy.
abstract: BACKGROUND
  The Iowa Infant Feeding Attitude Scale (IIFAS) was developed to measure maternal attitudes toward infant feeding, but a number of validated studies on the IIFAS found that it was subject to methodological limitations.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the psychometric properties of the IIFAS among a multiethnic population in Singapore.
  
  
  METHODS
  A cross-sectional research design was used on a sample of 417 antenatal women. The internal consistency and stability of the IIFAS were evaluated using Cronbach's α and test-retest reliability. Known-group comparisons discriminated certain group differences in a predictable way. A series of exploratory factor analyses (EFAs) was conducted to test the factor structure of the IIFAS using the maximum likelihood and principal axis factoring. The number of factors was selected according to theoretical and statistical considerations. A confirmatory factor analysis (CFA) was further performed to validate the factor structure constructed in the prior EFA.
  
  
  RESULTS
  The IIFAS had a Cronbach's α and Pearson correlation of 0.79 and 0.85, respectively. The known-group comparisons among certain groups were supported. The EFA results showed that the 3-factor structure produced the most interpretable and theoretical sense. A second-order CFA was conducted to confirm the construct dimensionality of the 15-item IIFAS, with satisfactory fit indices found.
  
  
  CONCLUSIONS
  The 15-item IIFAS is a psychometrically sound measurement tool that health care professionals can use to understand the diverse infant feeding attitudes and knowledge among different ethnic groups in order to provide breastfeeding interventions that are culturally sensitive.
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore nurly@nus.edu.sg.
authors.forename: Ying
authors.initials: Y
authors.lastname: Lau
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Tha Pyai
authors.initials: TP
authors.lastname: Htun
authors.affiliation: Nursing Department, National University Hospital, Singapore.
authors.forename: Peng Im
authors.initials: PI
authors.lastname: Lim
authors.affiliation: Nursing/Department of Obstetrics and Gynaecology, National University Hospital, Singapore.
authors.forename: Sarah Su Tin
authors.initials: SS
authors.lastname: Ho-Lim
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Piyanee
authors.initials: P
authors.lastname: Klainin-Yobas
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People / Q000523:psychology*; D001294:Attitude to Health / Q000208:ethnology*; D001942:Breast Feeding / Q000208:ethnology / Q000523:psychology*; D002681:China / Q000208:ethnology; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D008296:Malaysia / Q000208:ethnology; D011247:Pregnancy / Q000523:psychology*; D011594:Psychometrics; D015203:Reproducibility of Results; D012846:Singapore; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology*; D055815:Young Adult
keywords: Iowa Infant Feeding Attitude Scale; Singapore; breastfeeding; confirmatory factor analysis; psychometric evaluation