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The Child Dental Control Assessment (CDCA) in youth: reliability, validity and cross-cultural differences.

AIM
The Child Dental Control Assessment (CDCA) measures children's preferred control strategies in the dental situation. Three studies are reported, assessing aspects of this instrument in youths from the USA, Japan and Australia. In particular, measurements were made as to the reliability and validity of this instrument in this age group in the three cultures, as well as comparing some results across cultures.


STUDY DESIGN
These studies used a questionnaire design.


METHODS
Questionnaires (including the CDCA and other measures) were given to youths aged 11-15 in the three cultures. In one culture, youths received the questionnaire twice, to compute test-retest reliability.


RESULTS
The measure's reliability and validity were similar to those of other measures. The CDCA behaves similarly to the Revised Iowa Dental Control Index (R-IDCI). Youths in all three cultures showed similar responses, although the Japanese were less likely to endorse items.


STATISTICS
Internal reliability of the scale ranged from 0.74 to 0.85. Test- retest reliability was 0.74. Participants in the High Desire/Low Predicted classification on the R-IDCI scored higher on the CDCA (t (73) = 2.9, p < .01). In the Japanese and Australian samples the correlation between CDCA and dental fear was 0.29-0.33 (p < .001). The Australian and USA samples scored significantly higher than the Japanese sample (overall F(2,1544) = 383.98, p < .001, followed by Tukey's HSD, p < .001).


CONCLUSIONS
These results provide evidence for the reliability and validity of the CDCA in youth. It appears to measure the discrepancy between Desired and Predicted Control identified in the Revised Iowa Dental Control Index (R-IDCI). Responses of the youth in all three cultures were similar, indicating common dental control preferences for individuals of this age. However, consistent with cultural values, Japanese youth were less likely to endorse the control strategies. These results underline the need to develop culturally-specific, as well as situationally-specific control measures.