title: Validation of a pediatric oral health-related quality of life scale in Navajo children.
abstract: BACKGROUND
  American Indian (AI) children experience the highest rates of early childhood caries (ECC) in the USA, yet no tool has been validated to measure the impact of ECC on their oral health-related quality of life (OHRQoL).
  
  
  OBJECTIVE
  To validate a pediatric OHRQoL scale in a preschool, rural, reservation-based AI population.
  
  
  METHODS
  In 2011 and 2012, we measured the OHRQoL of AI children attending Head Start in Navajo Nation with the 12-item preschool version of the pediatric oral health-related quality of life (POQL) scale administered to their parents/caregivers. Parents/caregivers also reported their children's subjective oral health status (OHS) and oral health behavior adherence. Concurrently, calibrated dental examiners measured the children's decayed, missing, and filled tooth surfaces (dmfs). Validation was assessed with internal reliability and convergent and divergent validity testing and exploratory factor analyses.
  
  
  RESULTS
  We measured the outcomes in 928 caregiver-child dyads. All children were AI and in preschool [mean (SD) child age was 4.1 (0.5) years]. The majority of children had experienced decay [dmfs: 89 %, mean (SD): 21.5 (19.9)] and active decay [any ds: 70 %, mean (SD): 6.0 (8.3)]. The mean (SD) overall POQL score was 4.0 (9.0). The POQL scale demonstrated high internal consistency reliability (Cronbach alpha = 0.87). Convergent validity of the POQL scale was established with highly significant associations between POQL and caries experience, OHS, and adherence to oral health behaviors (all ps < 0.0001).
  
  
  CONCLUSIONS
  The POQL scale is a reliable and valid measure of OHRQoL in preschoolers from the Navajo Nation.
authors.affiliation: Children's Outcomes Research, Colorado Health Outcomes Programs, University of Colorado Anschutz Medical Campus, 13199 E. Montview Blvd. Suite 300 F443, Aurora, CO, 80045, USA, Patricia.braun@ucdenver.edu.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Braun
authors.forename: Kimberly E
authors.initials: KE
authors.lastname: Lind
authors.forename: William G
authors.initials: WG
authors.lastname: Henderson
authors.forename: Angela G
authors.initials: AG
authors.lastname: Brega
authors.forename: David O
authors.initials: DO
authors.lastname: Quissell
authors.forename: Judith
authors.initials: J
authors.lastname: Albino
mesh_terms: D000328:Adult; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000453:epidemiology*; D005163:Factor Analysis, Statistical; D005260:Female; D006304:Health Status; D006801:Humans; D007198:Indians, North American; D008297:Male; D009909:Oral Health; D010290:Parents; D010372:Pediatrics; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires