International Journal of Environmental Research and Public Health · 11 authors, 8 centres
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This cross-sectional study developed and validated the Breastfeeding Literacy Assessment Instrument (BLAI) for obstetric women, finding it has good psychometric properties with four factors explaining 60.54% of variance. A key limitation is the absence of convergent validity and the use of convenience sampling.
Global exclusive breastfeeding rates are low, and health literacy may influence breastfeeding duration, but generic instruments lack specificity. This study aimed to develop and validate a specific breastfeeding literacy instrument. Methods: The Breastfeeding Literacy Assessment Instrument (BLAI) was designed based on a health literacy model, with content validation by 9 experts. A cross-sectional study was conducted in three Spanish hospitals with 204 women during the postpartum period. Psychometric properties were assessed using exploratory factor analysis and internal consistency measures. Key Results: The BLAI achieved a content validity index of 0.912. Exploratory factor analysis confirmed feasibility with KMO 0.924 and Bartlett's test p ≤ 0.001, explaining 60.54% of variance across four factors: Access, Understand, Appraise, and Apply. Internal consistency was excellent with McDonald's Omega of 0.949 overall. Associations were found between breastfeeding literacy and socioeconomic status, breastfeeding type, and parity. Limitations: The study lacked convergent validity due to no gold standard, used convenience sampling, and requires confirmatory factor analysis. Implications: The BLAI is a valid tool for assessing breastfeeding literacy in perinatal women, but further validation is needed to confirm its structure and explore its relationship with breastfeeding outcomes.
