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Development and validation of the Oral health behavior questionnaire for adolescents based on the health belief model (OHBQAHBM).

ABSTRACT: BACKGROUND:Oral health belief is a prerequisite of changing oral health behaviors especially during adolescence. However, there is a paucity of well-established questionnaire for use among adolescents. This study aimed to develop and validate an instrument to evaluate adolescents' beliefs about oral health behaviors using health belief model. METHODS:A preliminary 43-item questionnaire was developed by an expert panel. Then the questionnaire was finalized by decreasing the number of items to 35 by analyzing the results from face validity and factor analysis from 421 Hong Kong secondary school students. The content validity were evaluated by a panel of 2 behavioral scientists, 2 dentists, 2 schoolteachers and 10 adolescents. The construct validity of the questionnaire was assessed by performing exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The Cronbach's alpha coefficient, item-total correlation and intraclass coefficient were used to test its reliability. In addition, to confirm its applicability, multiple regression analysis and path analysis were used to evaluate the possibility of HBM as predictors for oral health behaviors and oral hygiene status. RESULTS:The initial analysis extracted six factors that jointly accounted for 62.47% of the variance observed. Based on CFA, the final version of the questionnaire consisted of 35 items and the data of the final version fitted the model well. The Cronbach's alpha coefficient for the subscale (>?0.7), item-total correlations (0.47-0.91) and the intraclass coefficient (0.82-0.91) were all above acceptable thresholds. The results of multiple regression analysis and path analysis confirmed its ability to predict oral health behaviors and status. CONCLUSIONS:The present findings indicate satisfactory validity, reliability and applicability of the proposed Oral Health Behavior Questionnaire for Adolescents based on the Health Belief Model (OHBQAHBM) for measuring oral health beliefs of adolescents. This questionnaire can be used as an instrument to measure oral health beliefs and predict oral health behavior and oral hygiene status of adolescents.

SUBMITTER: Xiang B

PROVIDER: S-EPMC7227318 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Development and validation of the Oral health behavior questionnaire for adolescents based on the health belief model (OHBQAHBM).

Xiang Bilu B Wong Hai Ming HM Cao Wangnan W Perfecto Antonio P AP McGrath Colman P J CPJ

BMC public health 20200515 1

<h4>Background</h4>Oral health belief is a prerequisite of changing oral health behaviors especially during adolescence. However, there is a paucity of well-established questionnaire for use among adolescents. This study aimed to develop and validate an instrument to evaluate adolescents' beliefs about oral health behaviors using health belief model.<h4>Methods</h4>A preliminary 43-item questionnaire was developed by an expert panel. Then the questionnaire was finalized by decreasing the number ...[more]

PMID: 32414375

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Project description:BACKGROUND:A vicious cycle exists between dental anxiety, oral health behaviors and oral health status. Based on previous research, psychological factors of the Health Belief Model (HBM) are associated with oral health behaviors and oral health, and are likely involved in this cycle. However, little is known about the relationship between HBM factors and dental anxiety of adolescents. The purpose of this cross-sectional study was to investigate the relationship between health belief factors, oral health and dental anxiety based on the constructs of the HBM. METHODS:1207 Grade 2 students from 12 secondary schools in Hong Kong were randomly selected and measured for the decayed, missing and filled permanent teeth (DMFT) index. Data for oral health behaviors, HBM constructs and dental anxiety were collected using questionnaires. The hierarchical entry of explanatory variables into logistic regression models estimating prevalence odds ratios (POR) were analyzed and 95% confidence intervals (95% CI) for DMFT and dental anxiety were generated. Path analysis was used to evaluate the appropriateness of the HBM as predictors for oral health behaviors, DMFT and dental anxiety. RESULTS:Based on the full model analysis, individuals with higher perceived susceptibility of oral diseases (POR: 1.33, 95% CI: 1.14-1.56) or girls or whose mother received higher education level were likelier to have a DMFT?1, while those with higher perceived severity (POR: 1.31, 95%CI: 1.09-1.57), flossing weekly, DMFT?1 or higher general anxiety level statistically increases the possibility of dental anxiety. The results from path analysis indicated that stronger perceived susceptibility, greater severity of oral diseases, less performing of oral health behaviors and a higher score of DMFT were directly related to increased dental anxiety level. Other HBM variables, such as perceived susceptibility, self-efficacy beliefs, cues to action and perceived barriers, might influence dental anxiety through oral health behaviors and caries status. CONCLUSIONS:Clarifying the propositional structures of the HBM may help the future design of theory-based interventions in reducing dental anxiety and preventing dental caries.

