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

Manager attitudes play a pivotal role in female employees' perceptions of breastfeeding support in the workplace. However, no instrument exists to assess manager attitudes toward supporting women wishing to combine breastfeeding with work. The objective of this study was to develop and pilot an instrument that measured manager attitudes toward workplace breastfeeding support. A modified version of an instrument development process was followed. Five focus groups were conducted to assess attitudes of managers on workplace breastfeeding and results were used to create subscales and items within each subscale. Survey design and item development was done iteratively. Experts' input was used to evaluate the instrument through content (n=20) and item fit (n=17). Individual cognitive interviews (n=8) were conducted with managers to ensure the appropriateness of the wording of each item. The resulting survey consisted of 4 subscales with 60 items measured in either dichotomous agree/disagree or four-point Likert rating scale. The instrument development processes demonstrated that the subscales and items sufficiently reflect manager attitudes toward supporting breastfeeding in the workplace. Therefore, this instrument is suitable for piloting with a sample of managers to assess its validity as a measure of manager attitudes toward workplace breastfeeding support.