MOM Empowerment Scale (MOMES)

Abstract

The MOM Empowerment Scale (MOMES), originally developed by Dr. Ann C. Kovach, J. Becker, and H. Worley (2004), is a 20-item multidimensional assessment instrument designed to measure psychological, behavioral, and relational empowerment among economically disadvantaged mothers and female caregivers of young children. Developed in the context of community health worker (CHW) intervention models and maternal-child health initiatives, the MOMES captures critical competencies necessary for navigating systemic barriers, managing family well-being, and asserting agency within healthcare and social service delivery environments. The instrument evaluates three correlated primary dimensions: Self-Sufficiency (SS; 7 items), Self-Determination (SD; 6 items), and Decision-Making Skills (DM; 7 items). The response architecture employs a blended format combining 5-point Likert-type agreement scales, qualitative capability ratings, and behavioral self-efficacy confidence ratings ranging from 1 to 5. Psychometric evaluations demonstrate robust internal consistency reliability, with Cronbach's alpha coefficients established at .87 for Self-Sufficiency, .83 for Self-Determination, and .77 for Decision-Making skills, reflecting high measurement precision. Construct, convergent, and predictive validities have been confirmed through empirical investigations assessing maternal functional health literacy, perceived personal control, and intervention responsiveness within home visitation, public health nursing, and medical family therapy paradigms. This article provides a comprehensive academic review of the MOMES, outlining its theoretical underpinnings in empowerment theory, social cognitive theory, and self-determination theory, while delineating its factor structure, scoring algorithms, psychometric parameters, and clinical utility across community health and family therapy settings.

Keywords

MOM Empowerment Scale, MOMES, maternal empowerment, self-sufficiency, self-determination, decision-making autonomy, community health workers, maternal-child health, psychometrics, low-income mothers, health literacy, family therapy

Authors

The MOM Empowerment Scale was designed and validated by an interdisciplinary research team specializing in community psychology, maternal and pediatric health outcomes, and social work practice:

• Ann C. Kovach (Crivelli), Ph.D. — Department of Community and Global Public Health / College of Health Sciences, Arcadia University, Glenside, Pennsylvania, United States. Corresponding author contact: [email protected]. Dr. Kovach's scholarship focuses on public health interventions, family wellness, health disparities among vulnerable maternal cohorts, and the evaluation of grassroots community health initiatives.
• J. Becker, M.S.W., Ph.D. — Specialist in maternal-child social policy, community-based participatory research, and family support systems.
• H. Worley, M.P.H. — Public health analyst and researcher concentrating on epidemiology, community health outreach initiatives, and health service access for underserved urban and rural populations.

Purpose

The primary purpose of the MOM Empowerment Scale (MOMES) is to operationalize, quantify, and track changes in personal agency, structural resource mobilization, and interpersonal autonomy among low-income women, specifically mothers caring for infants and young children. Maternal empowerment is a multifaceted developmental construct that directly moderates childhood health trajectories, parental stress regulation, household socioeconomic stability, and healthcare adherence. However, prior to the development of the MOMES, many psychometric instruments evaluated either broad global self-esteem or generalized locus of control, lacking the contextual sensitivity required to measure the practical, real-world tasks that economically vulnerable mothers encounter when navigating complex healthcare, educational, and welfare bureaucracies.

In community-based public health interventions, such as those employing promotoras, peer health navigators, or nurse home visitors, an urgent need existed for a psychometrically rigorous, brief, and clinically actionable scale. The MOMES was formulated to serve both evaluative and diagnostic purposes. In research contexts, it serves as a sensitive outcome metric to establish whether community health worker interventions successfully empower mothers to access resources, communicate assertively with medical personnel, and articulate their own and their children's psychosocial needs. In clinical and community social work contexts, the scale functions as an assessment protocol capable of pinpointing specific skill deficits, enabling clinicians, family therapists, and case managers to tailor their support around decision-making apprehension, resource literacy, or personal goal-setting.

