Development and Validation of an Adult Periodontal Health Knowledge and Belief Questionnaire in Thai Adults

Abstract

Introduction and aims

Periodontal diseases pose a significant oral health challenge, with many adults lacking adequate understanding of these conditions. This study aimed to develop and validate a questionnaire, designed for standardized assessment of periodontal health knowledge and beliefs in adults (ALPHABET).

Methods

The ALPHABET questionnaire, initially composed of 70 items focusing on periodontal health knowledge (ALPHA-K) and belief (ALPHA-B), underwent thorough development and validation via expert panel review. Structural validity of ALPHA-B was evaluated using confirmatory factor analysis, while convergent validity was confirmed by expected relationship between the scores of ALPHA-K and ALPHA-B, and reliability was assessed through internal consistency. A cross-sectional analysis involving 380 Thai adult dental patients examined the association between ALPHABET scores and patient types, as well as the association with oral health behaviours.

Results

After refinement, the final 40-item ALPHABET questionnaire showed a strong fit with the underlying model, confirming its structural validity. The correlations between the scores of ALPHA-K and ALPHA-B were proved its convergent validity. It also demonstrated high reliability, with Cronbach’s alpha coefficients exceeding 0.7, and favourable item-total correlations ranging from 0.406 to 0.773. Patients with a history of periodontal treatment scored significantly higher on all ALPHABET subscales compared to new patients (P < .05). The logistic regression analysis demonstrated association of both knowledge and self-efficacy with both brushing and flossing behaviours.

Conclusions

To our knowledge, this questionnaire is the first to validate and assess periodontal health and belief in adults. It should serve as a valuable standardized tool that would potentially drive intervention and raise awareness of the disease and improve periodontal health outcomes.

Clinical relevance

This questionnaire should improve clinician insights into patient perspectives on periodontal disease so as to provide individualized oral health education, guiding tailored interventions for better outcomes.