Forward-backward translation, content validity, face validity, construct validity, criterion validity, test-retest reliability, and internal consistency of a questionnaire on patient acceptance of orthodontic retainer

• Published in: PLOS ONE
• Main Authors: Saw, Zhi Kuan; Yuen, Jonathan Jun Xian; Ashari, Asma; Ibrahim Bahemia, Fatima; Low, Yun Xuan; Nik Mustapha, Nik Mukhriz; Lau, May Nak
• Format: Article
• Language: English
• Published: PUBLIC LIBRARY SCIENCE 2025
• Subjects: Science & Technology - Other Topics
• Online Access: https://www-webofscience-com.uitm.idm.oclc.org/wos/woscc/full-record/WOS:001401801400065

This study aimed to assess the validity and reliability of a questionnaire on patient acceptance of orthodontic retainers. The original questionnaire was forward- and backward-translated, followed by four validity tests (content validity, face validity, construct validity, criterion validity) and two reliability tests (test-retest reliability, internal consistency). Content validity was assessed by nine orthodontists who appraised the questionnaire's representativeness, relevance, clarity, and necessity. Face validity was established through semi-structured in-depth interviews with 35 English-literate participants currently wearing orthodontic retainers. Construct validity was established through Exploratory Factor Analysis (EFA). For criterion validity, 107 participants concurrently answered the questionnaire and the Retainer-modified Malaysian Oral Health Impact Profile questionnaire. Test-retest reliability was verified by 34 subjects who responded to the questionnaire again after a two-week interval. Six revised items passed the threshold value of 0.78 for Item-Content Validity Index and Content Validity Ratio and were revised based on findings from the face validity test. Principal Component Analysis of EFA extracted information on only one component, and all items were positively correlated with the component matrix. Spearman's rho value (rs = 0.490 and rs = 0.416) indicated a moderate correlation between the two questionnaires for criterion validity. Intraclass Correlation Coefficient ranged from 0.687 to 0.913, indicating moderate to excellent test-retest reliability. Cronbach's alpha ranged from 0.687 to 0.913 indicating that none of the questionnaire items showed unacceptable or poor internal consistency. The questionnaire on patient acceptance of orthodontic retainers has been validated and can be used in both clinical and research settings.