Development of an Attitudes Measure for Prenatal Screening in Diverse Populations

Background: Prenatal screening for chromosomalabnormalities is routinely offered to allpregnant women who present for care by their20th gestational week. Not all women,however, choose to undergo one of these tests,and choice of which test(s) to undergo alsovary. The reasons for variation in screeningtest behavior have not been fully explored.Methods: We examined the psychometricproperties of scales developed to measurefactors related to prenatal screening usingdata collected as part of a survey of 448racial/ethnically diverse pregnant women. These women were consecutively recruited fromprenatal care clinics when they were betweentheir 12th and 20th week ofpregnancy. The Theory of Reasoned Action wasused to develop to measures of attitudes towardand beliefs about prenatal screening. All itemswere subjected to factor analysis. Scalesidentified in the factor analysis were thensubjected to reliability analysis. Allanalysis was conducted for the entire studygroup as well as separately for eachracial/ethnic group.Results: Six scales emerged: who makes medicaldecisions, fatalism, health care trust, valueof screening, fear of screening and value ofpregnancy. All scales had adequate reliabilitywhen the analysis was conducted for the entirestudy group; however there were differences inreliability across racial/ethnic group.Conclusions: Because of these between groupdifferences comparisons of racial/ethnic groupmay be difficult to interpret and potentiallylead to erroneous conclusions.