Peer-reviewed article
Assessing the Reliability and Validity of Attitudes and Confidence Scales for the Care of Women and Girls Affected by Female Genital Mutilation/Cutting
Marea CX, Warren N, Glass N, Johnson-Agbakwu C, Perrin N ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study developed and validated two measurement scales to assess healthcare provider attitudes toward female genital mutilation/cutting (FGM/C) and their confidence in providing clinical care to affected women and girls. The researchers tested these scales with healthcare providers in Arizona and Maryland. The attitudes scale measures both negative attitudes and empathetic attitudes toward FGM/C, while the confidence scale measures clinical care skills and communication abilities. These validated instruments can help identify provider training needs and improve quality of care for affected populations in the USA.
Key points
- Approximately 545,000 women and girls in the USA have undergone FGM/C or have mothers from countries where it is practiced
- The Attitudes scale has two factors: Negative Attitudes (Cronbach's alpha 0.814) and Empathetic Attitudes (Cronbach's alpha 0.628)
- The Confidence scale has two factors: Confidence in Clinical FGM/C Care (Cronbach's alpha 0.857) and Confidence in Critical Communication Skills (Cronbach's alpha 0.694)
- Healthcare provider attitudes and confidence may affect quality of care and health outcomes for women and girls with FGM/C
- No validated instruments for measuring provider attitudes and confidence toward FGM/C care existed prior to this study
Limitations
This study developed and validated measurement instruments but did not evaluate whether using these scales to identify and address provider gaps actually improves health outcomes for affected women and girls. The study used a convenience sample from two US states, which may not represent all healthcare providers or settings.
Abstract
Abstract Background: Approximately 545,000 women and girls in the USA have undergone Female Genital Mutilation/ Cutting (FGM/C) or have mothers from a country where FGM/C is practiced. Women and girls living with FGM/C in the USA may experience stigma and bias due to their FGM/C, immigration, racial, and language status. Health care provider attitudes toward FGM/C and confidence for related clinical care may affect the quality of care, yet there are no validated instruments. Methods: We developed the instruments via review of the FGM/C literature, the development of scale items, expert review, and pre-testing. We validated the instruments using a convenience sample of providers in Arizona and Maryland. We used exploratory factor analysis (EFA) to confirm factor structures, and compared scores between known groups to assess validity.Results: The EFA revealed a two-factor solution for attitudes, including subscales for Negative Attitudes and Empathetic Attitudes toward FGM/C and those who practice with Cronbach’s alphas of 0.814 and 0.628 respectively. The EFA for confidence revealed a two-factor solution including Confidence in Clinical FGM/C Care and Confidence in Critical Communication Skills for FGM/C Care with Cronbach’s alphas of 0.857 and 0.694 respectively.Conclusions: Health care provider attitudes and confidence toward FGM/C care may affect quality of care and health outcomes for women and girls. Our study describes the rigorous psychometric analysis to create reliable and valid instruments to assess health care provider attitudes and confidence for the care of women and girls who have experienced FGM/C.Trial Registration: Clinical Trials.Gov ID # NCT03249649, Study ID# 5252. Public website: https://clinicaltrials.gov/ct2/show/NCT03249649