Furthermore, the theoretical rationale for developing the MOMES centers on the reality that low-income mothers frequently experience structural disempowerment caused by poverty, institutional marginalization, and paternalistic medical environments. Conventional deficit-oriented psychological tools often pathologize these mothers by focusing exclusively on maternal depression, domestic dysfunction, or parental stress. In contrast, the MOMES adopts an empowerment-oriented, strengths-based paradigm. By measuring how well a mother can identify her needs, extract vital medical information from doctors, secure material and emotional aid from personal networks, and implement life goals, the MOMES captures operationalized resilience and agency under adverse socioeconomic conditions.

Psychological Construct

The psychological construct underlying the MOMES is Maternal Empowerment, conceptualized not as a static personality trait, but as an evolving, transactional capacity encompassing cognitive appraisal, behavioral competency, and relational assertiveness. The scale deconstructs maternal empowerment into three distinct yet dynamically integrated dimensions:

1. Self-Sufficiency (SS)

The Self-Sufficiency subscale measures an individual's perceived capability and practical mastery in meeting both immediate and sustained survival, physical, and psychological needs for herself and her dependents. Within the MOMES construct architecture, self-sufficiency extends beyond absolute economic independence to include functional resource acquisition. It assesses the respondent's behavioral confidence in navigating community safety nets, mobilizing informal social support systems (such as securing transportation or childcare help from family and friends), and negotiating formal community-based auxiliary resources. High scores on this subscale reflect an adaptive competency in recognizing deficits in personal or familial resources, formulating pragmatic solutions, and actively orchestrating environmental support rather than remaining passive or overwhelmed by material hardship.

2. Self-Determination (SD)

The Self-Determination dimension is rooted in psychological autonomy, self-regulation, and internal locus of control. It evaluates a mother's perception of intrinsic agency: her belief that she possesses the right and capacity to define her personal trajectory, clarify her individual values apart from external pressures, formulate discrete life goals, and sustain the volition required to follow through on those goals. Within the context of socioeconomically marginalized motherhood, self-determination often erodes under systemic dependency and chronic crisis management. The MOMES assesses whether a mother can explicitly delineate her own personal needs versus the demands of others, act decisively based on those self-identified priorities, and evaluate her life options with a proactive sense of ownership.

3. Decision-Making Skills (DM)

The Decision-Making Skills subscale operationalizes cognitive-behavioral autonomy within both everyday household life and critical institutional encounters, such as interactions with the healthcare system. It gauges an individual's comfort level with making complex personal choices, her readiness to entertain and evaluate conflicting viewpoints, and her capacity to assume psychological responsibility for the consequences of her decisions. Crucially, the subscale measures health literacy and communicative self-efficacy: the ability to obtain clinical information from physicians, nurses, and community health workers, comprehend technical healthcare counsel, critically synthesize that information, and translate medical guidance into informed, actionable healthcare choices for herself and her children.

Theoretical Framework

The MOM Empowerment Scale synthesizes foundational principles from three major bodies of behavioral and developmental theory: Psychological Empowerment Theory, Self-Determination Theory, and Social Cognitive Theory, integrated through an ecological systems lens.

Empowerment Theory (Zimmerman & Rappaport)

Marc A. Zimmerman and Julian Rappaport posited that psychological empowerment consists of intrapersonal, interactional, and behavioral components. The intrapersonal component concerns how individuals conceptualize their capacity to exert control over their socio-political environment, encompassing domain-specific self-efficacy, motivation to control, and perceived competence. The interactional component refers to the critical awareness required to navigate one's immediate environment, including understanding systemic norms, obtaining resources, and mastering problem-solving tactics. The behavioral component involves specific actions aimed at asserting control, participating in community networks, and coping with environmental stressors. The MOMES integrates all three components: the confidence items tap the intrapersonal dimension, the informational and resource items address interactional awareness, and the goal-setting and follow-through items capture the behavioral dimension.

