Al-Sarray Rusul Abdulameer Hadi, Shamshiri Ahmadreza, Alzubidi Muhammad, Gholami Mahdia, Mohebbi Simin Z
Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Department of Dentistry, Kut University College, Wasit, Iraq.
BMC Oral Health. 2025 Feb 3;25(1):181. doi: 10.1186/s12903-025-05566-6.
The theory of planned behavior (TPB) is one of the most commonly used theories to explain oral health behaviors. To gain a deeper understanding of the determinants of oral health behaviors, we aimed to design and evaluate the psychometrics of a theory of planned behavior model-based instrument for assessing the determinants of oral health behaviors in mothers of children younger than six years in Iraq.
Questionnaires and guidelines related to the topic were searched in 2023, and the appropriate items based on the domains of the TPB model were extracted. The items were revised and completed to develop the initial version of the instruments. Face validity and content validity of the instrument were assessed. The content validity index (CVI) and content validity ratio (CVR) were calculated subsequently. The construct validity was examined by confirmatory factor analysis (CFA). Cronbach's alpha, intra-class correlation coefficient (ICC), and percentage of agreement were employed to check the tool's internal consistency and reproducibility reliability. The data were analyzed using SPSS version 25 and Amos software.
The questionnaire had adequate content validity (CVR ≥ 0.75, CVI ≥ 0.75). The percentage of agreement, Kappa, and ICC coefficients were 57.1-95.3%, 0.52-0.89, and 0.43-0.90, respectively. The p-value for ICC was significant in all cases (p < 0.001). For the internal stability of the tool to keep Cronbach's alpha values > 0.7 for all domains, we had to omit three questions from attitude, one from subjective norms, and one from perceived behavioral control. In terms of construct validity, the results were as follows: the Goodness of Fit Index (GFI) was 0.942, the Comparative Fit Index (CFI) was 0.900, the Adjusted Goodness of Fit Index (AGFI) was 0.921, and the Root Mean Square Error of Approximation (RMSEA) was 0.046. These values indicate that the instrument demonstrates appropriate construct validity based on the TPB.
The psychometric evaluation of the designed instrument showed that it was a valid and reliable tool in Arabic-speaking countries for determining child-related oral health behaviors in mothers of children under six years old.
计划行为理论（TPB）是解释口腔健康行为最常用的理论之一。为了更深入地了解口腔健康行为的决定因素，我们旨在设计并评估一种基于计划行为理论模型的工具的心理测量学特性，该工具用于评估伊拉克6岁以下儿童母亲的口腔健康行为决定因素。
2023年检索了与该主题相关的问卷和指南，并根据TPB模型的领域提取了合适的条目。对条目进行修订和完善，以开发该工具的初始版本。评估该工具的表面效度和内容效度。随后计算内容效度指数（CVI）和内容效度比（CVR）。通过验证性因素分析（CFA）检验结构效度。采用Cronbach's α系数、组内相关系数（ICC）和一致性百分比来检验该工具的内部一致性和重测信度。使用SPSS 25版软件和Amos软件对数据进行分析。
该问卷具有足够的内容效度（CVR≥0.75，CVI≥0.75）。一致性百分比、Kappa系数和ICC系数分别为57.1 - 95.3%、0.52 - 0.89和0.43 - 0.90。所有情况下ICC的p值均具有统计学意义（p < 0.001）。为使该工具在所有领域的Cronbach's α值保持>0.7的内部稳定性，我们不得不从态度部分删除3个问题，从主观规范部分删除1个问题，从感知行为控制部分删除1个问题。在结构效度方面，结果如下：拟合优度指数（GFI）为0.942，比较拟合指数（CFI）为0.900，调整后拟合优度指数（AGFI）为0.921，近似均方根误差（RMSEA）为0.046。这些值表明该工具基于TPB具有适当的结构效度。
对所设计工具的心理测量学评估表明，在阿拉伯语国家，它是一种有效且可靠的工具，可用于确定6岁以下儿童母亲与儿童相关的口腔健康行为。
