Validity and Reliability of the Malay IOWA Infant Feeding Attitude Scale (IIFAS-M) Among Mothers with Infants in Malaysia

Abstract

Introduction / Background: Maternal knowledge, attitude and practices are factors that can influence infant feeding choices, particularly breastfeeding. Valid and reliable instruments on maternal attitudes towards infant feeding choices in the Malay language are still insufficient for the Malaysian population. Objectives: To translate and validate the Malay version of the IOWA Infant Feeding Attitude Scale (IIFAS). Methodology: Four independent language experts performed forward and backed translation of IIFAS. A cross-sectional study involving 272 mothers with infants below one-year-old was conducted between 8th March 2021 to 6th June 2021 through social media platforms using the final versions of the translated questionnaires. Construct validity, Cronbach’s alpha coefficients and test-retest reliability were calculated. Descriptive analysis and factor analysis were performed. Results: The online questionnaire received a total of 522 responses. Two hundred seventy-two responses fulfilled the inclusion criteria and were analysed. Most of the respondents are Malay women with the mean age is 30 years old and have two children with the youngest’s age is 5-month-old. The validity and reliability measures of the Malay IIFAS were acceptable. Pearson correlation shows all the items to be significant at 0.01. KMO is 0.657, and Bartlett’s test of sphericity is significant at 0.001. Principal component analysis extracted six factors with value ranges from 0.4 to 0.8. The Cronbach’s alpha value for the scale was 0.62 and ranged from 0.2 to 0.6. Test-retest showed good reliability (r = 0.802, p< 0.01). The IIFAS Malay showed acceptable internal consistency reliability. Conclusion: The Malay version of IIFAS is a valid, reliable, and locally accepted questionnaire to assess maternal attitude towards infant feeding in the Malaysian population. However, a locally developed questionnaire may be made in the future to produce a better statistical accepted questionnaire.