Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2015

Open Access 01-12-2015 | Research article

Development of a scale to evaluate midwives’ beliefs about assessing alcohol use during pregnancy

Authors: Rochelle E. Watkins, Janet M. Payne, Tracy Reibel, Heather M. Jones, Amanda Wilkins, Raewyn Mutch, Carol Bower

Published in: BMC Pregnancy and Childbirth | Issue 1/2015

Login to get access

Abstract

Background

Prenatal alcohol exposure is an important modifiable cause of adverse fetal outcomes during and following pregnancy. Midwives are key providers of antenatal care, and it is important to understand the factors which influence their ability to provide appropriate advice and support to women about alcohol use in pregnancy. The main aim of this study was to develop a psychometrically valid scale to evaluate midwives’ beliefs about assessing alcohol use during pregnancy.

Method

A self-administered questionnaire was developed to evaluate midwives’ beliefs about assessing alcohol use during pregnancy, including beliefs about positive and negative consequences of asking about alcohol use, and beliefs about capacity to assess alcohol use. The questionnaire was sent to 245 midwives working for a state-wide country health service in Western Australia. Exploratory factor analysis was used to identify the latent constructs assessed by the 36 belief items and provide initial construct validation of the Asking About Alcohol (AAA) Scale.

Results

Of the 166 (67.8 %) midwives who responded to the survey, 160 (96.4 %) completed one or more of the belief items and were included in this analysis. Factor analysis identified six subscales which assessed beliefs about discomfort, capacity, effectiveness, role, trust and knowledge. Midwives held the most positive beliefs about their capacity to ask and the effectiveness of asking about alcohol use, and the least positive beliefs about women’s knowledge about alcohol use and discomfort associated with asking about alcohol use in pregnancy. Midwives’ beliefs about their role and the effectiveness of asking were most strongly associated with the intention to ask all pregnant women about alcohol use during pregnancy (r = −0.59, p < 0.001 and r = −0.52, p < 0.001).

