Attitudes Toward Surrogacy Questionnaire (ATSS)

Abstract

The Attitudes Toward Surrogacy Survey (ATSS) is a newly developed, 14-item psychometric instrument designed to quantify individual differences in attitudes toward surrogacy, with a specific focus on the moderating role of religious beliefs. Initially developed in Turkish by a multidisciplinary team of experts in health sciences, statistics, and Turkish language, the ATSS is grounded in extensive antecedent literature.

To ensure its cross-cultural applicability and validity in multinational contexts, the questionnaire underwent rigorous Turkish-English and English-Turkish translation and back-translation procedures. The final instrument was successfully administered electronically to a large, diverse sample of adults (aged 18 to 81 years) spanning 11 geographically and religiously distinct countries, including Turkey, India, Iran, Mexico, and Japan. Psychometric evaluation confirmed acceptable internal consistency during both the initial piloting phase and the final 14-item version.

Keywords

Adult Attitudes, Atheism, Attitudes toward Surrogacy, Bioethics, Buddhism, Christianity, Hinduism, Islam, Reproductive Ethics, Cross-Cultural Research, Religious Beliefs, Psychometrics.

Authors

Yıldız, Metin, Felix, Ezomo Ojeiru, Ademiju, Olugbenga, Noibi, Tajudeen Oluwafemi, Gomes, Roseline Florence, Tanimowo, Abraham, Muhammed Tayyeb, Muhammed, Khadka, Ram Bahadur, Rhino, Andrianirina, Yildiz, Rabia, Ramazanzadegan, Kiarash, Yildirim, Mehmet Salih, Solmaz, Ebru, Haylı, Çiğdem Müge, Şengan, Aylin.

Purpose

The primary objective of the Attitudes Toward Surrogacy Survey (ATSS) is to provide a standardized tool for assessing and quantifying individuals’ attitudes concerning surrogacy practices. This assessment is crucial for understanding public and professional opinion regarding modern reproductive technologies.

A key differentiating feature of the ATSS is its design to explicitly examine how these attitudes are shaped by, and vary in relation to, specific religious affiliations and deeply held religious beliefs. The instrument aims to capture the influence of different religious perspectives on the acceptance or rejection of these complex bioethical practices.

Construct

The ATSS measures the psychological construct of Attitudes Toward Surrogacy. This construct is conceptualized as an individual’s evaluative stance—ranging from highly favorable to strongly unfavorable—regarding the ethical, social, and personal acceptability of third-party reproduction.

The scale is uniquely positioned to address issues at the intersection of psychology, bioethics, and religious studies. It captures the variance in attitudes across major global faiths, including Islam, Christianity, Hinduism, Buddhism, and Atheism, making it a critical tool for cross-cultural research in reproductive ethics.

Validity

Specific psychometric data regarding the validity (such as content, criterion, or construct validity) of the Attitudes Toward Surrogacy Survey are not explicitly detailed in the foundational documentation provided. The initial development focused heavily on ensuring content relevance through expert review and cross-cultural translation. Further psychometric research, including confirmatory factor analysis, is recommended to fully establish the structural and external validity of the instrument across diverse cultural contexts.

Reliability

The reliability of the ATSS was assessed primarily through measures of internal consistency, a key indicator of reliability for multi-item scales. The results demonstrated acceptable consistency for the inventory.

• Pilot Study: In the initial pilot phase, the calculated Cronbach’s alpha coefficient was found to be above 0.70.

• Final Version: For the final, refined 14-item questionnaire, the overall **Cronbach’s alpha** was 0.73, indicating acceptable reliability for a newly developed scale intended for diverse populations.

Factor Analysis

Data regarding the underlying factor structure of the Attitudes Toward Surrogacy Survey (ATSS) are not currently available. It is therefore unknown whether the 14 items comprise a single, unidimensional factor measuring overall attitude, or if they load onto multiple sub-factors related to specific dimensions of surrogacy (e.g., ethical concerns, religious permissibility, social acceptance).

Instrument

Test Type: Original Inventory/Questionnaire

Format: The ATSS is a 14-item measure administered electronically. The specific response format (e.g., Likert scale, dichotomous choice) is not specified in the available data.

Language Available: The ATSS is available in both Turkish and English. Its development included rigorous Turkish-English and English-Turkish translations to ensure suitability for multinational research.

Population Group: Human participants, suitable for both males and females.

Age Group: Suitable for adults aged 18 years and older. The initial validation study included respondents ranging widely in age, from 18 to 81 years old.

Population Details: The validation study was uniquely cross-cultural, encompassing 11 countries: Turkey, India, Iran, the Turkish Republic of Northern Cyprus, Madagascar, Nepal, Nigeria, Pakistan, Mexico, England, and Japan. Respondents represented diverse religious faiths, including Muslims, Christians, Hindus, Buddhists, and Atheists.

Test Methodology: The primary psychometric methodology involved assessing internal consistency via Cronbach’s alpha coefficients. The foundational study also employed advanced statistical techniques, including machine learning approaches and artificial neural networks, to analyze the multinational data set.

Keywords

Adult Attitudes, Reproductive Health, Cross-Cultural Psychology, Religious Beliefs, Bioethics, Psychometric Assessment, Surrogacy.

Authors

Author ORCID Identifier: Key ORCID identifiers for contributing authors include:

• Ademiju, Olugbenga: http://orcid.org/0000-0002-4755-4911

• Noibi, Tajudeen Oluwafemi: http://orcid.org/0000-0002-7175-4120

• Tanimowo, Abraham: http://orcid.org/0000-0002-4089-4729

• Rhino, Andrianirina: http://orcid.org/0000-0002-8670-9648

• Solmaz, Ebru: http://orcid.org/0000-0003-1962-8669

Affiliation Email addresses:

• Yıldız, Metin (Sakarya University): [email protected]

• Felix, Ezomo Ojeiru (Tottori University): [email protected]

• Gomes, Roseline Florence (Jyoti Nivas College): [email protected]

Correspondence Address: Correspondence regarding the ATSS should be directed to the corresponding author, Metin Yıldız, via email at [email protected].

Permissions & Fee and Test Year

Permissions: To obtain authorization or permissions for using the Attitudes Toward Surrogacy Survey (ATSS) in research or clinical settings, users must directly contact the corresponding author, Metin Yıldız, at [email protected].

Fee: There is no fee associated with the use of the ATSS instrument.

Test Year: The Attitudes Toward Surrogacy Survey (ATSS) was developed and initially published in 2023.

Reference’s

Yıldız, M., Felix, E. O., Ademiju, O., Noibi, T. O., Gomes, R. F., Tanimowo, A., Tayyeb, M., Khadka, R. B., Rhino, A., Yildiz, R., Ramazanzadegan, K., Yildirim, M. S., Solmaz, E., Haylı, Ç. M., & Şengan, A. (2023). Attitudes of different religions toward surrogacy: Analysis of 11 countries’ situation using machine learning approach and artificial neural networks. Journal of Religion and Health, 62(5), 3230–3251. doi:10.1007/s10943-023-01782-y

Items of the Attitudes Toward Surrogacy Questionnaire (ATSS)

The Attitudes Toward Surrogacy Survey (ATSS) consists of a final selection of 14 items. No specific details about the content or phrasing of these 14 items are provided in the available information.