Project description:BackgroundConsidering the importance of health behaviors in health outcomes, it is necessary to assess health behaviors precisely. This study aimed to develop and validate The Geriatrics Health Behavior Questionnaire among Iranian older adults.MethodsThis cross-sectional and methodological study was conducted on 420 community older adults (age ≥ 60) through random multi-stage sampling. The initial questionnaire has been developed with 22 items and seven subscales based on an extensive literature review, evaluation of related questionnaires, and experts' opinions. Face and content validity were evaluated by interviewing 10 older adults and 18 specialists. The construct validity was evaluated via Known-groups validity and convergent validity. The reliability of the questionnaire was calculated by internal consistency, test-retest, and absolute reliability.ResultsThe face validity was conducted by using interviews with older adults and gathering the specialists' opinions. The items were grammatically and lexically corrected accordingly. Two items were deleted due to CVR < 0.44. Modified Kappa statistic (K*) and I-CVI for all items were higher than 0.88. The average content validity index (S-CVI/Ave) value was 0.94. Three items were deleted to improve the internal consistency; the final GHBQ consisted of 17 items with Cronbach α = 0.72. Acceptable convergent validity was approved by a significant correlation between GHBQ and SF8™ health survey (r = 0.613, P value< 0.001). Independent t-test showed that older adults with education level ≥ high school have significantly higher health behavior scores than those with education level < high school (11.93 ± 2.27 vs. 9.87 ± 2.35, t = - 9.08, p < 0.001). Intra-class correlation coefficient (ICC) for the total questionnaire was 0.92 (95% CI =0.84 to 0.96). Standard Error Measurement (SEM) and Minimal Detectable Change (MDC95) were 0.71 and 1.98, respectively.ConclusionThe present study results showed that the Geriatrics Health Behavior Questionnaire had suitable validity and reliability among Iranian older adults. It is recommended to consider its comprehensiveness and yet its briefness in other populations after passing validation.

Project description:BackgroundThe need for Complementary and Alternative Medicine (CAM) and holistic approaches in allopathic medical school curricula has been well articulated. Despite increased CAM instruction, feasible and validated instruments for measuring learner outcomes in this content area do not widely exist. In addition, baseline attitudes or beliefs of medical students towards CAM, and the factors that may have formed them, including use of CAM itself, remain unreported.MethodsA 10-item measure (CHBQ--CAM Health Belief Questionnaire) was constructed and administered to three successive classes of medical students simultaneously with the previously validated 29-item Integrative Medicine Attitude Questionnaire (IMAQ). Both measures were imbedded in a baseline needs assessment questionnaire. Demographic and other data were collected on students' use of CAM modalities and their awareness and use of primary CAM information resources. Analysis of CHBQ items was performed and its reliability and criterion-related validity were established.ResultsResponse rate was 96.5% (272 of 282 students studied). The shorter CHBQ compared favorably with the longer IMAQ in internal consistency reliability. Cronbach's coefficient alpha was 0.75 and 0.83 for the CHBQ and IMAQ respectively. Students showed positive attitudes/beliefs towards CAM and high levels of self-reported CAM use. The majority (73.5%) of students reported using at least one CAM modality, and 54% reported using at least two modalities. Eighty-one percent use the internet as a primary source of information for CAM.ConclusionsThe CHBQ is a practical, valid and reliable instrument for measuring medical student attitudes/beliefs and has potential utility for measuring the impact of CAM instruction. Medical students showed a high self-reported rate of CAM use and positive attitudes towards CAM. Short, didactic exposure to CAM instruction in the first year of medical school did not additionally impact these already positive attitudes. Unlike the IMAQ, which was intended for use with physicians, the CHBQ is generic in design and content and applicable to a variety of learner types. Evaluation measures must be appropriate for specific CAM instructional outcomes.

