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

PLoS One. 2023 Mar 31;18(3):e0283925. doi: 10.1371/journal.pone.0283925. eCollection 2023.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Contraceptive Agents*
  • Counseling*
  • Ethiopia
  • Female
  • Humans
  • Psychometrics
  • Reproducibility of Results
  • Surveys and Questionnaires

Substances

  • Contraceptive Agents

Grants and funding

KH acknowledges funding support from the David & Lucile Packard Foundation (#2018-67680; www.packard.org). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.