Assessing Certified Nurse‐Midwives' Attitudes Towards Planned Home Birth
Bibliographic record
Abstract
INTRODUCTION: Certified nurse-midwives (CNMs) and certified midwives (CMs) are prepared for care in many settings and could increase access to planned home birth for American women. However, only 4% of American College of Nurse-Midwives members offer the home as a birth setting. CNMs'/CMs' attitudes towards birth place and the factors underlying their choice of practice site are largely unstudied. This article describes the development, content validation, and psychometric testing of an instrument to assess the attitudes of CNMs towards planned home birth. METHODS: A scale was designed to measure Provider Attitudes to Planned Home Birth (PAPHB). Item generation was informed by literature review and a systematic expert panel appraisal. Reliability and validity of the scale were evaluated with a sample of 1893 CNMs. RESULTS: Expert review indicated high relevancy and clarity of the scale items (scale-content validity index, 0.93). Construct validity was assessed using the Cattell scree test and factor analysis. The resultant 1-factor, attitude scale had strong internal consistency (Cronbach alpha = .94). The average PAPHB scale score among CNMs was 78.77 (range, 20-100; standard deviation, 15.9), with significant differences in attitude scores according to clinical home birth experience, educational background, and external barriers reported by CNMs. DISCUSSION: The PAPHB scale is a reliable and valid instrument for the measurement of attitudes towards home birth. It can be used to assess the impact of education, environment, and clinical experiences on maternity practice choices.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".