Project description:BackgroundOral health problems especially dental caries are common in school children, and education programs may help to prevent these conditions. The aim of current study was to examine the effects of an educational program based on a Health Belief Model (HBM) to improve oral health behaviors of elementary school children.MethodsA total of 112 children ages 6-12 years old accompanied by one of their parents were randomly assigned to intervention/test and control groups. In the intervention group, five consecutive weekly educational sessions based on the HBM were provided, while the control group received only routine education delivered by the dental clinic. The Decayed, Missing, and Filled Teeth (DMFT) score, papillary bleeding index, and responses to the HBM questionnaire were assessed in the intervention and control groups at baseline and three-month follow-up after the intervention was completed. Within-group and between-group differences were examined using the Student's t-test and analysis of covariance.ResultsAll HBM domains were improved at follow-up in the intervention group compared to the control group (p < 0.001). The largest change was in perceived susceptibility, whereas the smallest changes were in perceived severity and perceived benefits. The papillary bleeding index demonstrated a significant change from baseline to follow-up in the intervention group (reduction of 0.7, 95% CI = - 0.9 to - 0.5). All components of the DMFT score except missing teeth also improved in the intervention group compared to controls. However, no significant difference was found in total DMFT score between intervention and control groups.ConclusionAn education program based on HBM may be more effective than current methods used to educate children and their parents on optimal oral health behaviors. Administration of interventions of this type along with other school-based programs to prevent dental caries may be helpful in grade-school children.

Project description:Background: Vaccination is the most effective method for the prevention of COVID-19. However, willingness to be vaccinated is not consistent. This study aimed to explore vaccine cognition, risk perception, and health behavior of COVID-19 in China. Methods: A cross-sectional survey was performed in Guangdong province, China, including demographic characteristics, health status and preventive behaviors, cognition of COVID-19 vaccination, and the health belief model (HBM). Results: A total of 1640 participants were recruited. The main access to information about COVID-19 and vaccination as through official news and broadcasts (67.3%), social network software (58.7%), and professional popularization (46.2%). The precautions taken were wearing a mask (67.0%) and avoiding gathering together (71.3%). COVID-19 vaccination acceptability was different among different age groups and educational levels (p < 0.001). The major reasons for accepting vaccination included that it was an effective way to prevent COVID-19 (61.8%) and that it was required by working units/schools (51.1%). The fitting effect indexes of the (HBM) Model 2 showed better fitting than those of Model 1. In Model 2, perceived benefits (OR = 3.13, 95% CI: 1.79−5.47), cues to action (OR = 2.23, 95% CI: 1.60−3.11), and different occupations (OR = 1.13, 95% CI: 1.04−1.23) were positively correlated with vaccine acceptance; while perceived susceptibility (OR = 0.47, 95% CI: 0.30−0.74) and perceived barriers (OR = 0.44, 95% CI: 0.29−0.69) were negative factors associated with vaccine acceptance. Conclusion: Different sociodemographic characteristics lead to differences in acceptance of vaccination, and the publicity and credibility of government play an indispensable role in epidemic control. The establishment of the HBM further predicted that perceived susceptibility to COVID-19, benefits of vaccination, barriers of cognition, and cue to action were the influencing factors of intention and health behaviors.

Project description:BackgroundTraining dental and oral health behaviors by using appropriate training models and theories is an important issue in preventing dental and oral diseases. the present study aimed to investigate the effect of training based on the health belief model and behavioral intention on dental and oral health behaviors in female students aged 9-12 years old in the city of Rudsar, Guilan, Iran.MethodsThis research is an interventional study conducted on 84 female students aged 9-12 years old, who lived in the city of Rudsar (n = 42 in the control group and n = 42 in the interventional group) in 2019. The data collection tools included questions on demographic variables, structures of the health belief model (perceived sensitivity, perceived severity, perceived barriers and benefits, self-efficiency), behavioral intention, and performance. The questionnaire was completed before the intervention and 3 months after it by both groups. The intervention group received four 45-min sessions. The data were analyzed using SPSS 24, descriptive tests, independent sample t-test, pair sample t-test, and regression (P < 0.05).ResultsThe mean age of the intervention and control groups was 10.88 ± 1.01 and 10.80 ± 1.01, respectively. The results showed that the average scores of all structures of the health belief model and behavioral intention in the intervention group significantly changed compared to the average scores obtained before the intervention (P < 0.05). Moreover, the average scores of perceived sensitivity (p < 0.009), perceived barriers (p < 0.007), self-efficiency (p < 0.001), and behavioral intention (p < 0.001) significantly changed after the intervention in both groups (p < 0.05).ConclusionAccording to the results, the health belief model and the behavioral intention were effective in improving dental and oral health so that they can be applied to improving people's dental and oral health. It can also be used as a model to design, implement, and monitor medical health programs.

