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Background <p>Despite the growing need for culturally valid oral health tools in refugee populations, no validated Amharic-language versions of key instruments currently exist. This review synthesises how the OHIP-14 and WHO Oral Health Assessment tools have been adapted across linguistic and cultural contexts, with implications for Amharic-speaking Ethiopian refugees.</p> Aim <p>To assess how OHIP-14 and WHO-OHAFT have been cross-culturally adapted and validated globally, and to identify gaps and equity implications for developing Amharic-language tools in refugee contexts.</p> Methods <p>We conducted a hybrid systematic–narrative review of 21 studies, using structured database and grey-literature searches followed by descriptive mapping and thematic synthesis. Studies were charted by language, adaptation procedures, and psychometric properties (e.g., Cronbach’s α, intraclass correlation coefficients). Cross-cultural adaptation frameworks, such as those of Beaton et al. and WHO translation guidelines, guided the assessment of methodological and linguistic rigour across studies.</p> Results <p>Three main themes emerged: [1] consistent psychometric strength across diverse cultural adaptations; [2] methodological variation and reporting gaps in cross-cultural validation; and [3] a complete absence of validated Amharic-language tools. While Cronbach’s α values ranged from 0.72 to 0.99 (mean = 0.88), many studies omitted essential adaptation steps. Refugee-specific oral health beliefs, such as spiritual interpretations of pain, are rarely integrated.</p> Conclusion <p>This review highlights both strong potential and critical limitations in current cross-cultural oral health assessments. It emphasises the ethical and clinical needs for developing validated, culturally appropriate Amharic tools. Cross-cultural adaptation should be seen as a step towards linguistic justice and oral health equity for Amharic-speaking refugee and displaced populations.</p>

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Amharic oral health tools for refugees: a hybrid review of OHIP-14 and WHO adaptations

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月11日

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  • Betelehem Ketema,
  • Karen Lansdown,
  • Zeina Al Naasan,
  • Heuiwon Han,
  • Julie Trafford

摘要

Background

Despite the growing need for culturally valid oral health tools in refugee populations, no validated Amharic-language versions of key instruments currently exist. This review synthesises how the OHIP-14 and WHO Oral Health Assessment tools have been adapted across linguistic and cultural contexts, with implications for Amharic-speaking Ethiopian refugees.

Aim

To assess how OHIP-14 and WHO-OHAFT have been cross-culturally adapted and validated globally, and to identify gaps and equity implications for developing Amharic-language tools in refugee contexts.

Methods

We conducted a hybrid systematic–narrative review of 21 studies, using structured database and grey-literature searches followed by descriptive mapping and thematic synthesis. Studies were charted by language, adaptation procedures, and psychometric properties (e.g., Cronbach’s α, intraclass correlation coefficients). Cross-cultural adaptation frameworks, such as those of Beaton et al. and WHO translation guidelines, guided the assessment of methodological and linguistic rigour across studies.

Results

Three main themes emerged: [1] consistent psychometric strength across diverse cultural adaptations; [2] methodological variation and reporting gaps in cross-cultural validation; and [3] a complete absence of validated Amharic-language tools. While Cronbach’s α values ranged from 0.72 to 0.99 (mean = 0.88), many studies omitted essential adaptation steps. Refugee-specific oral health beliefs, such as spiritual interpretations of pain, are rarely integrated.

Conclusion

This review highlights both strong potential and critical limitations in current cross-cultural oral health assessments. It emphasises the ethical and clinical needs for developing validated, culturally appropriate Amharic tools. Cross-cultural adaptation should be seen as a step towards linguistic justice and oral health equity for Amharic-speaking refugee and displaced populations.