Adaptation and psychometric assessment of a sexual and reproductive empowerment scale in Arabic among refugee and non-refugee adolescent girls.
Adolescent sexual and reproductive health
Cognitive interviewing
Confirmatory factor analysis
Lebanon
Sexual and reproductive empowerment
Journal
BMC medical research methodology
ISSN: 1471-2288
Titre abrégé: BMC Med Res Methodol
Pays: England
ID NLM: 100968545
Informations de publication
Date de publication:
12 Sep 2024
12 Sep 2024
Historique:
received:
28
07
2023
accepted:
25
07
2024
medline:
13
9
2024
pubmed:
13
9
2024
entrez:
12
9
2024
Statut:
epublish
Résumé
Sexual and reproductive empowerment (SRE) is an important determinant of women's and girls' health yet measuring it is complex due to cultural and domain-specific variations. This study describes the process of adapting an SRE scale consisting of four domains (self-efficacy; future orientation; social support; and safety) and testing its psychometric properties among Arabic speaking adolescent girls in Lebanon. An SRE scale developed in a Western context was adapted in four steps: (1) reviewing the scale and selecting culturally appropriate domains for translation to standard Arabic; (2) conducting cognitive interviews with 30 11-17-year-old adolescent girls in Lebanon; (3) administering the scale to 339 refugee adolescent girls who participated in an early marriage intervention; and (4) conducting confirmatory factor analysis (CFA) on the data to assess the scale's psychometric properties. The original model for the 13-item, four-domain adapted scale demonstrated poor fit in CFA. After iteratively removing two items, scale properties were improved, albeit were not optimal. The validity and reliability results for the self-efficacy domain were acceptable. Cognitive interview data revealed that Arab adolescent girls understood self-efficacy in relational terms, recognizing that autonomous decision-making is not necessarily favored but is influenced by parents and family. This study presents an effort to customize an SRE scale for use in studies on the health of adolescent girls in an Arab cultural context. Findings from cognitive interviews highlight the importance of taking into consideration relationality in adolescent sexual and reproductive decision-making. The self-efficacy domain in the adapted scale demonstrates acceptable psychometric properties and is recommended for use in health studies to capture SRE.
Sections du résumé
BACKGROUND
BACKGROUND
Sexual and reproductive empowerment (SRE) is an important determinant of women's and girls' health yet measuring it is complex due to cultural and domain-specific variations. This study describes the process of adapting an SRE scale consisting of four domains (self-efficacy; future orientation; social support; and safety) and testing its psychometric properties among Arabic speaking adolescent girls in Lebanon.
METHODS
METHODS
An SRE scale developed in a Western context was adapted in four steps: (1) reviewing the scale and selecting culturally appropriate domains for translation to standard Arabic; (2) conducting cognitive interviews with 30 11-17-year-old adolescent girls in Lebanon; (3) administering the scale to 339 refugee adolescent girls who participated in an early marriage intervention; and (4) conducting confirmatory factor analysis (CFA) on the data to assess the scale's psychometric properties.
RESULTS
RESULTS
The original model for the 13-item, four-domain adapted scale demonstrated poor fit in CFA. After iteratively removing two items, scale properties were improved, albeit were not optimal. The validity and reliability results for the self-efficacy domain were acceptable. Cognitive interview data revealed that Arab adolescent girls understood self-efficacy in relational terms, recognizing that autonomous decision-making is not necessarily favored but is influenced by parents and family.
CONCLUSIONS
CONCLUSIONS
This study presents an effort to customize an SRE scale for use in studies on the health of adolescent girls in an Arab cultural context. Findings from cognitive interviews highlight the importance of taking into consideration relationality in adolescent sexual and reproductive decision-making. The self-efficacy domain in the adapted scale demonstrates acceptable psychometric properties and is recommended for use in health studies to capture SRE.
Identifiants
pubmed: 39266993
doi: 10.1186/s12874-024-02300-8
pii: 10.1186/s12874-024-02300-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
202Subventions
Organisme : International Development Research Centre
ID : 108673
Informations de copyright
© 2024. The Author(s).
Références
UN Women. In focus: sustainable Development Goal 5. Achieving gender equality and empowering all women and girls. 2022, August 24.
