DEVELOPMENT AND PSYCHOMETRIC VALIDATION OF A QUESTIONNAIRE ON PREGNANT WOMEN’S INTENTIONS TO USE MULTIPLE MICRONUTRIENT SUPPLEMENTATION (MMS): A CONFIRMATORY FACTOR ANALYSIS

Abstract

Adherence to multiple micronutrient supplementation (MMS) during pregnancy remains challenging, whereas intention is a primary antecedent of health behavior. A theoretically grounded, psychometrically validated instrument is needed to assess pregnant women’s intention to use MMS. The aim is to develop and validate a questionnaire measuring pregnant women’s intention to consume MMS by integrating the health belief model and the theory of planned behavior. Methods: A sequential mixed-methods design was employed. The items were generated from focus group discussions and a literature review and then tested among 216 pregnant women (second trimester). Construct validity was evaluated via confirmatory factor analysis (CFA), and reliability was assessed via Cronbach’s alpha and composite reliability (CR). Convergent and discriminant validity were examined via average variance extracted (AVE) and the Fornell–Larcker criterion. Results: A five-construct model demonstrated marginal yet acceptable fit (χ²/df ≈ 3.278; RMSEA ≈ 0.103). The final scale comprises 17 items: susceptibility (4), severity (2), benefits (3), motivation (5), and intention (3). All factor loadings were significant (≈0.53–0.95). Reliability was adequate (most α and CR ≥ 0.70). The AVE criteria were met for four constructs; severity fell slightly below the threshold but was retained on substantive grounds. The questionnaire has good validity and reliability for measuring the likelihood of using MMS among pregnant women. It is suitable for the early identification of women with low intention, targeted intervention planning, and evaluation of supplementation programs in primary care settings.