To our knowledge, our study is the first to evaluate the usefulness of the ATI for assessing the impact of spectacle treatment on younger children (<3 years) and their families. We conducted an EFA to determine the reliability, validity, and underlying factors measured with the ATI in our sample and identified three factors. Two factors had several items in common with factors identified in previous studies of older children prescribed patching or atropine treatments: “Adverse Effects of Treatment” (present analysis, items 2, 3, 4, 7, 8, 18; Holmes et al.,
16 2, 3, 4, 7, 8, 9, 13, 16), and “Treatment Compliance” (present analysis, 1, 10, 12, 17, 19; Holmes et al.,
16 1, 5, 6, 10, 12). Both factors had strong internal consistency reliability as measured by Cronbach's Standardized α. Our third factor, “Perceived Benefit of Treatment” had lower internal consistency reliability and had no item overlap with the third factor, “Social Stigma,” identified in previous ATI factor analyses (present analysis, 9, 15; Holmes et al.,
16 11, 14, 18). It is possible that “Social Stigma” is not a significant concern for parents of young children prescribed spectacles. Few parents responded that they “agree” or “strongly agree” with ATI items 14 (other children stare at my child; 9.1%) and 18 (worry that my child feels different; 2.6%;
Table 2). Similarly, a previous study also found that negative comments on spectacle wear from others were rare for younger children.
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