Assessing Fertility Knowledge: Development and Validation of the Male and Female Fertility Knowledge Inventories

Abstract

Infertility and involuntary childlessness remain global public health issues. Previous research reveals poor understandings of fertility. Health behaviour change interventions, such as those based on the Information-Motivation-Behavioural Skills Model, state that information is a prerequisite to health behaviour change, yet previous measurement of fertility knowledge is poor, with limitations in construct operationalisation, item generation, and theoretical and psychometric analysis. Moreover, scales do not differentiate between male and female infertility risks. This research aimed to develop two psychometrically sound scales specific to measuring knowledge about male and female fertility using Classical Test Theory and established scale development protocol. A three-stage approach was adopted, where analysis and refinement of scale items occurred sequentially in three groups including fertility health professionals (n=8), laypeople (n=13), and people of reproductive age (n=226). From the original 36 items in each item pool, following data analysis, results yielded a 14-item, three-factor solution for the Male Fertility Knowledge Inventory (MFKI) and a 15-item, four-factor solution Female Fertility Knowledge Inventory (FFKI). The MFKI and FFKI had acceptable internal consistency (𝛼 = .78, 𝛼 = .77, respectively) and partial support for concurrent validity. Convergent and divergent validity were not supported; future research should determine constructs that are appropriate to further validate these scales. While the scales may undergo further refinement in the future, their development allows researchers to measure knowledge of male and female fertility separately and to determine their importance in fertility decision-making. The scales may be used in clinical practice as screening tools to identify people at risk of infertility and involuntary childlessness.