The MOHIP-14PW (Modified Oral Health Impact Profile 14-Item Version for Pregnant Women): A Real-World Study of Its Psychometric Properties and Relationship with Patient-Reported Oral Health.

Chengwu Yang,Shulamite S Huang,Stefanie L Russell,Tiffany A Moore Simas,Hugh Silk,Judith A Savageau

doi:10.3390/healthcare10030461

Abstract

Background: The 14-item version of the Oral Health Impact Profile (OHIP-14) has been widely used as a measure for oral health-related quality of life (OHQoL) since its publication in 1997. However, few studies have examined its psychometric properties and relationship with patient-reported oral health in pregnant women. Aim: To offer empirical evidence for appropriate use of the OHIP-14 among pregnant women in research and clinical practice. Objectives: (1) to empirically investigate the psychometric properties of the OHIP-14, (2) to modify it into the MOHIP-14PW (modified OHIP-14 for pregnant women), and (3) to compare their relationships with patient-reported oral health in pregnant women. Methods: In this real-world study (RWS) from suburban New York clinics, we collected OHIP-14 data from 291 pregnant women and assessed its psychometric properties at the item-, dimension-, and measure-level, including confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Accordingly, we modified the OHIP-14 into the MOHIP-14PW. Finally, we compared their correlations with patient-reported oral health scores. Results: All OHIP-14 items had severely skewed distributions, and two had a correlation with the patient-reported oral health < 0.1. All seven pairs of items correlated well (0.47 to 0.62), but the Cronbach’s alphas indicated suboptimal reliability, with two below 0.70. CFA results offered suboptimal support to the original structure, and EFA found a three-dimensional structure best fitted the data. Therefore, we modified the OHIP-14 into the MOHIP-14PW. CFA on the MOHIP-14PW offered stronger supports, and the Cronbach’s alphas increased to 0.92, 0.72, and 0.71. The MOHIP-14PW’s dimensions were more meaningful to pregnant women and had stronger relationships with patient-reported oral health than the OHIP-14; the average correlation coefficients increased by 26% from 0.19 in OHIP-14 to 0.24 in the MOHIP-14PW. Conclusions: The original OHIP-14 required modifications at the item-, dimension-, and measure- level, and the MOHIP-14PW had better psychometric properties, easier interpretation, and stronger correlation with patient-reported oral health in low-income pregnant women. Through an interdisciplinary RWS on a large sample of pregnant women, this study offers concrete empirical evidence for the advantages of the MOHIP-14PW over the original OHIP-14.

Highlights

Oral diseases are highly prevalent and greatly reduce oral health-related quality of life (OHQoL) [1]
The Oral Health Impact Profile (OHIP)-14 offers seven dimension-scores and one total score, which is burdensome for busy clinicians and researchers. This burden can be eased in practical application if a simpler factor structure of the OHIP-14 can be identified for pregnant women resulting in fewer dimension-scores. In this real-world study using empirical clinical data collected from two dental clinics, we aim to (1) thoroughly investigate the psychometric properties of the OHIP-14 in pregnant women at the item, dimension, and measure-level; (2) modify the scale into the MOHIP-14PW; and (3) assess the relationship of patient-reported oral health with the OHIP-14 in comparison with the MOHIP-14PW in low-income pregnant women
Measure-Level Analysis of the OHIP-14 We investigated the factor structure of the OHIP-14 items by using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) techniques

Summary

Introduction

Oral diseases are highly prevalent and greatly reduce oral health-related quality of life (OHQoL) [1] This relationship is true for pregnant women, when their bodies undergo significant hormonal and physiological changes, affecting gingival inflammation [2,3]. Few studies have examined its psychometric properties and relationship with patient-reported oral health in pregnant women. We modified the OHIP-14 into the MOHIP-14PW We compared their correlations with patient-reported oral health scores. The MOHIP-14PW’s dimensions were more meaningful to pregnant women and had stronger relationships with patient-reported oral health than the OHIP-14; the average correlation coefficients increased by 26% from 0.19 in OHIP-14 to 0.24 in the MOHIP-14PW. Conclusions: The original OHIP-14 required modifications at the item-, dimension-, and measure- level, and the MOHIP-14PW had better psychometric properties, easier interpretation, and stronger correlation with patient-reported oral health in low-income pregnant women. Through an interdisciplinary RWS on a large sample of pregnant women, this study offers concrete empirical evidence for the advantages of the MOHIP-14PW over the original OHIP-14

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