The Development and Psychometric Testing of the Supportive Needs of Adolescents Breastfeeding Scale

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Aim. To report the development and psychometric testing of the Supportive Needs of Adolescents Breastfeeding Scale.

Background. Nurses worldwide can influence adolescent mothers' decisions to initiate and continue breastfeeding through understanding their social support needs in the early postpartum. Review of the literature reveals a lack of instruments that measure adolescents' perceptions of supportive nursing behaviours when initiating breastfeeding.

Method. An instrument development and psychometric evaluation study was conducted. In phase 1, scale items were developed from the literature using social support theory. Eight lactation consultants evaluated the scale's content validity in phase 2. During phase 3, the psychometric properties of the scale were tested using item analysis, scale reliability, and exploratory factor analysis. A convenience sample of 101 adolescents, aged 15–20 years old, was recruited during their postpartum stay at three hospitals in the USA between July 2009–July 2010.

Results. Content validity index was 0·82. Alpha estimate of internal consistency was 0·83. Principal components analysis resulted in a 3 factor scale that explained 48% of the total variance: Practical support, Informational support and Miscellaneous.

Conclusion. The findings suggest evidence of the scale's adequate internal consistency. The factor analysis suggests two clear underlying dimensions of support: instrumental/emotional/appraisal and informational/emotional/appraisal, and a third miscellaneous dimension related to immediate skin-to-skin care and mothers' support persons. Further exploration of the possible global implications of the scale's dimensions is needed.

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This is the peer reviewed version of the following article:

Grassley, J.S.; Spencer, B.S.; & Bryson, D. (2013). The development and psychometric testing of the supportive needs of adolescents breastfeeding scale. Journal of Advanced Nursing, 69(3), 708-716.,

which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.