Romanian Version of the Oral Health Values Scale: Adaptation and Validation

Cross-cultural adaptation and validation of the Persian version of the oral health values scale

BACKGROUND

The decisions individuals make regarding oral health reflect their values. Prioritizing oral and dental health is essential for public health. This study aimed to evaluate the validity and reliability of the Persian version of the Oral Health Values Questionnaire.

METHODS

A cross-sectional study was conducted involving 500 adults aged 18 years and older at health centers in Shiraz in 2023. The Original Oral Health Values Scale (OHVS) questionnaire was translated into Persian using a forward-backward translation. Participants completed the Persian version of the OHVS, which comprises a 12-item scale with a four-factor structure: professional dental care, appearance and health, flossing, and preservation of natural teeth. The Content Validity Index (CVI), Content Validity Ratio (CVR) and Scale-Level Content Validity Index (S-CVI/Ave) were assessed. Test-retest reliability and Cronbach's alpha were used to evaluate the internal consistency of the questionnaire. To determine the adequacy of the sample size, the Kaiser-Meyer-Olkin (KMO) index, with a minimum value of 0.7, Bartlett's test of sphericity, eigenvalues greater than 1, and the Varimax rotation method were utilized, using SPSS Version 24 statistical software.

RESULTS

All questions demonstrated satisfactory Content Validity Ratio (CVR) and Content Validity Index (CVI), scoring above the expected thresholds of 0.8 and 0.9, respectively. The test-retest correlation results confirmed the reliability of the questionnaire, with correlation coefficients exceeding 0.7 for all questions and their sub-areas. Internal consistency was also established usings domains. Factor analysis revealed four primary components with eigenvalues greater than 1, which collectively accounted for 58.963% of the total variance.

CONCLUSIONS

The Persian version of the OHVS demonstrated excellent validity and reliability. Consequently, it can be regarded as a reliable and valuable tool for epidemiological and behavioral dental studies.

Psychometric Analysis and Cross-Cultural Adaptation of the Croatian Version of the Oral Health Values Scale (OHVS)

Background/Objectives: A person's values regarding oral health significantly shape their related behaviors and habits. Therefore, it is essential to systematically study this relationship and create reliable tools to assess perceptions of oral health values, which can inform evidence-based interventions and policy decisions. This study aimed to translate, culturally adapt, and validate the "Oral Health Values Scale" (OHVS) for use in the Croatian context. Methods: The process involved two key phases. First, an expert committee oversaw the translation to ensure consistency across all versions and produce a test-ready instrument. To identify any ambiguities in translation and test the instrument's reliability, a pilot study with 40 participants was conducted. Once the expert committee confirmed content validity, the finalized OHVS was administered to a sample of 702 Croatian adults to evaluate its psychometric properties. Results: Factor analysis revealed a three-factor structure in the Croatian version, differing from the original four-factor model, with items from the "Retaining Natural Teeth" subscale distributed across two factors. Results demonstrated strong internal consistency (Cronbach's α > 0.78) and test-retest reliability (ICC = 0.976, 95% CI: 0.955-0.987, p < 0.01), confirming the instrument's reliability. Conclusions: These results confirm the OHVS-CRO as a valid and reliable instrument for assessing oral health values, offering valuable insights into the perspectives of Croatian populations. This validation study provides a foundation for future research, supports culturally tailored interventions, and highlights the potential for the OHVS to inform oral health research and policy development both locally and globally.

Cross-cultural adaptation of the Arabic version of the oral health values scale

AIMS

The study aimed to adapt the original English-language oral health values scale (OHVS) to the Arabic culture and to test its psychometric properties.

