Developing and Psychometric Evaluation of a Reproductive Health Assessment Scale for Married Adolescent Women: An Exploratory Mixed-Method Study

Afrouz Mardi, Abbas Ebadi, Zahra Behboodi , Moghadam, Malek Abazari, Nazila Nezhad-Dadgar, Atefeh Shadman

Abstract


Background: Adolescent women’s reproductive health is often neglected despite the high prevalence of early marriage. Since no appropriate scales were found to assess the health status of adolescent women, this study aimed to develop a reproductive health scale in married adolescent women in Iran and investigate its psychometric properties.

Materials and Methods: An exploratory mixed‑methods study was conducted in Ardabil healthcare centers (Ardabil City, Iran) between May 2017 and December 2018. In the qualitative phase, 14 semi‑structured in‑depth interviews were conducted with married adolescent women, and two focus group discussions were held with 12 key informants. In the quantitative phase, the initial scales were validated using face, content, and construct validities. In a cross‑sectional study among 300 women, Exploratory Factor Analysis (EFA) was used to assess the construct validity. Internal consistency and test‑retest methods were used to review. The initial scale was designed with 45 items, but only 30 items reached the construct validity stage. EFA revealed five factors that explained 50.96% of the variance. Cronbach’s alpha coefficient of 0.75 estimates the reliability of the scale.

Results: The qualitative study identified 76 items that reached 88 items through literature confirmed its reliability, and test‑retest with a two‑week interval confirmed its consistency (ICC = 0.99, p < 0.001). Finally, the scale was approved with 27 items and four domains: sexual, pregnancy and childbirth, psychosocial, and family planning.

Conclusions: This valid and reliable scale with cultural sensitivity can be used to help health professionals to improve the reproductive health of married adolescent women.



Keywords


Adolescent, Iran, psychometrics, reproductive health, scale, women

Full Text:

PDF

References


United Nations Population Fund and United Nations Children’s Fund, ‘Technical Note on Gender Transformative Approaches in the Global Programme to End Child Marriage’, UNFPA and UNICEF, New York, 2019 , [Last accessed on 24 Sep 2020].

Heidari F, Dastgiri S. Prevalence and determinants of child marriage. Razavi Int J Med 2015;3:34 42.

Mabuza MP. Adolescents, Sexual Reproductive Health (SRH) and Equity.Evaluating International Public Health Issues. Springer; 2020. p. 255 63.

Oshrieh Z, Tehranian N, Ebrahimi E, Keramat A, Hassani M, Kharaghani R. Childbearing intention and its associated factors among adolescent girls: A narrative review. Iran J Nurs Midwifery Res 2020;25:7 11.

Mardi A, Ebadi A, Shahbazi S, Moghadam ZB. Factors influencing the use of contraceptives through the lens of teenage women: A qualitative study in Iran. BMC Public Health 2018;18:202.

Sajadi HS, Majdzadeh R. From primary health care to universal health coverage in the Islamic Republic of Iran: A journey of four decades. Arch Iran Med2019;22:262 8.

Mirzaee Njmabadi Kh, Babazadeh R, Shariati M, Mousavi A. Reproductive and sexual health information and services among Iranian adolescent girls: A qualitative study.IJOGI 2015;17:9 18 [In Persian]

Khani S, Moghaddam Banaem L, Mohamadi E, Vedadhir AA, Hajizadeh E.Psychometric properties of the Persian version of the sexual and reproductive healthneeds assessment questionnaire. East Mediterr Health J 2015;21:29 38.

Bam K, Haseen F, Kumar BCR, Newman MS, Chaudhary AH, Thapa R. Perceivedsexual and reproductive health needs and service utilization among highersecondary school students in urban Nepal.Am J Public Health 2015;3:36 45.

Karrobi M. 1041 Iran civil code Tehran Iran. Islamic Parliament Research Center Of The Islamic Republic Of IRAN. 2003. Available from: http://rc.majlis.ir/fa/law/show/99682.

National Organization for Civil Registration. Statistics of vital events Islamic Republicof Iran: Ministry of Interior; 2015 Available from: https://www.sabteahval.ir/Upload/Modules/ Contents/asset99/e g 94.pdf. [Last accessed on 2018 Jul 13].

Ishtiaq M. Book Review Creswell, JW (2014). Research Design: Qualitative, Quantitative and Mixed Methods Approaches. Thousand Oaks, CA: Sage. English Language Teaching 2019;12:40.

Lincoln YS, Lynham SA, Guba EG. Paradigmatic controversies, contradictions, and emerging confluences, revisited. The Sage handbook of qualitative research 2011;4:97 128.

Graneheim UH, Landman B. Qualitative content analysis in nursing research: Consepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004;24:105 12.

Broder HL, McGrath C, Cisneros GJ. Questionnaire development: Face validity and item impact testing of the Child Oral Health Impact Profile. Community Dent Oral Epidemiol 2007;35:8 19.

Ayre C, Scally AJ. Critical values for Lawshe’s content validity ratio: Revisiting the original methods of calculation. MeasEval Couns Dev2014;47:79 86.

Wilson FR, Pan WA, Schumsky DA. Recalculation of the critical values for Lawshe’s content validity ratio. Meas Eval Couns Dev 2012;45:197 210.

Waltz CF, Strickland OL, Lenz ER. Measurement in Nursing and Health Research. Springer Publishing Company; 2010.

Ferguson E, Cox T. Exploratory factor analysis: A users’ guide. Int J Select Assess1993;1:84 94.

Taherdoost H, Sahibuddin S, Jalaliyoon N. Exploratory Factor Analysis; Concepts and Theory', Advances in Applied and Pure Mathematics. Tavakol, M. and Dennick. 2014:53 5.

Grove SK, Burns N, Gray J. The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence. Elsevier Health Sciences; 2012.

Kim H Y. Statistical notes for clinical researchers: Evaluation of measurement error 1: Using intraclass correlation coefficients. RestorDent Endod 2013;38:98 102.

Hall KS, Manu A, Morhe E, Harris LH, Loll D, Ela E, et al. Development and validation of a scale to measure adolescent sexual and reproductive health stigma: Results from young women in Ghana. J Sex Res 2018;55:60 72.

Simbar M, Bostani Khalesi Z, Azin SA.The development and validation of sexual health education needs assessment questionnaire of Iranian engaged couples.GMJ 2017;6:302 11.

Rahmani A, Merghati Khoei E, Moghadam Banaem L, Hajizadeh E, Hamdieh M, Montazeri A. Development and psychometric evaluation of the Premarital Sexual Behavior Assessment Scale for Young Women (PSAS YW): An exploratory mixed method study. ReprodHealth 2014;11:43.


Refbacks

  • There are currently no refbacks.