Factor structure of the short-form CPQ11-14

Abstract

OBJECTIVES: To examine the factor structure and other psychometric characteristics of the most commonly-used child OHRQoL measure (the 16-item short-form CPQ11-14) in a large number of children (N = 5804) from different settings and who had a range of caries experience and associated impacts. METHODS: Secondary data analyses used subnational epidemiological samples of 11-to-14-year-olds in Australia (N = 372), New Zealand (three samples; 352, 202, 429), Brunei (423), Cambodia (244), Hong Kong (542), Malaysia (439), Thailand (220, 325), England (88, 374), Germany (1055), Mexico (335) and Brazil (404). Confirmatory factor analysis (CFA) was used to examine the factor structure of that scale across the combined sample and within four regions (Australia/NZ, Asia, UK/Europe, Latin America). Item impact and internal reliability analysis were also conducted. RESULTS: Just over half were female. Caries experience varied, with mean DMFT scores lowest in the Malaysian sample and highest in a New Zealand sample. The CFA revealed two factors with eigenvalues greater than 1. The first involved all items in the oral symptoms and functional limitations subscales; the second all emotional well-being and social well-being items. Cronbach’s alpha scores were 0.72 and 0.84 respectively. The first was designated the “Symptoms/function” subscale, and the second was designated the “Well-being” subscale. The former contained more of the items with greater impact, with the item “Food stuck in between your teeth” having greatest impact; in the Well-being subscale, the “Felt shy or embarrassed” item had the greatest impact. Repeating the analyses by region gave similar findings. CONCLUSIONS: The CPQ11-14 performed well cross-sectionally in the largest analysis to date, with robust and mostly consistent psychometric characteristics, albeit with two underlying factors (rather than the originally hypothesised four-factor structure). It appears to be a sound, robust measure which should be useful for research, practice and policy.