Development and validation of two questionnaires: Dental home care and dental health in Swedish dogs

Abstract

Background: Dental disease is one of the most common health problems in dogs. However, no studies have investigated the attitudes, opinions and practices of dog owners, veterinarians and veterinary nurses regarding dental health and preventative dental home care in dogs. The objective of this study was therefore to develop and validate questionnaires for this purpose, in accordance with survey methodology guidelines.

Methods: Questionnaire items were determined based on the authors' academic knowledge and clinical experience, and modified throughout the validation process. Several measures were taken to reduce sampling, coverage, measurement and non-response errors. Content validity was assessed by Subject-Matter Experts (SME) and cognitive interviews were conducted in accordance with the "think-aloud protocol". Non-response analysis was performed using several methods.

Results: Constructs were identified using exploratory factor analysis and two predefined constructs from the dog owner questionnaire were confirmed "Dog owners' attitudes towards brushing their dog's teeth" (Cronbach's α = 0.86) and "Dog owners' assessment of their dog's dental health" (α = 0.76). Additionally, exploratory factor analysis identified three potential constructs. In the veterinary health practitioner questionnaire, two constructs were identified: "Veterinary health practitioners' attitudes towards dental chews and dental feed" (α = 0.78) and "Veterinary health practitioners' attitudes and opinions on dental problems and dental cleaning" (α = 0.73). Non-response analysis showed a higher proportion of women in the sample of dog owners and veterinarians compared to the target populations. Veterinarians in the sample were also younger. In contrast, gender and age distributions in veterinary nurses did not differ between sample and target.

Conclusion: The validation presented in this work showed that the developed questionnaires could be used as accurate and reliable tools for measuring attitudes and practices regarding dental home care in dogs among Swedish dog owners, veterinarians and veterinary nurses.

Fig 1. The validation process employed in the present study.

Detailed information on number and order of items, construction of questions and response options are reported in the S2 Doc.

Fig 2. Age distribution in target and sample populations.

Age distribution in target (dog owners registered in the Swedish Board of Agricultures register) and sample populations of dog owners (left) and first vs last quantiles of the sample (right). The sample population had a narrower age distribution than the target population and the last responders were systematically younger than the first responders.

Fig 3

a. Factor Analysis of the dog owner questionnaire identified two constructs. Exploratory Factor Analysis (EFA) was performed on half the data to identify factors which were tested by Confirmatory Factor Analysis (CFA) on the other half. Of the five identified factors, the first two were identified as potential constructs. These constructs were named “Dog owners’ attitudes towards brushing their dogs’ teeth” (BrushAttitude) and “Dog owners’ assessment of their dogs’ dental health” (DentalHealth) and coincided with constructs predefined by the authors KBE and AP. Variable loadings are shown for both EFA and CFA. Detailed information on variables and variable/factor (co)-variance is available in S2 Table. 3b. Factor Analysis of the veterinary health practitioner questionnaire identified two constructs. Exploratory Factor Analysis (EFA) was performed on half the data to identify factors which were tested by Confirmatory Factor Analysis (CFA) on the other half, resulting in two potential constructs. These constructs were named “Veterinary health practitioners’ attitudes towards dental chews and dental feed” (ChewFeed) and “Veterinary health practitioners’ attitudes and opinions on dental problems and dental cleaning” (Cleaning). Variable loadings are shown for both EFA and CFA. Detailed information on variables and variable/factor (co)-variance is available in S2 Table.