Kabeer N. Resources, agency, achievements: reflections on the measurement of women’s empowerment. Dev Change. 1999;30(3):435–64.
doi: 10.1111/1467-7660.00125
Van Eerdewijk A, Wong F, Vaast C, Newton J, Tyszler M, Pennington A. White paper: A conceptual model on women and girls’ empowerment. 2017.
Kabeer N. Conflicts over credit: re-evaluating the empowerment potential of loans to women in rural Bangladesh. World Dev. 2001;29(1):63–84.
doi: 10.1016/S0305-750X(00)00081-4
Malhotra A, Schuler SR. Women’s empowerment as a variable in international development. Measuring empowerment: Cross-disciplinary perspectives. 2005;1(1):71–88.
Sen G, Mukherjee A. No empowerment without rights, no rights without politics: Gender-equality, MDGs and the post-2015 development agenda. J Hum Dev Capabilities. 2014;15(2–3):188–202.
doi: 10.1080/19452829.2014.884057
Desai S, Chen F, Reddy S, McLaughlin A. Measuring women’s empowerment in the Global South. Ann Rev Sociol. 2022;48:507–27.
doi: 10.1146/annurev-soc-030420-015018
Pratley P. Associations between quantitative measures of women’s empowerment and access to care and health status for mothers and their children: a systematic review of evidence from the developing world. Soc Sci Med. 2016;169:119–31.
doi: 10.1016/j.socscimed.2016.08.001
pubmed: 27716549
Upadhyay UD, Danza PY, Neilands TB, Gipson JD, Brindis CD, Hindin MJ, et al. Development and validation of the sexual and reproductive empowerment scale for adolescents and young adults. J Adolesc Health. 2021;68(1):86–94.
doi: 10.1016/j.jadohealth.2020.05.031
pubmed: 32690468
Yount KM, VanderEnde KE, Dodell S, Cheong YF. Measurement of women’s agency in Egypt: a national validation study. Soc Indic Res. 2016;128:1171–92.
doi: 10.1007/s11205-015-1074-7
pubmed: 27597801
Samari G. Women’s empowerment and short-and long-acting contraceptive method use in Egypt. Cult Health Sex. 2018;20(4):458–73.
doi: 10.1080/13691058.2017.1356938
pubmed: 28786755
Anik AI, Ghose B, Rahman MM. Relationship between maternal healthcare utilisation and empowerment among women in Bangladesh: evidence from a nationally representative cross-sectional study. BMJ open. 2021;11(8):e049167.
doi: 10.1136/bmjopen-2021-049167
pubmed: 34389576
pmcid: 8365820
Mahmood S. Feminist theory, agency, and the liberatory subject: some reflections on the islamic revival in Egypt. Temenos-Nordic J Comp Relig. 2006;42(1).
El Feki S. The arab bed spring? Sexual rights in troubled times across the Middle East and North Africa. Reprod Health Matters. 2015;23(46):38–44.
doi: 10.1016/j.rhm.2015.11.010
pubmed: 26718995
Gackle L. The adolescent female voice characteristics of change and stages of development. Choral J. 1991;31(8):17.
Woog V, Kågesten A. The sexual and reproductive health needs of very young adolescents aged 10–14 in developing countries: what does the evidence show? 2017.
Koenig LR, Li M, Zimmerman LA, Kayembe P, Lou C, Mafuta E, et al. Associations between agency and sexual and reproductive health communication in early adolescence: a cross-cultural, cross-sectional study. J Adolesc Health. 2020;67(3):416–24.
doi: 10.1016/j.jadohealth.2020.02.026
pubmed: 32331930
pmcid: 7456790
Vizheh M, Muhidin S, Behboodi Moghadam Z, Zareiyan A. Women empowerment in reproductive health: a systematic review of measurement properties. BMC Womens Health. 2021;21(1):1–13.
doi: 10.1186/s12905-021-01566-0
Pulerwitz J, Mathur S, Woznica D. How empowered are girls/young women in their sexual relationships? Relationship power, HIV risk, and partner violence in Kenya. PLoS ONE. 2018;13(7):e0199733.
doi: 10.1371/journal.pone.0199733
pubmed: 30024908
pmcid: 6053148
Closson K, Dietrich JJ, Beksinska M, Gibbs A, Hornschuh S, Smith T, et al. Measuring sexual relationship power equity among young women and young men South Africa: implications for gender-transformative programming. PLoS ONE. 2019;14(9):e0221554.
