Dental vulnerability scale in primary health care: evidence of content and structure internal validity

Abstract

Background Access to oral health services remains a challenge in the Brazilian healthcare system, especially in the primary health care setting, where the use of a risk stratification tool that could identify individuals with higher dental vulnerability would be extremely valuable. However, there literature on this theme is scarce, and there is no validated instrument in Brazil that is capable of measuring dental vulnerability. Hence, this psychometric study aimed at the development and evaluation of content and internal structure validity of the Dental Vulnerability Scale for Primary Health Care (PHC). Methods The items were developed based on a qualitative exploratory analysis. A total of 172 items were prepared and submitted to a panel of specialists, with content validity analyzed with the Content Validity Ratio (CVR), resulting in an the initial version of the instrument composed by 41 items. Internal structure validity was analyzed by Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and by applying 3 reliability indicators (Cronbach’s Alpha, McDonald's Omega and Greatest Lower Bound – GBL), with a sample of 1227 individuals. Results The final configuration indicated a scale of 15 items divided into 4 dimensions (overall health, oral health, infrastructure, and healthcare services) with explained variance of 72.11%. The factor loads varied from 0.37 to 0.96. The model adjustment indices were set at × 2/df(51) = 3.23, NNFI = 0.95, CFI = 0.98, GFI = 0.96, AGFI = 0.97, RMSEA = 0.04 and RMSR = 0.03. Conclusion DVS presented satisfactory evidence of validity, indicating its suitability to be used by healthcare professionals, students and managers to plan oral health actions and services at PHC.

Validação da estrutura interna da Escala Brasileira de Vulnerabilidade Odontológica

“…The first stage of collection was performed by dentists 3 and the second by trained data collectors, during a two-week visit to the municipalities outside São Paulo.…”

“…Participants were approached during care at the dental clinic or in the waiting room of the BHU and invited to participate in the research. After signing the informed consent form, the clinical and sociodemographic characterization structured questionnaire and the EVO-BR items were applied ( Table 1 ) 3 . Research Electronic Data Capture (RedCap) software program was used for data collection and storage.…”

“…In addition to assessing the database, an individual analysis of items was conducted, as recommended, so that their unsuitability for factoring could affect the solution of the model. The missing values were treated using the multiple imputation technique 3 .…”

Correction to: Dental vulnerability scale in primary health care: evidence of content and structure internal validity

“…1186/ s12903-021-01742-6. *Correspondence: daniellepalacio@yahoo.com.br 1 Hospital Israelita Albert Einstein, Av. Albert Einstein 627, São Paulo, SP, Brazil Full list of author information is available at the end of the article…”

Organization of the demand for primary oral health care in the Brazilian Unified Health System

“…The criteria for case prioritization should not be that of order of arrival, but the severity of the case and the level of pain [13]. The objective of vulnerability assessment is to allow for the prioritization of care to those with higher risk or higher disease activity during treatment [14]. Thus, organizing the demand for oral healthcare is a big challenge for the oral health teams, because it needs careful planning and requires time and communication with other professionals.…”