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Updated: Apr 14, 2026
Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Factorial Validity and Reliability of the Executive Function-Related Toothbrushing Behavior Questionnaire Among
Asuka Ishiguro-Matsumoto1, Satoko Shibata1, Roxana Stegaroiu1
1Department of Oral Health and Welfare, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Objectives:
To understand and improve toothbrushing behavior among persons with intellectual disability (ID) and who have difficulties with toothbrushing and vulnerabilities in executive function (EF), using the 'Executive Function-related Toothbrushing Behaviour Questionnaire' (EF-TB). This study aimed to evaluate the validity and reliability of the EF-TB in a population of adults with ID.
Methods:
In total, 92 participants with ID who utilize commuting (non-residential) welfare facilities were rated by family members or guardians using the EF-TB and by facility staff using the Dysexecutive Questionnaire (DEX). The DEX was used as an external standard to assess the concurrent validity of the EF-TB. The comparison group, comprising 70 participants without ID, completed the EF-TB. Factor structure, internal consistency reliability, discriminant validity, and concurrent validity were investigated.
Results:
Exploratory factor analysis yielded three factors: 'Systematic implementation', 'Sustained implementation', and 'Start and Finish'. The Cronbach's alpha and item-total correlation showed good levels of internal consistency reliability. All three sub-scale scores and the total score, showed statistically significant differences between the two groups, indicating a satisfactory level of discriminant validity for the EF-TB. Futhermore, a significant correlation was observed between the total scores of the two measures, suggesting an acceptable level of concurrent validity of the EF-TB.
Conclusions:
The EF-TB is a valid and reliable tool for assessing EF related to toothbrushing behavior among persons with ID. The EF-TB scores offer useful information for developing effective ways of improving oral health behavior in this population.
