(P27-014-25) Reliability of the BEliefs in Breastfeeding Empowerment Scale in Measuring Breastfeeding Perceptions

Objectives: Significant breastfeeding disparities among low-income families and underrepresented races and ethnicities highlight the need for tools to assess the impact of breastfeeding beliefs. This study examined the construct validity and reliability of the novel BEliefs in Breastfeeding Empowerment (BEBE) scale and explores differences in reliability among underrepresented races and ethnicities.

Methods: The BEBE scale consists of 6 benefit and 5 barrier belief statements asked in prenatal interviews with 2,645 WIC Infant Toddler Feeding Practices Study 2 participants. Participants were characterized as Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic (NH) White, NH Black, and NH Other. Survey responses were scored using a 5-point Likert scale and aggregated for a total BEBE score (range 11-55) with higher scores representing more positive beliefs. An exploratory factor analysis using maximum likelihood extraction and Promax rotation examined the factor structure of the 11-item BEBE scale. Cronbach’s coefficient alpha was calculated to assess internal consistency of the identified factors.

Results: Exploratory factor analysis revealed that scale items were strongly associated with two distinct factors: breastfeeding benefits and breastfeeding barriers. Factor 1 statements (benefits) included items like ‘breastfeeding is healthier’ and ‘reduces disease’, while factor 2 (barriers) included items like ‘breastfeeding ties you down’ and ‘takes too much time’. Cronbach’s alpha for the full BEBE scale indicated moderate internal consistency (α=0.68), with somewhat lower reliability for the barrier subscale (α=0.61) and higher reliability for the benefit subscale (α=0.74). The full BEBE scale also showed similar reliability across all racial, ethnic, and language groups (α= 0.62-0.70).

Conclusions: Results suggest the BEBE scale is a potential instrument for measuring prenatal breastfeeding beliefs among low-income women. Similar reliability across underrepresented races and ethnicities suggests that the BEBE scale may effectively capture differences in breastfeeding beliefs. Further studies should be conducted to validate the scale in broader contexts.

Funding Sources: University of California Office of the President Historically Black Colleges and Universities Fellowship