General Oral Health Assessment Index: A new evaluation proposal

Abstract

Objectives: To validity the General Oral Health Assessment Index (GOHAI) among adults who sought dental care and to present a new proposal for calculating scores on self-perception of oral health. Background: There is no study that presents a GOHAI scores using weight of the items. Materials and Methods: The one-factor model, the three-factor model (physical function, psychosocial/psychological function and pain/discomfort) and the second-order hierarchical model (SOHM) were evaluated from confirmatory factor analysis (λ, χ2/df, CFI,GFI and RMSEA). The reliability (CR,α) was estimated. Concurrent validity was assessed using the Oral Health Impact Profile (OHIP-14). The invariance of the models was estimated in independent samples. The calculation of an overall score using the factor scores was proposed to obtain the overall weighted scores. These overall weighted scores were compared to the scores estimated as the simple arithmetic mean (overall unweighted scores) using a repeated measures analysis of variance. Results: A total of 1000 individuals participated (74.1% female; age: 40.7 (SD=14.3) years). Three items of the GOHAI were excluded (λ<0.40). The one-factor model (λ=0.40-0.77; χ2/df=6.291; CFI=0.947; GFI=0.960; RMSEA=0.073) and the three-factor model (λ=0.40-0.78; χ2/df=8.321; CFI=0.932; GFI=0.954; RMSEA=0.086) each presented an adequate fit. Reliability was adequate (one-factor: CR=0.83/α=0.83; three-factor: CR=0.53-0.76/α=0.53-0.73), with the exception of the pain/discomfort factor. The GOHAI was invariant in independent samples, and the concurrent validity was adequate. The overall unweighted scores overestimated self-perceptions of oral health when compared with the weighted scores. Conclusion: Both the one-factor and three-factor models of the GOHAI were found to be valid, reliable and invariant for the sample after the exclusion of three items. The use of overall weighted scores is recommended for calculating the score of self-perception of oral health.