Validation of the Thai Version of Early Childhood Oral Health Impact Scale (Th-ECOHIS)

Abstract

Background: Early childhood caries (ECC) has been prevalent in Thailand. There has never been an appropriate tool to measure its impact on children. Early childhood oral health impact scale (ECOHIS) is a proxy-reported questionnaire developed in the United States for measuring the oral health related quality of life of preschool children and their families and widely adopted into many countries. This study translated it into Thai (Th-ECOHIS) and investigated its psychometric properties in Thai caregivers and their children. Methods: Forward–backward translation by expert was used for the scale development. A face and content validation test were conducted among a group of caregivers to revise and attain the final Th-ECOHIS. Psychometric testing was done on caregivers of 3-year-olds in Bangkok with the interviewer-administered mode. Children’s oral health was indicated by caries experience (decayed, missing and filled primary teeth, dmft). The caregivers answered the Th-ECOHIS and global questions regarding perception of their children’s oral health. Reliability was assessed by measuring internal consistency and reproducibility using Cronbach’s alpha coefficient. Test-retest reliability was managed at 2-week interval in 10% of samples using the intraclass correlation coefficient calculated by two-way analysis of variance. The discriminant validity was tested by the relationship between the severity of dental caries and Th-ECOHIS scores using Kruskal- Wallis test.Results: A total of 214 child-parent pairs participated. Of the 214 children, 22% had ECC (dmft 1-3) and 17.3% had severe ECC (dmft 4 or higher). The mean (SD) dmft score was 1.63 (2.92). All items in the original ECOHIS were retained in the Thai version. The test-retest reliability of Th-ECOHIS was 0.87; internal consistency was 0.85; the total of Th-ECOHIS scores were significantly correlated with the global rating of oral health questions (r = 0.604). The child impact section, family impact section and total Th-ECOHIS scores were significantly associated with the severity of dental caries (p < 0.001).Conclusions: Psychometric evaluation of the Th-ECOHIS demonstrated good reliability and validity and could be used to assess impacts of early childhood caries on quality of life of Thai pre-school children through caregivers and be compared with studies in other languages.