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Oral Health Assessment by Lay Personnel for Older Adults

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Published on: February 2, 2020

Validation of an improved questionnaire assessing the social cognitive constructs of the Health Action Process

Karin Alexandra van Nes¹, Cor van Loveren¹, Irene Helena Adriana Aartman²

¹Department of Paediatric Dentistry, Academic Centre for Dentistry, University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands.

|June 4, 2024

Abstract

Objective:

The Health Action Process Approach (HAPA) describes social cognitive constructs related to behaviour change. A validated questionnaire is needed to measure these constructs in paediatric dentistry. The aim of this study was to improve an existing HAPA-based questionnaire for parents regarding brushing their children's teeth and to assess its validity and reliability in a population of parents of high caries risk children.

Methods:

Parents of high caries risk children of 3-10 years filled out the adjusted HAPA-based questionnaire. Mokken scale analysis, graded response model analyses, factor analyses and reliability analyses were performed according to the protocol of Dima. Discriminant validity was assessed by comparing the mean scores of the HAPA constructs between two groups of participants, based on different levels of caries experience, brushing frequency and education level of the mother.

Results:

The Mokken scale analysis and factor analyses indicated a multidimensional eight factor scale. The graded response model did not fit our data. The subscale action control could be identified as a two-factor subscale. Reliability indices from the Dima protocol varied, for instance Cronbach alpha ranged from 0.73 to 0.96. The constructs coping self-efficacy, action planning and action control discriminated between brushing frequencies.

Conclusions:

The adjusted HAPA-based questionnaire is an improved, valid and reliable instrument that could be used to evaluate HAPA-based interventions to improve children's oral health.

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