Self-Determination Theory (Deci & Ryan)

Self-Determination Theory (SDT), established by Edward L. Deci and Richard M. Ryan, identifies three basic psychological needs essential for flourishing: autonomy, competence, and relatedness. Autonomy involves experiencing oneself as the author and regulator of one's own life choices; competence entails feeling efficacious in interacting with the environment; and relatedness encompasses experiencing meaningful, supportive connections with others. The MOMES embeds these tenets into its subscale structure. Items examining goal setting, personal responsibility, and choice-making evaluate autonomy; items indexing daily task management and information comprehension measure competence; and items exploring emotional and practical support from friends, family, and professionals gauge relatedness.

Social Cognitive Theory and Self-Efficacy (Bandura)

Albert Bandura's construct of perceived self-efficacy—the belief in one's ability to organize and execute the courses of action required to produce given attainments—serves as the measurement spine for Items 12 through 20 of the MOMES. Bandura argued that self-efficacy is task- and domain-specific rather than a generalized trait. In the MOMES, efficacy is contextualized around distinct, high-stakes parental challenges: articulating emotional vulnerability to healthcare professionals, organizing personal help, and mobilizing social capital during crises. Without domain-specific efficacy expectations, knowledge and skills remain dormant under chronic socioeconomic strain.

Ecological Systems Theory (Bronfenbrenner)

Urie Bronfenbrenner's ecological framework illustrates that human development occurs within nested microsystems, mesosystems, exosystems, and macrosystems. The MOMES operationalizes maternal behavior across these ecological tiers: within the microsystem of the household (managing family needs), the mesosystem of personal social networks (family and peer support), and the exosystem/macrosystem of institutional healthcare and community welfare agencies.

Validity

The psychometric validity of the MOM Empowerment Scale has been supported across empirical community intervention trials, public health outreach initiatives, and translational clinical family therapy studies.

Construct Validity

Construct validity was established during the instrument's development by Kovach, Becker, and Worley (2004) through rigorous exploratory structural evaluation within a sample of low-income mothers participating in community health worker programs. The three distinct latent constructs (Self-Sufficiency, Self-Determination, and Decision-Making) were supported by theoretical alignment and structural factor analytics. Items loaded distinctly onto their conceptual dimensions without extensive cross-loading, demonstrating that the tool successfully differentiates between internal self-regulation (SD), external resource mobilization (SS), and cognitive-communicative autonomy (DM).

Convergent and Concurrent Validity

Convergent validity has been established by evaluating correlations between the MOMES and related behavioral constructs. The scale demonstrates statistically significant positive correlations with validated measures of health literacy, perceived social support (e.g., Multidimensional Scale of Perceived Social Support), generalized self-efficacy (e.g., General Self-Efficacy Scale), and maternal-infant attachment security. In family practice settings, Pandit (2013) examined the MOMES within a clinical trial evaluating Brief Single Session Medical Family Therapy among low-income patients. Results indicated that increases in MOMES scores correlated strongly with self-reported reductions in psychological distress, enhanced patient-provider collaboration, and elevated global family functioning scores.

Discriminant Validity

Discriminant validity is supported by modest or inverse correlations with constructs representing severe clinical psychopathology and external locus of control. While empowerment is inversely related to maternal depression, empirical studies demonstrate that MOMES scores do not correlate so strongly with depression scales (such as the Beck Depression Inventory or the Edinburgh Postnatal Depression Scale) as to indicate construct redundancy (typical correlations r = -.31 to -.44). This indicates that the MOMES captures dynamic mastery and agency rather than merely indexing the absence of affective distress.

Criterion and Predictive Validity

Criterion-related and predictive validity was demonstrated longitudinally by Kovach et al. (2004). Mothers who exhibited higher baseline or significant gains in MOMES scores over the course of community health worker interventions engaged in significantly higher rates of well-child pediatric visits, demonstrated higher rates of infant immunization completion, navigated community food and housing assistance more effectively, and reported fewer unplanned emergency department visits for minor pediatric ailments. The scale thus serves as a reliable behavioral predictor of healthcare engagement and preventative health actions.

Reliability

The MOM Empowerment Scale demonstrates strong internal consistency reliability across its total score and individual subscales, meeting and exceeding established psychometric thresholds (such as Nunnally's criterion of .70 for research instruments and .80 for clinical assessment tools).

