Psychometric properties of translation of the Child Perception Questionnaire (CPQ11-14) in Telugu speaking Indian children

Abstract

Oral health related quality of life research among children in India is still nascent and no measures have been validated to date. Although CPQ11-14 has been previously used in studies from the Indian sub-continent, the instrument has never been tested for cross-cultural adaptability. This study aimed to assess the validity and reliability of CPQ11-14 in Telugu speaking Indian school children. Primary school children of Medak district, Telangana State, India, were recruited by a multi-stage probability sampling method. The translated questionnaire was initially pilot tested on a small subset of children (n = 40). Children with informed consent from parents (N = 1342) were then provided with questionnaires containing the Telugu translation of CPQ11-14, followed by a clinical examination conducted by a single examiner, using Basic WHO survey methods for dental caries, malocclusion, and Dean's Fluorosis index. Children (n = 161) in randomly chosen schools were re-administered the same questionnaire after a two week interval to test reliability of CPQ11-14 on repeated administrations. Internal consistency and test-retest reliability as determined by Cronbach's alpha and Intra-class correlation coefficient for overall CPQ11-14 scale were 0.925 and 0.923, respectively. CPQ11-14 discriminated between the categories of fluorosis and malocclusion while its discriminant validity with respect to dental caries was limited. CPQ11-14 also demonstrated good construct validity with both overall CPQ11-14 and its subscales having significant positive correlation with global ratings of oral health and overall wellbeing, even after adjusting for confounding variables. CPQ11-14 had a correlation of 0.405 with self-evaluated oral health and 0.407 with self-evaluated impact of oral health on overall wellbeing. In conclusion, Telugu translation of CPQ11-14 demonstrated good internal consistency and excellent reliability on repeated administrations after two weeks. It also exhibited good discriminant and construct validity.