DESCRIPTION OF TOPIC:
Background: Preconception care (PCC) plays a crucial role in improving maternal and child health outcomes. However, validated tools to assess attitudes toward PCC remain limited, particularly in non-Western contexts. This study aimed to develop and validate a scale for measuring women’s attitudes toward PCC in Japan. Objectives: To examine the factorial structure of a newly developed PCC attitude scale using a nationally representative sample. Methods: A cross-sectional survey was conducted among 1,700 women aged 18–49 across Japan in 2024. Based on existing literature and prior qualitative studies, 24 items were constructed to assess attitudes toward PCC. Exploratory factor analysis (EFA) using the maximum likelihood method with promax rotation was performed. The number of factors was determined by eigenvalues, scree plot, and conceptual coherence. Results: The EFA identified six factors explaining 62.5% of the total variance: (1) Health literacy and appropriate use of health services, (2) Safe living environment, (3) Stress coping, (4) Healthy body weight, (5) Balanced diet, and (6) Vaccination. This six-factor model aligned well with the conceptual domains of PCC. The model demonstrated acceptable conceptual coherence; evaluation of internal consistency is ongoing. Conclusions: This newly developed scale provides a promising tool for assessing women’s perspectives on preconception health. It may contribute to the design and evaluation of midwife-led interventions to promote PCC in diverse populations. Ethics and conflicts of interest: This study received ethical approval from St. Luke’s International University Ethics Committee. The authors declare no conflicts of interest.

RELEVANCE TO MIDWIFERY:
This scale equips midwives with an evidence-based tool to assess and understand women’s attitudes toward preconception care, enabling more personalized and effective counseling and health promotion during the pre-pregnancy period. It supports the expansion of the midwifery role beyond pregnancy and childbirth, aligning with global strategies for preventive reproductive health. Professional development - networks (including three-minute presentation competition)