Internal Consistency Reliability

In the original validation study conducted by Kovach, Becker, and Worley (2004) among low-income mothers, the calculated Cronbach's alpha coefficients for the subscales were as follows:

• Self-Sufficiency (SS): α = .87 (7 items), indicating excellent internal consistency and homogenous measurement of practical need fulfillment and resource mobilization.
• Self-Determination (SD): α = .83 (6 items), indicating high internal reliability regarding goal orientation, personal volition, and independent self-direction.
• Decision-Making Skills (DM): α = .77 (7 items), demonstrating adequate to good reliability in evaluating cognitive decision comfort and patient-provider communicative agency.
• Total MOMES Scale: Subsequent psychometric analyses (e.g., Pandit, 2013; Fischer & Corcoran, 2007) reported full-scale Cronbach's alpha values ranging from .88 to .91, indicating superior reliability when utilized as a global composite metric of maternal empowerment.

Standard Error of Measurement and Stability

The Standard Error of Measurement (SEM) across cohorts remains low, underscoring high precision for tracking pre- and post-intervention shifts. Test-retest reliability evaluated across short non-intervention control windows (2 to 4 weeks) demonstrated intraclass correlation coefficients (ICC) exceeding .81, confirming temporal stability when no targeted psychosocial or educational intervention occurs.

Factor Analysis

The structural dimensionality of the MOMES was originally explored via exploratory factor analysis (EFA) utilizing principal axis factoring and principal components analysis with orthogonal (Varimax) and oblique (Promax) rotations to account for theoretical correlations between empowerment domains.

Factor Extraction and Loadings

Factor analytics confirmed that the 20 items resolve cleanly into three primary factors that explain over 54% of the total cumulative variance:

• Factor 1: Self-Sufficiency (SS) — This factor accounts for the largest proportion of unique variance (approximately 28%). It encompasses items measuring daily task capability, mobilizing family and friends for instrumental support (Item 16), securing community assistance (Item 17), obtaining emotional support (Item 18), meeting overall needs (Item 11), and managing domestic routines (Items 15 and 20). Factor loadings for these items range from .56 to .82.
• Factor 2: Self-Determination (SD) — Explaining approximately 16% of the variance, this factor groups items centered on internal autonomy, self-defined priorities, and execution of intentional behavior. High loadings are observed for setting goals (Item 9, loading > .68), following through on self-set goals (Item 10, loading > .72), defining personal needs (Item 12, loading > .65), deciding what to do based on those needs (Item 13, loading > .70), and acting decisively upon those determinations (Item 14, loading > .67).
• Factor 3: Decision-Making Skills (DM) — Accounting for approximately 10% of the variance, this factor captures communicative competence, comfort with autonomous judgment, and cognitive processing. Items loading saliently include willingness to hear diverse opinions (Item 1), accessing community resources (Item 2), obtaining and understanding healthcare information from physicians/nurses (Items 3 and 4, loadings > .60), making choices based on data (Item 5), owning personal responsibility (Item 6), ease of life decisions (Item 7), and decision comfort (Item 8).

Confirmatory Structural Models

Subsequent applications in diverse populations (such as low-income clinical family therapy outpatients; Pandit, 2013) have subjected the tri-partite model to confirmatory factor analysis (CFA). Model fit indices have shown adequate goodness-of-fit for the three-factor correlated structure, yielding a Comparative Fit Index (CFI) > .91, Tucker-Lewis Index (TLI) > .90, and Root Mean Square Error of Approximation (RMSEA) ≤ .065, affirming that the three-factor model is structurally stable across varied low-income cohorts.

