{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T23:49:51Z","timestamp":1773272991606,"version":"3.50.1"},"reference-count":40,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Oral health during pregnancy is a critical factor in preventing caries in both mothers and children. Croatia currently lacks validated psychometric instruments for reliably assessing knowledge, attitudes, and oral hygiene practices in the general population. This study aimed to develop and provide initial psychometric evidence for a comprehensive instrument for this purpose in Croatia, with potential relevance for future cross-cultural adaptation. Following Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines, an initial item pool was generated through literature review and expert consultation. The study was conducted from May 2024 to February 2025 in primary healthcare settings across Primorje-Gorski Kotar County (PGC). The validation study included 319 pregnant women. Exploratory factor analysis (EFA) revealed a six-factor structure with acceptable to strong factor loadings (ranging from 0.423 to 0.984). The instrument showed acceptable to good internal consistency (Cronbach\u2019s \u03b1 = 0.61\u20130.87) and excellent test\u2013retest reliability (Pearson r = 0.993). Results indicated that knowledge about oral health was independent of attitudes and practices during pregnancy. Regression analyses were exploratory and did not provide evidence of predictive validity at this stage, suggesting that additional contextual and psychosocial factors should be considered in future modelling. The present study provides initial psychometric evidence supporting the proposed structure and reliability of the instrument; however, further confirmatory and longitudinal validation studies are required before broader implementation and generalization can be fully justified.<\/jats:p>","DOI":"10.3390\/ijerph23030352","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T09:00:37Z","timestamp":1773219637000},"page":"352","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Pregnant Women\u2019s Knowledge, Attitudes, and Habits Regarding Oral Health: Development and Validation of a Measurement Instrument"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3148-7635","authenticated-orcid":false,"given":"Helena Gliboti\u0107","family":"Kresina","sequence":"first","affiliation":[{"name":"Department of Public Health, Teaching Institute of Public Health of Primorje-Gorski Kotar County, Kre\u0161imirova 52a, 51000 Rijeka, Croatia"},{"name":"Department of Public Health, Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 5, 51000 Rijeka, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivana","family":"Dabo","sequence":"additional","affiliation":[{"name":"Department of Public Health, Teaching Institute of Public Health of Primorje-Gorski Kotar County, Kre\u0161imirova 52a, 51000 Rijeka, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0116-9445","authenticated-orcid":false,"given":"Sandro","family":"Kresina","sequence":"additional","affiliation":[{"name":"Department of School and Adolescence Medicine, Teaching Institute of Public Health of Primorje-Gorski Kotar County, Kre\u0161imirova 52a, 51000 Rijeka, Croatia"},{"name":"Department of Family Medicine, Faculty of Medicine Rijeka, University of Rijeka, Bra\u0107e Branchetta 20, 51000 Rijeka, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3119-5205","authenticated-orcid":false,"given":"Elizabeta","family":"Dadi\u0107 Hero","sequence":"additional","affiliation":[{"name":"Department of Public Health, Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 5, 51000 Rijeka, Croatia"},{"name":"Department of Psychiatry, Clinical Hospital Centre Rijeka, Kre\u0161imirova 42, 51000 Rijeka, Croatia"},{"name":"Department of Social Medicine and Epidemiology, Faculty of Medicine Rijeka, University of Rijeka, Bra\u0107e Branchetta 20, 51000 Rijeka, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Kresina","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Rijeka, University of Rijeka, Bra\u0107e Branchetta 20, 51000 Rijeka, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1680-1174","authenticated-orcid":false,"given":"Danko","family":"Bakar\u010di\u0107","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Faculty of Dental Medicine, University of Rijeka, Kre\u0161imirova 40\/42, 51000 Rijeka, Croatia"},{"name":"Department of Pediatric Dentistry, Clinical Hospital Centre Rijeka, Kre\u0161imirova 42, 51000 Rijeka, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Mavrinac","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Rijeka, University of Rijeka, Bra\u0107e Branchetta 20, 51000 Rijeka, Croatia"},{"name":"Medical Faculty of Pula, University Juraj Dobrila, Zagreba\u010dka 30, 52100 Pula, Croatia"},{"name":"Faculty for Speech and Language Therapy, University of Rijeka, Radmile Matej\u010di\u0107 2, 51000 Rijeka, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2241-0268","authenticated-orcid":false,"given":"Neda","family":"Smiljan Severinski","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Faculty of Medicine Rijeka, University of Rijeka, Vjekoslava Duji\u0107a 7, 51000 Rijeka, Croatia"},{"name":"Department of Obstetrics and Gynecology, University Hospital Rijeka, Vjekoslava Duji\u0107a 7, 51000 Rijeka, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s13005-020-00237-z","article-title":"Dental caries in primary and permanent teeth in children\u2019s worldwide, 1995 to 2019: A systematic review and meta-analysis","volume":"16","author":"Kazeminia","year":"2020","journal-title":"Head Face 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