Dual psychometric evaluation of measures assessing attitudes toward prenatal alcohol exposure and fetal alcohol spectrum disorder.

backgroundUninformed attitudes toward prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorder (FASD) remain barriers in the assessment and diagnosis of affected individuals. While there is a growing need to evaluate the attitudes of professionals who work closely with pregnant individuals and those living with FASD, it is currently unknown whether existing psychometric tools, quantifying such attitudes, are reliable. The psychometric properties of two measures were therefore investigated: the "Alcohol and Pregnancy Measure" (capturing attitudes toward PAE) and the "Knowledge and Attitudes Regarding FASD Measure" (capturing attitudes toward FASD).

methodsA total of 1797 healthcare workers, recruited largely from the National Health Service in Scotland, completed both psychometric measures as part of a nationwide survey of attitudes. Participants also completed novel measurements of their knowledge of FASD and their attitudes toward the health advice for pregnant women regarding alcohol use during pregnancy.

resultsSupport for the psychometric validity of the two measures was partially observed. Both measures were found to have multifactor structures, instead of the hypothesised one-factor solutions. Such multifactor structures demonstrated goodness-of-fit in confirmatory factor analyses. Moreover, both measures showed convergent validity with both knowledge of FASD and attitudes toward current health advice regarding PAE. Both the measures' sensitivity to ceiling effects and poor subfactor internal consistencies, however, remain a concern.

conclusionResults indicate that both measures, when used at the total-scale level, can acceptably assess attitudes toward PAE and FASD. Revisions are required at the item-level to further improve subfactor internal consistency and minimize ceiling effect likelihood.