doi: 10.1371/journal.pone.0221554
pubmed: 31553723
pmcid: 6760831
Crandall A, Rahim H, Yount K. Validation of the general self-efficacy scale among Qatari young women. East Mediterr Health J. 2015;21(12):891–6.
doi: 10.26719/2015.21.12.891
El Ayoubi LEL, Abdulrahim S, Sieverding M. Sexual and reproductive health information and experiences among Syrian refugee adolescent girls in Lebanon. Qual Health Res. 2021;31(5):983–98.
doi: 10.1177/1049732321989685
pubmed: 33733937
Ghandour R, Hammoudeh W, Giacaman R, Holmboe-Ottesen G, Fjeld HE. Coming of age: a qualitative study of adolescent girls’ menstrual preparedness in Palestinian refugee camps in the West Bank and Jordan. Sex Reproductive Health Matters. 2022;30(1):2111793.
doi: 10.1080/26410397.2022.2111793
Othman A, Shaheen A, Otoum M, Aldiqs M, Hamad I, Dabobe M, et al. Parent–child communication about sexual and reproductive health: perspectives of Jordanian and Syrian parents. Sex Reproductive Health Matters. 2020;28(1):1758444.
doi: 10.1080/26410397.2020.1758444
Sieverding M, Bteddini D, Mourtada R, Al Ayoubi L, Hassan O, Ahmad A et al. Design and implementation of the amenah early marriage pilot intervention among Syrian refugees in Lebanon. Global Health: Sci Pract. 2022;10(1).
Keith T, Hyslop F, Richmond R. A systematic review of interventions to reduce gender-based violence among women and girls in sub-saharan Africa. Trauma Violence Abuse. 2023;24(3):1443–64.
doi: 10.1177/15248380211068136
pubmed: 35057674
Lee-Rife S, Malhotra A, Warner A, Glinski AM. What works to prevent child marriage: a review of the evidence. Stud Fam Plann. 2012;43(4):287–303.
doi: 10.1111/j.1728-4465.2012.00327.x
pubmed: 23239248
Upadhyay UD, Lipkovich H. Using online technologies to improve diversity and inclusion in cognitive interviews with young people. BMC Med Res Methodol. 2020;20:1–10.
doi: 10.1186/s12874-020-01024-9
Willis GB. Cognitive interviewing: a how to guide. Research Triangle Park, NC: Research Triangle Institute; 1999.
Muthén BO, du Toit S, Spisic D. Robust inference using weighted least squares and quadratic estimating equations in latent variable modeling with categorical and continuous outcomes. Unpublished Manuscr. 1997.
Brown TA. Confirmatory factor analysis for applied research. Guilford; 2015.
Xia Y, Yang Y, RMSEA, CFI. TLI in structural equation modeling with ordered categorical data: the story they tell depends on the estimation methods. Behav Res Methods. 2019;51:409–28.
doi: 10.3758/s13428-018-1055-2
pubmed: 29869222
Brown TA, Moore MT. Confirmatory factor analysis2012. (pp. 361 – 79) p.
Cortina JM. What is coefficient alpha? An examination of theory and applications. J Appl Psychol. 1993;78(1):98.
doi: 10.1037/0021-9010.78.1.98
Rosseel Y. Lavaan: an R package for structural equation modeling. J Stat Softw. 2012;48:1–36.
doi: 10.18637/jss.v048.i02
Bandura A. Exercise of human agency through collective efficacy. Curr Dir Psychol Sci. 2000;9(3):75–8.
doi: 10.1111/1467-8721.00064
Joseph S. Gender and relationality among arab families in Lebanon. Feminist Stud. 1993;19(3):465–86.
doi: 10.2307/3178097
Zia Y, Upadhyay U, Rhew I, Kimanthi S, Congo O, Onono M, et al. Confirmatory Factor Analysis and validation of the sexual and Reproductive empowerment scale for adolescents and young adults in Kenya. Studies in Family Planning; 2024.
Dwairy M, Achoui M, Abouserie R, Farah A. Adolescent-family connectedness among arabs: a second cross-regional research study. J Cross-Cult Psychol. 2006;37(3):248–61.
doi: 10.1177/0022022106286923