Background: Oral Health Related Quality of Life (OHRQoL) measures play an important role in understanding subjective patient experiences in oral health care. The Oral Impact on Daily Performance (OIDP) scale is a validated OHRQoL tool that measures the impact and extent to which an individual's daily activities may be compromised by their oral health. It is commonly used to facilitate oral health service planning. The aim of this study was to modify and validate a Sinhalese version of the OIDP for use in Sri Lankan adolescents. Methods: Stage I involved cultural adaptation of the tool through translation and modification. Stage II involved the exploring factor structure, validation and a reliability assessment. After translation and cultural adaptation, stage II was conducted among 220 secondary school students aged 15-19 in the Gampaha district, Sri Lanka. Participants completed the modified OIDP scale along with questions on self-reported perceived oral health problems and treatment need which were used to assesses the concurrent validity of the modified OIDP scale. Factorability was assessed by inspection of correlation matrix and Kaiser-Meyer-Olkin and Bartlett's Test of Sphericity tests as a measure of sampling adequacy. An exploratory factor analysis was carried out using Principal Component Analysis method and factors were rotated using the oblimin method. Results: The Kaiser-Meyer-Olkin measure was 0.87 and Bartlett's test of Sphericity was significant (p < 0.001) Cronbach's alpha was calculated as 0.88, indicating a high level of internal consistency of the modified OIDP scale. The principal component analysis produced two factors with Eigen values ranging from 1.12 to 4.40, explaining 70.0% of total variance. Concurrent validity was satisfactory as the OIDP score increased when the adolescents' perceived oral health decreased. The final modified OIDP consists of eight self-reported items which assesses the impact severity of eight daily performances over past three months. Participant scores ranged from 0 to 24 out of a worst possible score of 40, and nearly 48% of the responders reported at least one impact during past three months. The most prevalent oral health impact related to chewing and enjoying foods, reported by 36.8% of respondents. Conclusion: This study suggests that the modified OIDP scale has promising psychometric properties and is appropriate for use among adolescents in Sri Lanka. Further research is required to test the validity of this tool in other cohorts.

Background Oral Health Related Quality of Life (OHRQoL) surveys play an important role in understanding subjective patient experiences in oral health care. The Oral Impact on Daily Performance (OIDP) scale is a validated OHRQoL tool that measures the impact and extent to which an individual’s daily activities may be compromised by their oral health. It is commonly used to facilitate oral health service planning. The aim of this study was to modify and validate a Sinhalese version of the OIDP for use in Sri Lankan adolescents. Methods The stage I involved cultural adaptation of the tool through translation and modification. After translation and cultural adaptation, the modified OIDP was tested on 220, 15-19 year secondary school students in the Gampaha district, Sri Lanka. The adolescents completed the modified OIDP scale along with questions on self-reported perceived oral health problems and treatment need which were used to assesses the concurrent validity of the modified OIDP scale. Stage II and III involved the exploring factor structure, validation and a reliability assessment. Factorability was assessed by inspection of correlation matrix and Kaiser-Meyer-Olkin and Bartlett's Test of Sphericity tests as a measure of sampling adequacy. An exploratory factor analysis was carried out using Principal Component Analysis method and factors were rotated using the oblimin method. Results 220 adolescents participated in factor analysis and validation studies. The most prevalent oral health impact related to chewing and enjoying foods, reported by 36.8% of respondents The Kaiser-Meyer-Olkin measure was 0.87 and Bartlett’s test of Sphericity was significant (p<0.001) Cronbach’s alpha was calculated as 0.88, indicating a high level of internal consistency. The principal component analysis produced two factors with Eigen values ranging from 1.12 to 4.40, explaining 70.0% of total variance. Concurrent validity was satisfactory as the OIDP score increased when the adolescents’ perceived oral health decreased.Conclusion This study showed that the modified OIDP scale is applicable for use among adolescents in Sri Lanka. It has promising psychometric properties but further research is required to use this tool in other cohorts.

