title: Performance and cross-cultural comparison of the short-form version of the CPQ11-14 in New Zealand, Brunei and Brazil.
abstract: BACKGROUND
  The Child Perception Questionnaire (CPQ11-14) is a self-report instrument developed to measure oral-health-related quality of life (OHRQoL) in 11-14-year-olds. Earlier reports confirm that the 16-item short-form version performs adequately, but there is a need to determine the measure's validity and properties in larger and more diverse samples and settings.
  
  
  OBJECTIVE
  The objective of this study was to examine the performance of the 16-item short-form impact version of the CPQ11-14 in different communities and cultures with diverse caries experience.
  
  
  METHODS
  Cross-sectional epidemiological surveys of child oral health were conducted in two regions of New Zealand, one region in Brunei, and one in Brazil. Children were examined for dental caries (following WHO guidelines), and OHRQoL was measured using the 16-item short-form item-impact version of the CPQ11-14, along with two global questions on OHRQoL. Children in the 20% with the greatest caries experience (DMF score) were categorised as the highest caries quintile. Construct validity was evaluated by comparing the mean scale scores across the categories of caries experience; correlational construct validity was assessed by comparing mean scores and children's global ratings of oral health and well-being.
  
  
  RESULTS
  There were substantial variations in caries experience among the different communities (from 1.8 in Otago to 4.9 in Northland) and in mean CPQ11-14 scores (from 11.5 in Northland to 16.8 in Brunei). In all samples, those in the most severe caries experience quintile had higher mean CPQ11-14 scores than those who were caries-free (P < 0.05). There were also greater CPQ scores in those with worse self-rated oral health, with the Otago sample presenting the most marked gradient across the response categories for self-rated oral health, from 'Excellent' to 'Fair/Poor' (9.6 to 19.7 respectively).
  
  
  CONCLUSIONS
  The findings suggest that the 16-item short-form item impact version of the CPQ11-14 performs well across diverse cultures and levels of caries experience. Reasons for the differences in mean CPQ scores among the communities are unclear and may reflect subtle socio-cultural differences in subjective oral health among these populations, but elucidating these requires further exploration of the face and content validity of the measure in different populations.
authors.affiliation: Department of Oral Rehabilitation, School of Dentistry, University of Otago, New Zealand. lyndie.fosterpage@otago.ac.nz
authors.forename: Lyndie A Foster
authors.initials: LA
authors.lastname: Page
authors.forename: W Murray
authors.initials: WM
authors.lastname: Thomson
authors.forename: A Rizan
authors.initials: AR
authors.lastname: Mohamed
authors.forename: Jefferson
authors.initials: J
authors.lastname: Traebert
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002010:Brunei / Q000453:epidemiology; D002648:Child; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D003753:Dental Health Surveys; D005260:Female; D006801:Humans; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D015588:Observer Variation; D009909:Oral Health; D011594:Psychometrics / Q000295:instrumentation*; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012649:Self Concept; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires