Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA.
James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
J Public Health Dent. 2023 Mar;83(1):116-122. doi: 10.1111/jphd.12558. Epub 2023 Jan 31.
To develop a content-valid set of items to characterize different types of topical fluoride hesitancy among caregivers. We will use this information to develop and test tailor-made interventions directed to caregivers with varied types and levels of topical fluoride hesitancy, to ultimately improve child oral health.
Caregivers participated in three study activities, in the following order: (1) semi-structured concept elicitation interviews (n = 56), (2) cognitive interviews (n = 9), and (3) usability interviews (n = 3). Interviews were conducted via telephone and audio-recorded and transcribed for qualitative analysis. Twelve pediatric dental providers and researchers participated in item review. An assessment of reading level of items was made with goal of 6th grade reading level or less.
Based on elicitation interviews, we initially developed 271 items, which the investigative team evaluated for conceptual clarity, specificity to topical fluoride hesitancy, and sensitivity to potential interventions. After four rounds of review and cognitive interviews, we retained 33 items across five previously identified domains. Changes after cognitive interviews included item revision to improve comprehension and item re-ordering to avoid order effects. Changes after usability testing including clarification regarding referent child for families with multiple children. The reading level of the item pool is grade 3.2.
The resulting 33-item fluoride hesitancy item pool is content valid and will address an important need for identifying and addressing topical fluoride hesitancy in the context of dental research and clinical practice. Next steps include psychometric evaluation to assess scale and test-retest reliability and construct validity.
开发一套内容有效的项目，以描述照顾者中不同类型的局部用氟化物犹豫。我们将利用这些信息来开发和测试针对不同类型和程度的局部用氟化物犹豫的照顾者的定制干预措施，最终改善儿童的口腔健康。
照顾者按照以下顺序参与了三项研究活动：（1）半结构化的概念启发访谈（n=56），（2）认知访谈（n=9），和（3）可用性访谈（n=3）。访谈通过电话进行，并进行音频记录和转录，以便进行定性分析。十二名儿科牙科医生和研究人员参与了项目审查。通过评估项目的阅读水平，目标是达到六年级或以下的阅读水平。
根据启发式访谈，我们最初开发了 271 个项目，调查团队对这些项目进行了概念清晰度、对局部用氟化物犹豫的特异性以及对潜在干预措施的敏感性的评估。经过四轮审查和认知访谈，我们保留了五个先前确定的领域中的 33 个项目。认知访谈后的变化包括修订项目以提高理解能力和重新排序项目以避免顺序效应。可用性测试后的变化包括澄清对于有多个孩子的家庭，参考孩子的问题。项目池的阅读水平为 3.2 年级。
由此产生的 33 项氟化物犹豫项目池内容有效，将解决在牙科研究和临床实践中识别和解决局部用氟化物犹豫的重要需求。下一步包括心理计量评估，以评估量表和重测信度和结构有效性。
