Psychometric Testing of an Arabic Version of the Attitude Toward Skin-to-Skin Contact Instrument among Women in Saudi Arabia: A Cross-Cultural Validation Study.

Abstract

The World Health Organization recommends skin-to-skin contact immediately after birth, yet the practice rate remains low in Saudi Arabia, impacting the health and well-being of mother-baby dyads. No previous studies have explored Saudi women's attitudes toward skin-to-skin contact, a critical factor in developing strategies to increase its adoption. This study aimed to develop and evaluate an instrument to assess attitudes toward skin-to-skin contact among women in Saudi Arabia. An instrument was developed by modifying the validated "Mother-Newborn Skin-to-Skin Contact Questionnaire". Psychometric testing was conducted to validate the instrument through a cross-cultural survey involving 383 participants recruited from two hospitals in Saudi Arabia using a convenience sampling method. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.885, indicating that the sample size was suitable for performing exploratory factor analysis. The overall Cronbach's alpha value was 0.85, reflecting adequate internal consistency of the questionnaire. The criteria of the two-factor confirmatory factor analysis were also met. The majority of women (85.6%) demonstrated a positive attitude towards skin-to-skin contact. A positive correlation was observed between higher educational levels and the total attitude score (r = 0.161, p = 0.002). The developed questionnaire is a reliable tool for measuring attitudes towards skin-to-skin contact among women in Saudi Arabia. The findings highlight the importance of educational interventions to improve the uptake of this practice.