Amharic Adaptation of the OHIP-14 and WHO Oral Health Tools

Abstract

Objective: To translate, culturally adapt, and preliminarily validate the English versions of the OHIP-14 and WHO Oral Health Assessment tools into Amharic for Ethiopian refugees in Aotearoa New Zealand.

Methods: Following the five-stage cross-cultural adaptation framework proposed by Beaton et al. (2000), forward and backward translation, expert committee review, and pilot testing were conducted. Content validity was assessed by a bilingual panel using Likert-scale ratings and qualitative feedback. Face validity was evaluated through semi-structured interviews with five Amharic-speaking adults of Ethiopian refugee background. Quantitative data were analysed descriptively; qualitative feedback was thematically analysed. Cronbach’s alpha assessed internal consistency.

Results: The adapted tools showed strong semantic and cultural equivalence. Key changes included gender-neutral pronouns (~~~ ), culturally resonant expressions (e.g., “~~~,~~~ ?” for “self-conscious”), and inclusion of traditional hygiene practices (mefakia, sintir, charcoal). Expert panel ratings confirmed clarity (M = 4.9), cultural appropriateness (M = 5.0), and semantic accuracy (M = 4.8). All OHIP-14 items scored ≥ 4 by participants, with mean clarity = 4.96 and cultural relevance = 5.0. Internal consistency was excellent (Cronbach’s α = 0.90). Participants found the modified tools respectful, understandable, and reflective of their experiences. Qualitative data from post-completion semi-structured interviews further confirmed the clarity, cultural alignment, and emotional safety of the adapted tool.

Conclusion: The Amharic OHIP-14 and WHO Oral Health Assessment tools demonstrated strong face and content validity. These findings support the value of culturally and linguistically adapted tools for equitable oral health assessment in refugee populations and provide a foundation for future large-scale validation.