METHODS

The original OHVS was translated into Arabic language and pre-tested using cognitive interviewing. The psychometric properties of Arabic OHVS were examined in a sample comprising 416 Libyan adults aged 18-70 years, recruited from the main public and private dental clinics in Benghazi. The participants' demographic information, oral health behaviour, perceived oral health, the Arabic version of the OHVS (A-OHVS), dental neglect scale, oral health-related quality of life, oral health literacy, simplified oral hygiene index (OHI-S), and decayed, missing, and filled teeth index (DMFT) were collected. Psychometric properties were tested using content validity, construct validity, discriminating validity, internal consistency, test-retest reliability, and floor as well as ceiling effects were examined.

RESULTS

The Arabic OHVS was successfully and smoothly developed. It showed an acceptable level of equivalence to the original version, The A-OHVS presented an overall Cronbach's Alpha of 0.74 and the average score was 40.02, ranging between 26 and 54. All hypotheses predefined to test construct validity were confirmed. The bivariate correlation between A-OHVS and other health indicators shows a significant positive correlation between A-OHVS and oral health literacy (p = 0.000). On the other hand, statistically significant negative correlations were observed between A-OHVS and dental neglect and quality of life (p ≤ 0.001) as well as DMFT and OHI-S (p ≤ 0.001). Floor or ceiling effects were not observed.

CONCLUSIONS

The A-OHVS was shown to be a valid and reliable tool for assessing oral health values in the Arabic-speaking population.

Exploring the Threefold Viewpoint on Children's Oral Health in a Cross-Sectional Study

Oral health is situated within the framework of the global health agenda, addressing facets pertaining to well-being and quality of life. The research is based on the need to address variables at the community level to improve schoolchildren's oral health and promote healthy behaviors and aims to carry out an in-depth analysis from the perspective of the factors that influence children's oral health. Step 1, designed by the World Health Organization, was utilized. An easy-to-use web interface was created for data collection. The statistical analysis consisted of using multinomial and binominal logistic regression models. The level of education of the adult has a high probability of influencing the consumption of unhealthy or healthy foods, it has a significant probability of exerting influence on social or medical problems and a correlation was found between the level of academic education and the pattern of dental visits. The development of health-promoting behaviors begins in childhood and involves parents, who have an essential role in the education of their children. Oral health promotion programs in schools need to target the child-adult-teacher-dentist relationships. Taking into consideration the aforementioned, a threefold viewpoint is necessary for the development of a national program aimed at promoting the oral health of schoolchildren in Romania.

Psychometric Properties of the Oral Health Values Scale and Cultural Adaptation in the Indian Population

AIM

The Oral Health Values Scale is a multidimensional instrument that identifies and measures a person's values related to oral health. This scale has been validated in American respondents. This study aims to evaluate the adaptability and validity of the Oral Health Values Scale in the Hindi language (H-OHVS).

METHODOLOGY

A total of 240 adults participated in the study that was carried out from July to November 2022. An offline one-to-one survey was carried out to collect data by an investigator blinded to the study protocol. The translation and testing of the OHVS were carried out based on the cross-cultural adaptation guidelines of the American Academy of Orthopedic Surgeons (AAOS) Evidence-Based Medicine Committee. The content validity was assessed by an expert panel. Construct validity was analyzed through Exploratory Factor Analysis (EFA), utilizing principal component analysis with varimax rotation. The internal consistency of the Hindi version of OHVS was evaluated using Cronbach's alpha.

RESULTS

 The results showed that H-OHVS had an Item-level Construct Validity Index (I-CVI) ranging from 0.82 to 1.00. Two components, compliance and hesitance, were formed on H-OHVS accounting for 63.91% of the cumulative variance. The resulting model fit indices on confirmatory factor analysis presented an adequate fit to the data. The overall Cronbach's alpha coefficient for H-OHVS (α = 0.868) presents excellent internal consistency.

CONCLUSIONS

The study findings provide a certain degree of evidence in favor of this scale and establish the Oral Health Values Scale (OHVS) as a psychometrically sound measure.