Conclusions

Our analysis has identified key constructs underlying midwives’ beliefs about the assessment of alcohol use during pregnancy. The AAA Scale provides a basis for improved clarity and consistency in the conceptualisation and measurement of midwives’ beliefs which can be used to enhance our understanding of factors influencing midwives’ ability to deliver interventions to prevent alcohol use during pregnancy. The constructs identified in this exploratory analysis require confirmatory analysis to support their validity and generalizability.
Appendix
Available only for authorised users
Literature
1.
go back to reference Burd L, Roberts D, Olson M, Odendaal H. Ethanol and the placenta: a review. J Matern Fetal Neonatal Med. 2007;20(5):361–75.CrossRefPubMed Burd L, Roberts D, Olson M, Odendaal H. Ethanol and the placenta: a review. J Matern Fetal Neonatal Med. 2007;20(5):361–75.CrossRefPubMed
2.
go back to reference O’Leary CM, Nassar N, Kurinczuk JJ, Bower C. The effect of maternal alcohol consumption on fetal growth and preterm birth. BJOG. 2009;116(3):390–400.CrossRefPubMed O’Leary CM, Nassar N, Kurinczuk JJ, Bower C. The effect of maternal alcohol consumption on fetal growth and preterm birth. BJOG. 2009;116(3):390–400.CrossRefPubMed
3.
go back to reference Bailey BA, Sokol RJ. Prenatal alcohol exposure and miscarriage, stillbirth, preterm delivery, and sudden infant death syndrome. Alcohol Res Health. 2011;34(1):86–91.PubMedPubMedCentral Bailey BA, Sokol RJ. Prenatal alcohol exposure and miscarriage, stillbirth, preterm delivery, and sudden infant death syndrome. Alcohol Res Health. 2011;34(1):86–91.PubMedPubMedCentral
4.
go back to reference O’Leary CM, Nassar N, Kurinczuk JJ, de Klerk N, Geelhoed E, Elliott EJ, et al. Prenatal alcohol exposure and risk of birth defects. Pediatrics. 2010;126(4):e843–50.CrossRefPubMed O’Leary CM, Nassar N, Kurinczuk JJ, de Klerk N, Geelhoed E, Elliott EJ, et al. Prenatal alcohol exposure and risk of birth defects. Pediatrics. 2010;126(4):e843–50.CrossRefPubMed
5.
go back to reference Institute of Medicine. Fetal Alcohol Syndrome: Diagnosis, epidemiology, prevention, and treatment. Washington, DC: National Academy Press; 1996. Institute of Medicine. Fetal Alcohol Syndrome: Diagnosis, epidemiology, prevention, and treatment. Washington, DC: National Academy Press; 1996.
6.
go back to reference May PA, Blankenship J, Marais AS, Gossage JP, Kalberg WO, Joubert B, et al. Maternal alcohol consumption producing fetal alcohol spectrum disorders (FASD): quantity, frequency, and timing of drinking. Drug Alcohol Depend. 2013;133(2):502–12.CrossRefPubMed May PA, Blankenship J, Marais AS, Gossage JP, Kalberg WO, Joubert B, et al. Maternal alcohol consumption producing fetal alcohol spectrum disorders (FASD): quantity, frequency, and timing of drinking. Drug Alcohol Depend. 2013;133(2):502–12.CrossRefPubMed
7.
go back to reference Colvin L, Payne J, Parsons D, Kurinczuk J, Bower C. Alcohol consumption during pregnancy in non-Indigenous West Australian women. Alcohol Clin Exp Res. 2007;31(2):276–84.CrossRefPubMed Colvin L, Payne J, Parsons D, Kurinczuk J, Bower C. Alcohol consumption during pregnancy in non-Indigenous West Australian women. Alcohol Clin Exp Res. 2007;31(2):276–84.CrossRefPubMed
8.
go back to reference Floyd RL, Decoufle P, Hungerford DW. Alcohol use prior to pregnancy recognition. Am J Prev Med. 1999;17:101–7.CrossRefPubMed Floyd RL, Decoufle P, Hungerford DW. Alcohol use prior to pregnancy recognition. Am J Prev Med. 1999;17:101–7.CrossRefPubMed
9.
go back to reference Cameron CM, Davey TM, Kendall E, Wilson A, McClure RJ. Changes in alcohol consumption in pregnant Australian women between 2007 and 2011. Med J Aust. 2013;199(5):355–7.CrossRefPubMed Cameron CM, Davey TM, Kendall E, Wilson A, McClure RJ. Changes in alcohol consumption in pregnant Australian women between 2007 and 2011. Med J Aust. 2013;199(5):355–7.CrossRefPubMed
10.
go back to reference Australian Institute of Health and Welfare. 2010 National Drug Strategy Household Survey Report. Canberra: Australian Institute of Health and Welfare; 2011. Australian Institute of Health and Welfare. 2010 National Drug Strategy Household Survey Report. Canberra: Australian Institute of Health and Welfare; 2011.
11.
go back to reference National Health and Medical Research Council. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. In. Canberra, Australian Capital Territory: Commonwealth of Australia; 2009. National Health and Medical Research Council. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. In. Canberra, Australian Capital Territory: Commonwealth of Australia; 2009.
12.
