Development and psychometric evaluation of a theory of planned behavior model-based instrument for evaluation of determinants of oral health behaviors in mothers of children younger than six years in Iraq

Abstract Background The theory of planned behavior (TPB) is one of the most commonly used theories to explain oral health behaviors. To gain a deeper understanding of the determinants of oral health behaviors, we aimed to design and evaluate the psychometrics of a theory of planned behavior model-ba...

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Main Authors: Rusul Abdulameer Hadi Al-Sarray, Ahmadreza Shamshiri, Muhammad Alzubidi, Mahdia Gholami, Simin Z. Mohebbi
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-05566-6
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author Rusul Abdulameer Hadi Al-Sarray
Ahmadreza Shamshiri
Muhammad Alzubidi
Mahdia Gholami
Simin Z. Mohebbi
author_facet Rusul Abdulameer Hadi Al-Sarray
Ahmadreza Shamshiri
Muhammad Alzubidi
Mahdia Gholami
Simin Z. Mohebbi
author_sort Rusul Abdulameer Hadi Al-Sarray
collection DOAJ
description Abstract Background The theory of planned behavior (TPB) is one of the most commonly used theories to explain oral health behaviors. To gain a deeper understanding of the determinants of oral health behaviors, we aimed to design and evaluate the psychometrics of a theory of planned behavior model-based instrument for assessing the determinants of oral health behaviors in mothers of children younger than six years in Iraq. Methods Questionnaires and guidelines related to the topic were searched in 2023, and the appropriate items based on the domains of the TPB model were extracted. The items were revised and completed to develop the initial version of the instruments. Face validity and content validity of the instrument were assessed. The content validity index (CVI) and content validity ratio (CVR) were calculated subsequently. The construct validity was examined by confirmatory factor analysis (CFA). Cronbach’s alpha, intra-class correlation coefficient (ICC), and percentage of agreement were employed to check the tool’s internal consistency and reproducibility reliability. The data were analyzed using SPSS version 25 and Amos software. Results The questionnaire had adequate content validity (CVR ≥ 0.75, CVI ≥ 0.75). The percentage of agreement, Kappa, and ICC coefficients were 57.1–95.3%, 0.52–0.89, and 0.43–0.90, respectively. The p-value for ICC was significant in all cases (p < 0.001). For the internal stability of the tool to keep Cronbach’s alpha values > 0.7 for all domains, we had to omit three questions from attitude, one from subjective norms, and one from perceived behavioral control. In terms of construct validity, the results were as follows: the Goodness of Fit Index (GFI) was 0.942, the Comparative Fit Index (CFI) was 0.900, the Adjusted Goodness of Fit Index (AGFI) was 0.921, and the Root Mean Square Error of Approximation (RMSEA) was 0.046. These values indicate that the instrument demonstrates appropriate construct validity based on the TPB. Conclusion The psychometric evaluation of the designed instrument showed that it was a valid and reliable tool in Arabic-speaking countries for determining child-related oral health behaviors in mothers of children under six years old.
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series BMC Oral Health
spelling doaj-art-9d634e76b51a4a29b4daa25939d36ebe2025-02-09T12:57:24ZengBMCBMC Oral Health1472-68312025-02-012511910.1186/s12903-025-05566-6Development and psychometric evaluation of a theory of planned behavior model-based instrument for evaluation of determinants of oral health behaviors in mothers of children younger than six years in IraqRusul Abdulameer Hadi Al-Sarray0Ahmadreza Shamshiri1Muhammad Alzubidi2Mahdia Gholami3Simin Z. Mohebbi4Department of Community Oral Health, School of Dentistry, Tehran University of Medical SciencesResearch Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical SciencesOrthodontic and Preventive Department (POP), College of Dentistry, Mustansiriyah University, PedodonticResearch Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical SciencesResearch Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical SciencesAbstract Background The theory of planned behavior (TPB) is one of the most commonly used theories to explain oral health behaviors. To gain a deeper understanding of the determinants of oral health behaviors, we aimed to design and evaluate the psychometrics of a theory of planned behavior model-based instrument for assessing the determinants of oral health behaviors in mothers of children younger than six years in Iraq. Methods Questionnaires and guidelines related to the topic were searched in 2023, and the appropriate items based on the domains of the TPB model were extracted. The items were revised and completed to develop the initial version of the instruments. Face validity and content validity of the instrument were assessed. The content validity index (CVI) and content validity ratio (CVR) were calculated subsequently. The construct validity was examined by confirmatory factor analysis (CFA). Cronbach’s alpha, intra-class correlation coefficient (ICC), and percentage of agreement were employed to check the tool’s internal consistency and reproducibility reliability. The data were analyzed using SPSS version 25 and Amos software. Results The questionnaire had adequate content validity (CVR ≥ 0.75, CVI ≥ 0.75). The percentage of agreement, Kappa, and ICC coefficients were 57.1–95.3%, 0.52–0.89, and 0.43–0.90, respectively. The p-value for ICC was significant in all cases (p < 0.001). For the internal stability of the tool to keep Cronbach’s alpha values > 0.7 for all domains, we had to omit three questions from attitude, one from subjective norms, and one from perceived behavioral control. In terms of construct validity, the results were as follows: the Goodness of Fit Index (GFI) was 0.942, the Comparative Fit Index (CFI) was 0.900, the Adjusted Goodness of Fit Index (AGFI) was 0.921, and the Root Mean Square Error of Approximation (RMSEA) was 0.046. These values indicate that the instrument demonstrates appropriate construct validity based on the TPB. Conclusion The psychometric evaluation of the designed instrument showed that it was a valid and reliable tool in Arabic-speaking countries for determining child-related oral health behaviors in mothers of children under six years old.https://doi.org/10.1186/s12903-025-05566-6Theory of planned behaviorPsychometric propertiesOral healthChildren
spellingShingle Rusul Abdulameer Hadi Al-Sarray
Ahmadreza Shamshiri
Muhammad Alzubidi
Mahdia Gholami
Simin Z. Mohebbi
Development and psychometric evaluation of a theory of planned behavior model-based instrument for evaluation of determinants of oral health behaviors in mothers of children younger than six years in Iraq
BMC Oral Health
Theory of planned behavior
Psychometric properties
Oral health
Children
title Development and psychometric evaluation of a theory of planned behavior model-based instrument for evaluation of determinants of oral health behaviors in mothers of children younger than six years in Iraq
title_full Development and psychometric evaluation of a theory of planned behavior model-based instrument for evaluation of determinants of oral health behaviors in mothers of children younger than six years in Iraq
title_fullStr Development and psychometric evaluation of a theory of planned behavior model-based instrument for evaluation of determinants of oral health behaviors in mothers of children younger than six years in Iraq
title_full_unstemmed Development and psychometric evaluation of a theory of planned behavior model-based instrument for evaluation of determinants of oral health behaviors in mothers of children younger than six years in Iraq
title_short Development and psychometric evaluation of a theory of planned behavior model-based instrument for evaluation of determinants of oral health behaviors in mothers of children younger than six years in Iraq
title_sort development and psychometric evaluation of a theory of planned behavior model based instrument for evaluation of determinants of oral health behaviors in mothers of children younger than six years in iraq
topic Theory of planned behavior
Psychometric properties
Oral health
Children
url https://doi.org/10.1186/s12903-025-05566-6
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