Confirmatory Factor Analysis of Knowledge, Attitude, and Behaviour Questionnaire towards Oral Health among Indian Adults

Siddharthan Selvaraj; Nyi Nyi Naing; Nadiah Wan-Arfah; Somasundaram Prasadh

doi:10.3390/jpm11040320

Confirmatory Factor Analysis of Knowledge, Attitude, and Behaviour Questionnaire towards Oral Health among Indian Adults

J Pers Med. 2021 Apr 20;11(4):320. doi: 10.3390/jpm11040320.

Authors

Siddharthan Selvaraj¹, Nyi Nyi Naing¹, Nadiah Wan-Arfah², Somasundaram Prasadh³

Affiliations

¹ Faculty of Medicine, Medical Campus, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu 20400, Malaysia.
² Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu 20400, Malaysia.
³ Faculty of Dentistry, National University of Singapore, Singapore 119077, Singapore.

Abstract

Background: Oral health-related conditions are among the common conditions seen in adults in India. The usage of inappropriate measurement tools that are unvalidated may result in deceptive and imprecise findings that might lead to substandard plans for cessation programs and ineffectiveness. This study was conducted to validate a questionnaire that can assess the factor structure of knowledge, attitude, and behaviour towards oral health among adults in India by confirmatory factor analysis. Methods: Simple random sampling was conducted among adults in India. A total of 260 adults participated in this study. The knowledge, attitude, and behaviour (KAB) questionnaire on oral health was circulated among the adults who were willing to participate in the study after it was explained to them, and the questionnaires were retrieved once they completed. Software R version 3.6 was used to analyse the data of this study. Robust maximum likelihood was utilized for the assessment due to the violation of multivariate normality assumption. For attitude and behaviour domain, a three-factor model was used for measurement model validity and construct validity. Results: The confirmatory factor analysis of the three-factor model for the 26-item KAB questionnaire on oral health gave sufficient goodness-of-fit values and the measurement model exhibited ideal convergent and discriminant validity following model re-specification. The three-factor model was tested to obtain measurement model validity and construct validity for attitude and behaviour domains. The results of this study gave a statistically significant value (p < 0.001), with χ² (df) values of 39 (7) and 28 (11) for attitude and behaviour domains, respectively. Conclusions: The KAB oral health questionnaire used in this study has a valid measurement model and reliable constructs. It was found to be an ideal tool to measure the KAB towards oral health among adults in India.

Keywords: attitude and behaviour; confirmatory factor analysis; item response theory; knowledge; oral health; validity.