Development and Validation of Oral Health-Related Quality of Life Scale for Patients Undergoing Endodontic Treatment (OHQE) for Irreversible Pulpitis

An oral health-related quality of life measure specific to patients undergoing endodontic treatment has not been developed. This study aimed to validate the oral health-related quality of life scale for patients undergoing endodontic treatment (OHQE) for irreversible pulpitis, comprised of 42 questions. Sixty-two patients with irreversible pulpitis, comprising 23 (37.1%) males and 39 (62.9%) females, were enrolled between August 2022 and February 2023. Data were collected at three time points: pretreatment, post-treatment, and at the second week post-treatment. Factor analysis revealed physical, psychological, and expectations as subscales of OHQE. Cronbach's alpha coefficients ranged from 0.87 to 0.95 for each subscale. Each subscale of the General Oral Health Assessment Index (GOHAI) was moderately correlated with the OHQE subscales. Good-poor analysis revealed a significant difference between the high-scoring and low-scoring groups for each OHQE subscale. The intraclass correlation coefficients of the OHQE subscales ranged from 0.89 to 0.95. Multivariate linear regression analysis revealed a significant correlation between the pretreatment and post-treatment psychological factors (p < 0.05). Thus, OHQE will help researchers and policymakers understand the impact of oral health on the quality of life of patients with irreversible pulpitis undergoing endodontic treatment. OHQE could contribute to the appropriate planning, treatment decisions, and management of dental treatment.

Gender Differences in Oral Health: Self-Reported Attitudes, Values, Behaviours and Literacy among Romanian Adults

A topic that has been less researched on, especially in Romania, is the identification of gender differences in oral health. The present scientific research used an online survey to assess the attitudes (dental beliefs survey-R/R-DBS), the values (oral health values scale/OHVS), the behaviours (dental neglect scale/DNS), and the literacy (oral health literacy scale/OHLS) related to oral health and to dental professional services in the case of a sample of 600 Romanian adults (Mean_age = 30.84). The relation between the level of knowledge as a predictor of attitudes and values related to oral health was analysed by the means of a structural equation based on the partial least square method (PLS-SEM). The results show that women have more positive attitudes towards dental medical services, higher oral health values, better self-care behaviours, and higher oral health literacy than men. In the case of men, attitudes and behaviours related to self-care are influenced by their oral health literacy and level of education; in the case of women, the latter are influenced only by their level of oral health literacy. The impact that knowledge in oral health has on attitudes, values, and behaviours was highlighted. The differences in attitudes and values related to oral health between the two genders can be accounted for by the differences in formal and informal education (studies and oral health literacy, respectively).

Validity and Reliability of the Dental Neglect Scale among Romanian Adults

The Dental Neglect Scale (DNS) is a well-known measure for assessing behaviours and attitudes related to oral health. However, the factor inconsistency revealed by the literature involves further investigations. The study focuses on the validation of the DNS in the case of a sample of the adult population from Romania. In this regard, data were collected online from 872 adults (616 females and 256 males). DNS reliability was examined from the perspective of internal consistency. Convergent validity was performed by associating DNS with different scales from the oral health field. In order to examine and confirm the factorial structure, the sample was broken down into two subsamples which made the subject of the exploratory factorial analysis (EFA) and confirmatory factorial analysis (CFA), respectively. DNS-RO is positively associated with the scale which measures the values related to oral health (OHVS) and negatively with those that assess the impact of the oral health on life quality (OHIP-14), the distrust of the benefits of oral health services (R-DBS), and reduced need for oral care (DIS). The Cronbach’s α = 0.70, McDonald’s ω = 0.70 and CR = 0.77 are acceptable. Both EFA and CFA (χ²/df = 1.13; CFI = 0.99; RMSEA = 0.017; SRMR = 0.059) support the unifactorial structure of the scale. The gender differences show that females evince greater care for oral health than male subjects. The study shows that the DNS-RO can be used to assess the behaviours and attitudes towards oral health in the case of the Romanian adult population in epidemiological studies and health promotion programs through health education.