Adaptation and validation of the quality of contraceptive counseling (QCC) scale for use in Ethiopia and India

We adapted the Quality of Contraceptive Counseling (QCC) scale, originally constructed in Mexico, for Ethiopia and India to expand its utility for measurement of client experiences with counseling. Scale items were modified based on prior research on women's preferences for counseling in each c...

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Bibliographic Details
Published in:PloS one 2023-03, Vol.18 (3), p.e0283925-e0283925
Main Authors: Holt, Kelsey, Gebrehanna, Ewenat, Sarnaik, Shashi, Kanchan, Lakhwani, Reed, Reiley, Yesuf, Aman, Uttekar, Bella Vasant
Format: Article
Language:English
Subjects:
Adaptation
Biology and Life Sciences
Birth control
Cognitive ability
Consent
Contraceptive Agents
Contraceptives
Correlation analysis
Counseling
Engineering and Technology
Ethiopia
Factor analysis
Family planning
Female
Health counseling
Health facilities
Human rights
Humans
Medical care
Medicine and Health Sciences
Methods
People and Places
Psychometrics
Public health
Quality management
Reproducibility of Results
Social Sciences
Surveys and Questionnaires
Validity
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Summary:We adapted the Quality of Contraceptive Counseling (QCC) scale, originally constructed in Mexico, for Ethiopia and India to expand its utility for measurement of client experiences with counseling. Scale items were modified based on prior research on women's preferences for counseling in each country, and refined through cognitive interviews (n = 20 per country). We tested the items through client exit surveys in Addis Ababa, Ethiopia (n = 599), and Vadodara, India (n = 313). Psychometric analyses revealed the adapted scales were valid and reliable for use, and the final scales retained content validity according to the original published QCC construct definition. Specifically, confirmatory factor analysis revealed high factor loadings for almost all items on the original dimensions: Information Exchange, Interpersonal Relationship, Disrespect and Abuse. Internal consistency reliability was high in both settings (Alpha = 0.92 for QCC-Ethiopia and 0.74 for QCC-India). Final item pools contained 26 items in the QCC-Ethiopia Scale and 23 in the QCC-India Scale. Correlation analyses established convergent validity. QCC Scales and subscales fill a gap in measurement tools for ensuring high quality of care and fulfillment of human rights in contraceptive services, and consistent findings across continents suggest versatility in use across different contexts.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0283925