Background Postnatal care (PNC) is important for preventing morbidity and mortality in mothers and newborns. Even though its importance is highlighted, PNC received less attention than antenatal care. This study determines the level of PNC coverage and its determinants in Srilanka. Methods This is a secondary analysis of the 2016 Demographic and Health Survey. Receiving full postnatal care (FPNC) was defined with a set of indicators to detect adequate care for mother and newborn. Demographic and socio-economic associated factors for receiving FPNC were identified using binary and multiple logistic regression. Variables that had marginal relationship with receiving FPNC which p-value less than or equal to 0.2 at binary analysis were selected and included in the multiple logistic regression models. We used manual backward stepwise regression to identify variables which had independent association with receiving FPNC on the basis of adjusted odds ratios (AOR), with 95% confidence interval (CI) and p-value less than 0.05. All analyses were performed in SPSS 25. Results Of the 8313 women with a live birth in the last 5 years, more than 98% had received postnatal care at facility at least 24 h. More than three-fourth of mothers (n = 5104) received the FPNC according to WHO guideline. Four factors were positively associated with receiving FPNC: mothers received antenatal home visits by Public health midwife (AOR = 1.98, 95% CI 1.65–2.39), mothers who got information about antenatal complications and places to go at antenatal clinics (AOR = 1.56, 95% CI 1.27–1.92), been Sinhala (AOR = 1.89, 95% CI 1.35–2.66) and having own mobile phone (AOR = 1.19, 95% CI 1.02–1.38). Mothers who are residing in rural area (AOR = 0.697 95% CI = 0.52–0.93] compared to those who reside in urban areas and maternal age between 20 and 34 years [AOR = 0.72, 95% CI 0.54–0.97] compared to maternal age less than 20 years were detected as negatively associated. Conclusion Receiving FPNC in Srilanka is high. However, inequity remains to be a challenge. Socio-demographic factors are associated with FPNC coverage. Strategies that aim to improve postnatal care should target improvement of non-health factors as well.

Background Oral Health Related Quality of Life (OHRQoL) measures have emerged as an important oral health outcome that is able to reveal the subjective burden of illness due to oral diseases. The association between sociodemographic and socioeconomic factors, clinical dental conditions and OHRQoL indicators has been investigated in adolescent populations across the world. The purpose of this study was to investigate key factors associated with oral health-related quality of life of Sri Lankan adolescents. Methods A cross sectional study was conducted in a sample of 15–19 year-old secondary school students in the Gampaha district of Sri Lanka. The data was collected using two self-administered questionnaires. A modified Sinhalese version of the Oral Impact on Daily Performance (OIDP) questionnaire that has been validated for Sri Lankan adolescents was administered. A second questionnaire collected information on socioeconomic characteristics, oral health care seeking and oral health behaviours. A clinical oral examination was performed on each participant. Oral health related quality of life was measured using OIDP domains and total OIDP scores. Poisson regression was used to investigate the key factors associated with the OIDP additive score. Results A total of 1332 adolescents participated in the study. Negative quality of life impacts were more prevalent in the social and psychological domains of OIDP as compared with the functional domain. Total OIDP scores ranged from 0 to 36 with a mean of 3.16 (SD = 4.71). The multivariable analysis revealed that increasing age, low income, brushing teeth only once per day, and increased number of decayed teeth were found to be associated with poor overall OHRQoL, while male gender, frequent oral healthcare seeking patterns and absent dento-facial anomalies were associated with good OHRQoL. Conclusion This study identified modifiable behavioural and oral health related factors which are associated with OHRQoL in Sri Lankan adolescents. Oral health interventions should target these modifiable factors to improve the OHRQoL in these populations.

Objectives: Most of the paediatric quality-of-life instruments in oral health research are not preference-based measures, thus cannot be used in economic evaluations.The Early Childhood Oral Health Impact Scale (ECOHIS) is one such instrument which assesses oral health impact on children's quality of life among three-to fiveyear-olds. With increasing demands for more resource allocation in oral health care, there is a need for an outcome metric which can be used as the outcome in economic evaluations. The aim of this study was to develop a preference-based, health-state classification system from the existing ECOHIS instrument. Methods:The 13-item ECOHIS instrument was applied to the carers of 280 preschoolers who participated in a clinical trial in metropolitan Perth, Western Australia.Exploratory factor analysis was conducted to assess the dimensionality of the ECOHIS. Rasch analysis was used to eliminate and select items per determined dimensions and to reduce the number of response options for each item, because six levels were not amenable to valuation. The final classification system was determined through a combination of psychometric and expert advice.Results: Items loaded on to four dimensions with the factor analysis. Using Rasch analysis, three items were selected from the first dimension (child functional and psychological impact) and one item from the second dimension (child social interaction impact). None were selected from the third dimension (parental distress and family function impact) as it is not an appropriate proxy method of measuring the level of impact on a child. The final classification system has four dimensions with three levels in each, and so it has been named the ECOHIS-4D. Conclusions:The ECOHIS-4D classification system is a new preference-based instrument derived from the existing ECOHIS instrument. Future valuation studies will develop a utility value set for the health states defined by this classification system, and this will guide economic evaluations related to oral health interventions.