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Validation of a pediatric oral health-related quality of life scale in Navajo children

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Abstract

Background

American Indian (AI) children experience the highest rates of early childhood caries (ECC) in the USA, yet no tool has been validated to measure the impact of ECC on their oral health-related quality of life (OHRQoL).

Objective

To validate a pediatric OHRQoL scale in a preschool, rural, reservation-based AI population.

Methods

In 2011 and 2012, we measured the OHRQoL of AI children attending Head Start in Navajo Nation with the 12-item preschool version of the pediatric oral health-related quality of life (POQL) scale administered to their parents/caregivers. Parents/caregivers also reported their children’s subjective oral health status (OHS) and oral health behavior adherence. Concurrently, calibrated dental examiners measured the children’s decayed, missing, and filled tooth surfaces (dmfs). Validation was assessed with internal reliability and convergent and divergent validity testing and exploratory factor analyses.

Results

We measured the outcomes in 928 caregiver-child dyads. All children were AI and in preschool [mean (SD) child age was 4.1 (0.5) years]. The majority of children had experienced decay [dmfs: 89 %, mean (SD): 21.5 (19.9)] and active decay [any ds: 70 %, mean (SD): 6.0 (8.3)]. The mean (SD) overall POQL score was 4.0 (9.0). The POQL scale demonstrated high internal consistency reliability (Cronbach alpha = 0.87). Convergent validity of the POQL scale was established with highly significant associations between POQL and caries experience, OHS, and adherence to oral health behaviors (all ps < 0.0001).

Conclusions

The POQL scale is a reliable and valid measure of OHRQoL in preschoolers from the Navajo Nation.

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Abbreviations

AI:

American Indian

AI/AN:

American Indian/Alaska Native

ECC:

Early childhood caries

dmfs:

Decayed, missing, filled surfaces

OHRQoL:

Oral health-related quality of life

OHS:

Oral health status

POQL:

Pediatric oral health-related quality of life

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Acknowledgments

Funding for the study was provided by the National Institute for Dental and Craniofacial Research (U54 DE019259-03, Albino). The findings and conclusions are those of the authors and do not necessarily represent the official position of the National Institutes of Health. We would like to thank the Navajo Tribe as well as the participants who gave so graciously of their time. We would like to thank Lucinda Bryant for her assistance with revising this manuscript and Carmen George and Nikola Toledo for their tireless work in Navajo Nation. Finally, we are grateful for the technical assistance provided by Michelle Henshaw and Sharron Rich at Boston University.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Children’s Outcomes Research, Colorado Health Outcomes Programs, University of Colorado Anschutz Medical Campus, 13199 E. Montview Blvd. Suite 300 F443, Aurora, CO, 80045, USA

    Patricia A. Braun & William G. Henderson

  2. Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Kimberly E. Lind, Angela G. Brega & Judith Albino

  3. Department of Health Systems, Management and Policy, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Kimberly E. Lind

  4. Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    William G. Henderson

  5. Department of Craniofacial Biology, School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    David O. Quissell

Authors
  1. Patricia A. Braun
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  2. Kimberly E. Lind
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  3. William G. Henderson
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  4. Angela G. Brega
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  5. David O. Quissell
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  6. Judith Albino
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Corresponding author

Correspondence to Patricia A. Braun.

Additional information

This work does not report results of a clinical trial. The work described in this manuscript has not been published before; it is not under consideration for publication anywhere else; the manuscript has been approved by all co-authors, the Colorado Multiple Institutional Review Board, the National Institute of Dental and Craniofacial Research, and the Navajo Nation Human Research Review Board.

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Braun, P.A., Lind, K.E., Henderson, W.G. et al. Validation of a pediatric oral health-related quality of life scale in Navajo children. Qual Life Res 24, 231–239 (2015). https://doi.org/10.1007/s11136-014-0751-3

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  • DOI: https://doi.org/10.1007/s11136-014-0751-3

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