Development and Initial Psychometric Evaluation of the Infant Oral Care Knowledge, Attitudes and Intended Practices (Iockap) Tool Among Pregnant Women: A Cross-Sectional Study

Abstract Background. Valid and concise instruments are needed to identify pregnant women’s educational needs regarding infant oral care. This study aimed to develop and conduct an initial psychometric evaluation of the Infant Oral Care Knowledge, Attitudes, and Intended Practices (IOCKAP) tool among pregnant women attending primary care in Mexico. Methods . A pool of 26 items was generated from previously published instruments, clinical recommendations, oral health policies, and conceptual models. Following expert assessment of face and content validity, a cross-sectional psychometric evaluation was conducted among 204 pregnant women aged 18–45 years attending a primary care facility in León, Guanajuato, Mexico. Item response characteristics and discriminatory ability were analyzed. The internal structure was examined using principal component analysis with Varimax rotation and Kaiser normalization, specifying a three-component solution corresponding to the theoretically defined Knowledge, Attitudes, and Intended Practices domains. Internal consistency was assessed using Cronbach’s alpha. Results. The final IOCKAP tool comprised 15 items: six Knowledge, five Attitudes, and four Intended Practices items. The content validity index was 0.89. The data were suitable for principal component analysis (KMO = 0.760; Bartlett’s test: χ²(105) = 811.66, p < 0.001). The three-component solution explained 50.64% of the total variance, with rotated component loadings ranging from 0.46 to 0.81. Cronbach’s alpha was 0.82 for the overall tool and 0.70, 0.73, and 0.82 for Knowledge, Attitudes, and Intended Practices, respectively. Conclusions. The IOCKAP showed evidence of content validity, an interpretable three-component internal structure, and acceptable internal consistency in this sample of pregnant women. The tool may be useful for identifying educational needs regarding infant oral care; however, external validation and assessment of temporal stability and predictive validity are warranted before broader application.