Development and psychometric validation of the fear of physical activity during pregnancy scale.

OBJECTIVE: To develop and evaluate the psychometric properties of the Fear of Physical Activity During Pregnancy Scale (FPAPS) among Chinese pregnant women. DESIGN: A methodological study. METHODS: The study was conducted in three phases. Phase I involved item generation informed by the fear-avoidance model, a literature review, and semi-structured interviews. Phase II refined the item pool through expert consultation and pilot testing. Phase III evaluated the scale in a cross-sectional sample of 507 pregnant women. The sample was divided into two non-overlapping subsamples for item analysis and exploratory factor analysis (n = 230) and confirmatory factor analysis (n = 277). Content validity, structural validity, hypotheses testing for construct validity, internal consistency, two-week test-retest reliability, and floor and ceiling effects were evaluated. RESULTS: The final FPAPS comprised seven items and showed a unidimensional structure. Exploratory factor analysis explained 50.5% of the variance, and a revised confirmatory factor analysis model showed acceptable fit. The S-CVI/Ave for the final scale was 1.000. Average variance extracted was 0.578, composite reliability was 0.900, Cronbach's alpha was 0.863, McDonald's omega was 0.870, and the two-week test-retest intraclass correlation coefficient was 0.706. No floor or ceiling effects were observed. Higher FPAPS scores were associated with lower total physical activity, moderate-intensity activity, vigorous-intensity activity, moderate-to-vigorous physical activity, and exercise/sports activity. Women without pre-pregnancy physical activity habits and primiparous women reported higher FPAPS scores. CONCLUSION: The FPAPS is a brief, pregnancy-specific scale with acceptable initial psychometric properties for assessing fear-related cognitions about physical activity during pregnancy among Chinese pregnant women.