Development of an instrument designed to measure manager attitudes toward workplace breastfeeding support

Manager attitudes play a pivotal role in female employees' perceptions of workplace breastfeeding support. However, no instrument exists to measure manager attitudes toward supporting women wishing to combine breastfeeding with employment. The purpose of this study was to develop an instrument designed to measure manager attitudes toward breastfeeding support in the workplace, which would be suitable for piloting with the target population. A modified version of an instrument development process described by Wolfe & Smith (2007) was followed. Five focus groups were conducted to assess attitudes of managers toward breastfeeding in the workplace and the results were used to create subscales and items within each subscale. Survey design and item development was done through an iterative process. Experts' input including researchers (in the field of breastfeeding, work-family balance, organizational behavior, and survey development) and practitioners (with experience in breastfeeding and business) were used to evaluate the instrument through content (n=20) and item's fit (n=17). Additionally, individual cognitive interviews (n=8) were conducted with managers. Results of expert reviews and cognitive interviews determined no additional subscales were needed, but survey items were added, reworded, or eliminated to improve clarity, readability, and organization. The final survey consisted of four subscales and 83 items measured in either dichotomous agree/disagree or four-point Likert rating scale.