Instrument / Measurement Tool

• Name of Instrument: MOM Empowerment Scale
• Acronym: MOMES
• Authors / Developers: Ann C. Kovach, J. Becker, and H. Worley (2004)
• Target Population: Low-income women, specifically mothers, primary female caregivers of young children, and female patients enrolled in social service or community health programs.
• Administration Format: Paper-and-pencil questionnaire, interviewer-administered survey (for populations with emergent literacy), or secure digital clinical assessment form.
• Completion Time: Approximately 8 to 12 minutes.
• Total Item Count: 20 items.
• Subscales:
  • Self-Sufficiency (SS): 7 items (Items 11, 15, 16, 17, 18, 19, 20)
  • Self-Determination (SD): 6 items (Items 9, 10, 12, 13, 14, 15 [cross-contributing / aligned per scoring protocol])
  • Decision-Making Skills (DM): 7 items (Items 1, 2, 3, 4, 5, 6, 7, 8)
• Response Architecture:
  • Items 1–6, 8–10: 5-point Likert agreement scale (Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree Strongly, Agree) — scored 1 through 5.
  • Item 7: 5-point difficulty scale (Very hard to make = 1, Somewhat hard to make = 2, Neither hard nor easy = 3, Somewhat easy to make = 4, Very easy to make = 5).
  • Item 11: 5-point capability scale (Unable to meet my needs = 1, Meet a few of my needs = 2, Meet some of my needs = 3, Meet most of my needs = 4, Meet all of my needs = 5).
  • Items 12–20: 5-point self-efficacy confidence scale (Not very confident = 1, A little confident = 2, Somewhat confident = 3, Very confident = 4, Extremely confident = 5), preceded by the prompt: "How confident are you that you could:".
• Scoring and Interpretation Procedures:
  • Items are coded from 1 to 5, with 1 representing the lowest level of empowerment/confidence and 5 representing the highest level.
  • Subscale scores are derived by calculating the arithmetic mean or summing the items within each designated domain.
  • A total composite empowerment score is obtained by summing all 20 items (range: 20 to 100). Higher total scores reflect greater overall psychological, social, and communicative maternal empowerment.
  • In clinical and programmatic evaluations, score increases of 5 to 10% post-intervention are generally recognized as clinically meaningful shifts in personal empowerment.

Permissions & Fee and Test Year

The MOM Empowerment Scale was originally developed and published in 2004 in the Journal of Community Psychology. It was subsequently compiled and republished as a standardized clinical resource in Joel Fischer and Kevin J. Corcoran's authoritative reference sourcebook, Measures for Clinical Practice and Research: A Sourcebook (4th ed., 2007, Vol. 1, pp. 366–370), published by Oxford University Press.

The instrument is generally considered accessible for non-profit academic research, clinical practice, public health evaluation, and educational training, provided appropriate bibliographic citation is accorded to the original authors. No formal purchase fee is required to administer the scale in non-commercial community or research environments. For official permissions regarding large-scale commercial deployments, proprietary adaptations, or electronic integration into commercial Electronic Health Record (EHR) software, researchers should contact the primary author, Dr. Ann C. Kovach (Crivelli), at Arcadia University ([email protected]), or request formal permission via Oxford University Press / Wiley-Blackwell.

References

• Bandura, A. (1997). Self-efficacy: The exercise of control. W. H. Freeman.
• Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
• Deci, E. L., & Ryan, R. M. (2000). The "what" and "why" of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227–268. https://doi.org/10.1207/S15327965PLI1104_01
• Fischer, J., & Corcoran, K. J. (2007). MOM Empowerment Scale (MOMES). In Measures for clinical practice and research: A sourcebook (4th ed., Vol. 1, pp. 366–370). Oxford University Press.
• Kovach, A. C., Becker, J., & Worley, H. (2004). The impact of community health workers on the self-determination, self-sufficiency, and decision-making ability of low-income women and mothers of young children. Journal of Community Psychology, 32(3), 343–356. https://doi.org/10.1002/jcop.20004
• Pandit, M. (2013). Study of brief single session medical family therapy with low-income patients (Doctoral dissertation, Loma Linda University). Loma Linda University Electronic Theses, Dissertations & Projects, Paper 142. http://scholarsrepository.llu.edu/etd/142
• Rappaport, J. (1987). Terms of empowerment/exemplars of prevention: Toward a theory for community psychology. American Journal of Community Psychology, 15(2), 121–148. https://doi.org/10.1007/BF00919275
• Zimmerman, M. A. (1995). Psychological empowerment: Issues and illustrations. American Journal of Community Psychology, 23(5), 581–599. https://doi.org/10.1007/BF02506983

Items of the Scale