go back to reference National Health and Medical Research Council. Australian Alcohol Guidelines: Health Risks and Benefits. Canberra: Commonwealth of Australia; 2001. National Health and Medical Research Council. Australian Alcohol Guidelines: Health Risks and Benefits. Canberra: Commonwealth of Australia; 2001.
13.
go back to reference Payne J, France K, Henley N, D’Antoine H, Bartu A, O’Leary C, et al. Changes in health professionals’ knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder. Paediatr Perinat Epidemiol. 2011;25(4):316–27.CrossRefPubMed Payne J, France K, Henley N, D’Antoine H, Bartu A, O’Leary C, et al. Changes in health professionals’ knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder. Paediatr Perinat Epidemiol. 2011;25(4):316–27.CrossRefPubMed
15.
go back to reference France KE, Donovan RJ, Bower C, Elliott EJ, Payne JM, D’Antoine H, et al. Messages that increase women’s intentions to abstain from alcohol during pregnancy: results from quantitative testing of advertising concepts. BMC Public Health. 2014;14:30.CrossRefPubMedPubMedCentral France KE, Donovan RJ, Bower C, Elliott EJ, Payne JM, D’Antoine H, et al. Messages that increase women’s intentions to abstain from alcohol during pregnancy: results from quantitative testing of advertising concepts. BMC Public Health. 2014;14:30.CrossRefPubMedPubMedCentral
16.
go back to reference Royal Australian College of General Practitioners: Guidelines for preventive activities in general practice. 8th edn. Melbourne, Victoria; 2012. Royal Australian College of General Practitioners: Guidelines for preventive activities in general practice. 8th edn. Melbourne, Victoria; 2012.
17.
go back to reference Australian Government Department of Health and Ageing. Clinical practice guidelines: Antenatal care - module 1. Canberra, Australian Capital Territory: Commonwealth of Australia; 2012. Australian Government Department of Health and Ageing. Clinical practice guidelines: Antenatal care - module 1. Canberra, Australian Capital Territory: Commonwealth of Australia; 2012.
18.
go back to reference World Health Organization. Guidelines for the identification and management of substance use and substance use disorders in pregnancy. Geneva: World Health Organization; 2014. World Health Organization. Guidelines for the identification and management of substance use and substance use disorders in pregnancy. Geneva: World Health Organization; 2014.
19.
go back to reference Godin G, Belanger-Gravel A, Eccles M, Grimshaw J. Healthcare professionals’ intentions and behaviours: a systematic review of studies based on social cognitive theories. Implement Sci. 2008;3:36.CrossRefPubMedPubMedCentral Godin G, Belanger-Gravel A, Eccles M, Grimshaw J. Healthcare professionals’ intentions and behaviours: a systematic review of studies based on social cognitive theories. Implement Sci. 2008;3:36.CrossRefPubMedPubMedCentral
20.
go back to reference Glasgow RE, Emmons KM. How can we increase translation of research into practice? Types of evidence needed. Annu Rev Public Health. 2007;28:413–33.CrossRefPubMed Glasgow RE, Emmons KM. How can we increase translation of research into practice? Types of evidence needed. Annu Rev Public Health. 2007;28:413–33.CrossRefPubMed
22.
go back to reference Jones SC, Telenta J, Shorten A, Johnson K. Midwives and pregnant women talk about alcohol: what advice do we give and what do they receive? Midwifery. 2011;27(4):489–96.CrossRefPubMed Jones SC, Telenta J, Shorten A, Johnson K. Midwives and pregnant women talk about alcohol: what advice do we give and what do they receive? Midwifery. 2011;27(4):489–96.CrossRefPubMed
23.
go back to reference Holmqvist M, Nilsen P. Approaches to assessment of alcohol intake during pregnancy in Swedish maternity care--a national-based investigation into midwives’ alcohol-related education, knowledge and practice. Midwifery. 2010;26(4):430–4.CrossRefPubMed Holmqvist M, Nilsen P. Approaches to assessment of alcohol intake during pregnancy in Swedish maternity care--a national-based investigation into midwives’ alcohol-related education, knowledge and practice. Midwifery. 2010;26(4):430–4.CrossRefPubMed
24.
go back to reference Skagerstrom J, Johansson AL, Holmqvist M, Envall EK, Nilsen P. Towards improved alcohol prevention in Swedish antenatal care? Midwifery. 2012;28(3):314–20.CrossRefPubMed Skagerstrom J, Johansson AL, Holmqvist M, Envall EK, Nilsen P. Towards improved alcohol prevention in Swedish antenatal care? Midwifery. 2012;28(3):314–20.CrossRefPubMed
25.
go back to reference Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A, et al. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14(1):26–33.CrossRefPubMedPubMedCentral Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A, et al. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14(1):26–33.CrossRefPubMedPubMedCentral