Project description:BackgroundQuestionnaires have been used in the past 2 decades to predict the diagnosis of vertigo and assist clinical decision-making. A questionnaire-based machine learning model is expected to improve the efficiency of diagnosis of vestibular disorders.ObjectiveThis study aims to develop and validate a questionnaire-based machine learning model that predicts the diagnosis of vertigo.MethodsIn this multicenter prospective study, patients presenting with vertigo entered a consecutive cohort at their first visit to the ENT and vertigo clinics of 7 tertiary referral centers from August 2019 to March 2021, with a follow-up period of 2 months. All participants completed a diagnostic questionnaire after eligibility screening. Patients who received only 1 final diagnosis by their treating specialists for their primary complaint were included in model development and validation. The data of patients enrolled before February 1, 2021 were used for modeling and cross-validation, while patients enrolled afterward entered external validation.ResultsA total of 1693 patients were enrolled, with a response rate of 96.2% (1693/1760). The median age was 51 (IQR 38-61) years, with 991 (58.5%) females; 1041 (61.5%) patients received the final diagnosis during the study period. Among them, 928 (54.8%) patients were included in model development and validation, and 113 (6.7%) patients who enrolled later were used as a test set for external validation. They were classified into 5 diagnostic categories. We compared 9 candidate machine learning methods, and the recalibrated model of light gradient boosting machine achieved the best performance, with an area under the curve of 0.937 (95% CI 0.917-0.962) in cross-validation and 0.954 (95% CI 0.944-0.967) in external validation.ConclusionsThe questionnaire-based light gradient boosting machine was able to predict common vestibular disorders and assist decision-making in ENT and vertigo clinics. Further studies with a larger sample size and the participation of neurologists will help assess the generalization and robustness of this machine learning method.

Project description:The study aimed in developing and validating a Health Belief Model (HBM) based instrument used for cross-sectional studies among secondary school students in Jimma town, Oromia, Ethiopia. A school-based cross-sectional study was conducted from May 25 to June 10, 2021. The sample size was 634, and students were randomly selected from public and private secondary schools. The 81 items were developed reviewing different literatures based on the constructs of HBM. The constructs were perceived severity, perceived vulnerability, perceived benefit, perceived barrier, self-efficacy, cues to action, perceived school support and self-protective practice. Data were collected using a self-administered questionnaire. The data were cleaned, entered into and analyzed using SPSS 23.0. A principal axis factoring with varimax rotation was carried out to extract items. Items with no loading factor or cross-loaded items were deleted. Items having factor loading coefficient of ≥0.4 were retained. An internal reliability was ensured at Cronbach's alpha >0.70. All items with corrected item-total correlation coefficient below 0.30 were deleted from reliability analysis. In this study, 576 respondents were participated making a response rate of 90.8%. A total of thirty items were extracted and loaded in to eleven factors with cumulative variance of 56.719%. Percieved social support, percieved benefit, percieved school responsibility, self-efficacy, and practice items were internally consistent. Percieved vurnerability was neither valid nor reliable construct. Similarly, from the extracted factors, attitude towards face mask use and percieved peer influence were not internally consistent. Lastly, percieved benefit, self-efficacy and percieved school responsibility significantly predicted student's adherence to COVID-19 self-protective practices. The study found that perceived benefit, perceived school support, social support, self-efficacy, perceived school environment cleanness, perceived school responsibility, perceived school health education, attitude to use face mask, perceived severity, cues to action and perceived peer influence were valid. Finally, perceived benefit, self-efficacy and perceived school responsibility significantly predicted student's adherence to COVID-19 self-protective practices.

Dataset Information

Development and validation of the Oral health behavior questionnaire for adolescents based on the health belief model (OHBQAHBM).

Publications

Development and validation of the Oral health behavior questionnaire for adolescents based on the health belief model (OHBQAHBM).

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