Pilot study of the QAA-25 questionnaire for assessing legal representatives' adherence to preschool children's oral health

Relevance. Adherence to oral health practices is among the most important factors determining a patient's general health. When considering adherence during the preschool years, it is essential to assess the child's parents or guardians because adults are primarily responsible for following clinicians' recommendations at this age. This area remains largely unexplored. In particular, no specialized questionnaire is available for assessing oral health adherence among legal representatives, including parents, guardians, and trustees, of persons under 12 years of age.

Objective. This pilot study aimed to assess the adaptation of the QAA-25 questionnaire for evaluating legal representatives' adherence to preschool children's oral health.

Materials and methods. First, the original QAA-25 D questionnaire was modified to determine the level of adherence to oral health practices. Respondents were then interviewed to refine the questionnaire wording, after which they completed the original and new questionnaires concurrently to determine the validity of the modified version. The questionnaires were compared using nonparametric statistical methods: the Wilcoxon signed-rank test and Spearman's rank correlation coefficient.

Results. The study revealed a consistent pattern. Respondents who demonstrated a high level of adherence on the study questionnaire (n = 16) also demonstrated a high level of adherence on the original questionnaire (n = 15). Respondents with a moderate level of adherence (n = 9) likewise demonstrated a moderate level of adherence on the original questionnaire (n = 11), while respondents with a low level of anxiety (n = 5 on the study questionnaire and n = 4 on the original questionnaire) demonstrated low adherence. In the Wilcoxon comparison, the observed T value of 163.0 deviated from the expected mean of 232.5 by 1.43σ. The z statistic was 1.429, the p value was 0.153, and Spearman's rank correlation coefficient (ρ) was 0.911.

Conclusion. The modified QAA-25 questionnaire, designated by the authors as QAA-25(III) and intended to assess legal representatives' adherence to preschool children's oral health, showed a strong correlation with the original QAA-25 D questionnaire (p = 0.153, ρ = 0.911), supporting its use as a reliable version of the existing questionnaire.

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