26.
go back to reference Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50:179–211.CrossRef Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50:179–211.CrossRef
27.
go back to reference Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7:37.CrossRefPubMedPubMedCentral Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7:37.CrossRefPubMedPubMedCentral
28.
go back to reference Lipworth W, Taylor N, Braithwaite J. Can the theoretical domains framework account for the implementation of clinical quality interventions? BMC Health Serv Res. 2013;13:530.CrossRefPubMedPubMedCentral Lipworth W, Taylor N, Braithwaite J. Can the theoretical domains framework account for the implementation of clinical quality interventions? BMC Health Serv Res. 2013;13:530.CrossRefPubMedPubMedCentral
29.
go back to reference Payne J, Elliott E, D’Antoine H, O’Leary C, Mahony A, Haan E, et al. Health professionals’ knowledge, practice and opinions about Fetal Alcohol Syndrome and alcohol consumption in pregnancy. Aust N Z J Public Health. 2005;29(6):558–64.CrossRefPubMed Payne J, Elliott E, D’Antoine H, O’Leary C, Mahony A, Haan E, et al. Health professionals’ knowledge, practice and opinions about Fetal Alcohol Syndrome and alcohol consumption in pregnancy. Aust N Z J Public Health. 2005;29(6):558–64.CrossRefPubMed
30.
go back to reference van der Wulp NY, Hoving C, de Vries H. A qualitative investigation of alcohol use advice during pregnancy: Experiences of Dutch midwives, pregnant women and their partners. Midwifery. 2013;29:e89–98.CrossRefPubMed van der Wulp NY, Hoving C, de Vries H. A qualitative investigation of alcohol use advice during pregnancy: Experiences of Dutch midwives, pregnant women and their partners. Midwifery. 2013;29:e89–98.CrossRefPubMed
32.
go back to reference Hayton JC, Allen DG, Scarpello V. Factor retention decisions in exploratory factor analysis: a tutorial on parallel analysis. Organ Res Methods. 2004;7:191.CrossRef Hayton JC, Allen DG, Scarpello V. Factor retention decisions in exploratory factor analysis: a tutorial on parallel analysis. Organ Res Methods. 2004;7:191.CrossRef
33.
go back to reference Henson RK, Roberts JK. Use of exploratory factor analysis in published research: common errors and some comment on improved practice. Educ Psychol Meas. 2006;66:393.CrossRef Henson RK, Roberts JK. Use of exploratory factor analysis in published research: common errors and some comment on improved practice. Educ Psychol Meas. 2006;66:393.CrossRef
34.
go back to reference Worthington RL, Whittaker TA. Scale development Research: a content analysis and recommendations for best practices. Couns Psychol. 2006;34:806.CrossRef Worthington RL, Whittaker TA. Scale development Research: a content analysis and recommendations for best practices. Couns Psychol. 2006;34:806.CrossRef
35.
go back to reference Kaner EF, Dickinson HO, Beyer F, Pienaar E, Schlesinger C, Campbell F, et al. The effectiveness of brief alcohol interventions in primary care settings: a systematic review. Drug Alcohol Rev. 2009;28(3):301–23.CrossRefPubMed Kaner EF, Dickinson HO, Beyer F, Pienaar E, Schlesinger C, Campbell F, et al. The effectiveness of brief alcohol interventions in primary care settings: a systematic review. Drug Alcohol Rev. 2009;28(3):301–23.CrossRefPubMed
36.
go back to reference MacCallum R, Widaman K, Zhang S, Hong S. Sample size in factor analysis. Psychol Methods. 1999;4:84–99.CrossRef MacCallum R, Widaman K, Zhang S, Hong S. Sample size in factor analysis. Psychol Methods. 1999;4:84–99.CrossRef
37.
go back to reference Mundfrom D, Shaw D, Tian L. Minimum sample size recommendations for conducting factor analyses. Int J Test. 2005;5:159–68.CrossRef Mundfrom D, Shaw D, Tian L. Minimum sample size recommendations for conducting factor analyses. Int J Test. 2005;5:159–68.CrossRef
38.
go back to reference Osborne J, Costello A. Sample size and subject to item ratio in principal components analysis. Prac Assess Res Eval. 2004;9:11. Osborne J, Costello A. Sample size and subject to item ratio in principal components analysis. Prac Assess Res Eval. 2004;9:11.
Metadata
Title
Development of a scale to evaluate midwives’ beliefs about assessing alcohol use during pregnancy
Authors
Rochelle E. Watkins
Janet M. Payne
Tracy Reibel
Heather M. Jones
Amanda Wilkins
Raewyn Mutch
Carol Bower
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2015
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-015-0779-6

Other articles of this Issue 1/2015

BMC Pregnancy and Childbirth 1/2015 Go to the issue