Development and Validation of the Agency in Contraceptive Decisions Scale in Uganda and Nigeria.

IF 3.1 3区医学 Q2 DEMOGRAPHY

Studies in Family Planning Pub Date : 2025-09-22 DOI:10.1111/sifp.70033

Sneha Challa,Ushma D Upadhyay,Ronald Wasswa,Sylvia Nanono,Ivan Idiodi,Chioma Okoli,Phoebe Alitubeera,Dinah Amongin,Ayobambo Jegede,Aminat Tijani,Catherine Birabwa,Lynn Atuyambe,Shakede Dimowo,Grace Nmadu,Christine Dehlendorf,Elizabeth Omoluabi,Peter Waiswa,Kelsey Holt

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Abstract

To fill a gap in measures of empowered contraceptive decision-making, we developed the Agency in Contraceptive Decisions Scale in Uganda and Nigeria. We developed an item pool drawing on the previously published Contraceptive Agency framework. We refined items through cognitive interviews (N = 80) and expert feedback and piloted a reduced item pool via surveys (N = 3002). Exploratory factor analysis using a random half of the sample suggested a 15-item scale (Cronbach's α = 0.8) including four subscales: (1) Beliefs about Rights and Perceived Decision-making Control (α = 0.8), (2) Decision-making Self-efficacy (α = 0.8), (3) Knowledge Aligned with Preferences (α = 0.8), and (4) Control over Use or Non-use (α = 0.8). Confirmatory factor analysis with the other half of the sample supported this solution. Agency in Contraceptive Decisions Scale scores were significantly associated with scores on the contraceptive existence of choice and contraceptive exercise of choice subscales of the Women's and Girls Empowerment in Sexual and Reproductive Health Index, supporting construct validity. The 15-item Agency in Contraceptive Decisions Scale and individual subscales are valid and reliable for use in Nigeria and Uganda. This measure offers an innovative alternative for gauging the success of contraceptive programs and policies in advancing the right to empowered choices.

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制定和验证乌干达和尼日利亚机构避孕决定量表。

为了填补在避孕决策授权措施方面的空白，我们在乌干达和尼日利亚制定了避孕决策机构量表。我们根据以前公布的避孕机构框架制定了一个项目库。我们通过认知访谈（N = 80）和专家反馈来改进项目，并通过调查（N = 3002）试点减少项目池。随机抽取一半样本进行探索性因子分析，得出15项量表（Cronbach's α = 0.8），包括4个子量表：(1)权利信念与感知决策控制（α = 0.8），(2)决策自我效能（α = 0.8），(3)知识与偏好一致（α = 0.8），(4)使用或不使用控制（α = 0.8）。对另一半样品的验证性因子分析支持该解决方案。避孕决策机构量表得分与妇女和女童性健康和生殖健康赋权指数的避孕选择存在和避孕选择行使分量表得分显著相关，支持结构效度。15项避孕决定机构量表和个别子量表在尼日利亚和乌干达使用是有效和可靠的。这一措施为衡量避孕规划和政策在促进自主选择权方面的成功与否提供了一种创新的替代方法。

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来源期刊

Studies in Family Planning Multiple-

CiteScore

4.00

自引率

9.50%

发文量

期刊介绍： Studies in Family Planning publishes public health, social science, and biomedical research concerning sexual and reproductive health, fertility, and family planning, with a primary focus on developing countries. Each issue contains original research articles, reports, a commentary, book reviews, and a data section with findings for individual countries from the Demographic and Health Surveys.