Linguistic–Cultural Validation of the Oral Health Assessment Tool in Chinese Community-Dwelling Older Adults

INTRODUCTION AND AIMS: The Oral Health Assessment Tool (OHAT) could be used by nondental health professionals for oral screening in older adults, but it has not been validated in China. This study aimed to translate the original English version of the OHAT into Chinese and to cross-culturally adapt it with evaluation of its reliability and validity for oral health screening among community-dwelling older adults in China. METHODS: Structured translation processes were used to validate a Chinese version of the OHAT (OHAT-C). A total of 513 community-dwelling older adults were screened with the OHAT-C by 45 trained community nurses. Interrater reliability was assessed by two dentists. Test-retest reliability was assessed two weeks after the initial screening. Cohen's kappa was used to test for interrater agreement for individual items of the OHAT-C. The Intraclass Correlation Coefficient (ICC) was used to evaluate the reliability of the total OHAT-C score. Criterion validity was calculated using contingency tables derived from the interrater reliability data, and construct validity was examined through Confirmatory Factor Analysis (CFA) based on the initial assessment conducted by the nurses. RESULTS: The conceptual equivalence between the OHAT-C and the original OHAT was confirmed. The OHAT-C demonstrated excellent interrater reliability (ICC = 0.922, 95% CI = 0.907-0.934) and test-retest reliability (ICC = 0.924, 95% CI = 0.910-0.936). The OHAT-C demonstrated good criterion validity, the area under the ROC curve (AUC) ranged from 0.822 to 0.912 (P < .001). Moreover, the results of the CFA supported the structure of the OHAT-C, indicating a good model fit, χ²(20) = 35.621, P = .017. CONCLUSIONS: The OHAT-C is a reliable and valid tool for screening oral health among community-dwelling older adults by trained community nurses in China. CLINICAL RELEVANCE: The OHAT-C supports early identification of oral health problems and facilitates communication between dental professionals and those from other disciplines.