Background. Exclusive breastfeeding plays a critical role in promoting infant growth and reducing morbidity; however, adherence to it remains below desirable levels. Misconceptions regarding milk insufficiency, colostrum, and early supplementation, often shaped by cultural norms and traditional family structures, are major barriers to initiating and maintaining exclusive breastfeeding. Given the limitations of existing instruments, this study aimed to design and psychometrically evaluate a culturally adapted questionnaire for assessing misconceptions about exclusive breastfeeding among pregnant women. Methods. This methodological cross-sectional study was conducted in 2021 on 225 pregnant women attending prenatal clinics at Al-Zahra and Taleghani hospitals in Tabriz. The initial questionnaire included 30 items. Content validity was assessed by a panel of 10 experts in pediatrics and social medicine using the Content Validity Ratio (CVR) and Content Validity Index (CVI). Reliability was evaluated using Cronbach’s alpha coefficient and test-retest stability (Intraclass Correlation Coefficient, ICC). Data were analyzed using SPSS version 21.0. Results. All items achieved acceptable values above the cut-off points for CVR (0.62) and CVI (0.79) and were retained in the final version. Cronbach’s alpha coefficient for the entire questionnaire was 0.868, indicating good internal consistency. The ICC was 0.895 (95% CI: 0.867–0.923; P<0.001), demonstrating excellent test-retest reliability. Conclusion. The developed questionnaire is a valid and reliable indigenous tool for assessing misconceptions about exclusive breastfeeding among Iranian pregnant women. It can be utilized in future research, clinical screening, and maternal and child health education programs. Practical Implications. This tool can identify pregnant women with stronger misconceptions and facilitate the design of tailored educational and counseling interventions. Furthermore, it can guide policymakers in refining breastfeeding promotion programs and improving exclusive breastfeeding rates.
Babapour et al. (Sun,) studied this question.