A Health Belief Model-Based Instrument for Assessing Factors Affecting Oral Health Behavior During Pregnancy

Background: Maintaining optimal oral health behavior (OHB) during pregnancy could preserve short- term and long-term health of women and their children. Objectives: By applying the health belief model (HBM), this study aimed at developing and analyzing the psychometric properties of an instrument evaluating pregnant women's beliefs regarding OHB. Methods: In this instrument development study that carried out in Tehran (2015 - 2016), a preliminary 134-item questionnaire was developed, and content and face validity were assessed. The construct, convergent, discriminant, and criterion-oriented validity of the questionnaire were evaluated through a pilot study on 221 pregnant women, attending public health centers, by performing confirmatory factor analysis (CFA) and Linear Regression analysis. Cronbach's alpha coefficient, composite reliability (CR) and intraclass correlation coefficient (ICC) were calculated to examine reliability. Results: The mean age of participants was 27.5 +/- 5.6 years with mean gestational age of 21.5 +/- 8.5 weeks. Based on CFA, the data fitted the HBM model. Root Mean Square Error of Approximation (RMSEA) was 0.052, Non-Normed Fit Index (NNFI) was 0.95, and Comparative Fit Index (CFI) was 0.96. The final HBM-based questionnaire with 79 items was associated with individual OHB (P = 0.001 and B = 0.4). The overall Cronbach's alpha was 0.94 and ICC ranged between 0.84 and 0.99. Conclusions: This valid and reliable HBM-based questionnairemayidentify the potential barriers of optimalOHBamongpregnant women.