ArticleBMC public health2026
Psychometric validation of the Farsi version of the Attitudes toward Fertility and Childbearing Scale (AFCS) among married and unmarried Iranian women.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAttitudes toward fertility and childbearing play a critical role in reproductive behavior, yet few validated instruments in Iran account for marital status. This study aimed to develop and validate separate, context-specific Farsi versions of the Attitudes toward Fertility and Childbearing Scale (AFCS) for married and unmarried Iranian women.
methodsIn this methodological cross-sectional study, married and unmarried women were recruited and analyzed as two independent groups. The original 27-item scale underwent forward-backward translation, expert review, and qualitative and quantitative content validity assessment using the Content Validity Index and Content Validity Ratio. Items were adapted for unmarried women to reflect future and hypothetical fertility intentions. Reliability was evaluated through internal consistency and test-retest methods and construct validity was examined using exploratory and confirmatory factor analyses for each group. All analyses were performed in R 4.5.0 with a significance level of 0.05.
resultsContent validity indices supported the relevance and clarity of the items, and three items were removed for the unmarried women's version based on expert evaluation. Among married women, the final scale retained 27 items loading on five factors, whereas among unmarried women, a 24-item scale with four factors was identified. Both versions demonstrated acceptable model fit (CFI = 0.946, TLI = 0.938, RMSEA = 0.062), and (CFI = 0.926, TLI = 0.915, RMSEA = 0.070) and high reliability, with Cronbach's alpha values of 0.82 and 0.88 and intraclass correlation coefficients of 0.96 and 0.84 for the married and unmarried versions, respectively.
conclusionsTwo psychometrically sound, context-specific versions of the AFCS were developed for married and unmarried Iranian women. While the underlying factor structure was conceptually similar, differences in item content and the number of items underscore the importance of tailoring the scale to marital status when assessing fertility-related attitudes. This tool provides a culturally sensitive instrument that may support research, policy development, reproductive health interventions, and educational or counseling programs aimed at promoting informed fertility decisions in Iran.
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