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Afolabi AAA, Afolabi AO, Foláyan MNO. Validation of an online version of the rapid estimate of adult literacy in dentistry-30 for use by medical and dental students in Nigeria. BMC Oral Health 2024; 24:485. [PMID: 38649881 PMCID: PMC11034054 DOI: 10.1186/s12903-024-04238-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The need for online adaptations of research instruments became more pronounced amidst the COVID-19 pandemic. This study sought to modify the REALD-30 for online application (eREALD-30) and evaluate its content validity and internal reliability among medical and dental students in Nigeria. METHODS The eREALD-30 required participants to identify if each of the listed words were related to dentistry by ticking either a 'yes' or 'no' response with the option to mark 'don't know' for words they were unsure about. Scores ranged from 0 to 30. Five oral health experts reviewed the eREALD-30 for cultural appropriateness, while content validity was evaluated by 10 medical and dental students. Internal reliability was assessed with 320 students recruited from 15 medical and dental schools spanning the country's six geopolitical zones. These students also completed an oral health status assessment tool. Data collection utilized an online survey platform. Validity of the eREALD-30 was determined through correlation analysis between eREALD-30 scores and the oral health status assessment tool. Furthermore, binary logistic regression analysis was employed to explore the assocations between participants' oral health status and their oral health literacy, adjusting for age, sex, and level of medical and dental education. RESULTS Out of the respondents, 178 (55.6%) exhibited poor oral health literacy, while 205 (64.1%) reported having good oral health status. Those with good oral health literacy demonstrated significantly higher odds of having good oral health status (OR: 1.61; 95% CI: 1.02-2.54; p = 0.04). However, individuals with good oral health literacy had increased odds of good oral health status after adjusting for confounding factors,, though this association did not retain statistical significance (AOR: 1.39; 95% CI: 0.86-2.24; p = 0.17). The eREALD-30 displayed strong internal consistency (Cronbach alpha = 0.933), indicating its reliability in assessing oral health literacy levels, alongside a high content validity score of 0.90. CONCLUSION The study finding suggests that the e-version of the REALD-30 was reliable and valid for use among medical and dental students in Nigeria.
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Lotto M, Maschio KF, Silva KK, Ayala Aguirre PE, Cruvinel A, Cruvinel T. eHEALS as a predictive factor of digital health information seeking behavior among Brazilian undergraduate students. Health Promot Int 2023; 38:daab182. [PMID: 34718563 DOI: 10.1093/heapro/daab182] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study aimed to perform the cross-cultural adaptation and validation of the eHealth Literacy Scale (eHEALS) for Brazilian Portuguese. The cross-cultural adaptation was conducted through conceptual equivalence, verbatim translation, semantic, item and operational equivalence, and back-translation. Subsequently, 521 undergraduate students answered the adapted version of the eHEALS, the General Perceived Self-Efficacy Scale (GSES), the Oral Health Impact Profile-14 (OHIP-14) and sociodemographic and health-related questions. Statistical analysis was performed to determine the dimensionality, internal consistency, stability and concurrent/convergent/discriminant/predictive validities of the eHEALS (p < 0.05). The adequacy of sample size was confirmed by a non-identity correlation matrix (Bartlett's test of sphericity, p < 0.001), without influence of multicollinearity (determinant = 0.026). The confirmatory factor analysis identified four factors in agreement to the constructs namely as online searching self-efficacy, awareness of available sources, information usage ability, and critical analysis of useful information. The eHEALS displayed an excellent internal consistency (Cronbach's alpha = 0.88), a good stability (ICC = 0.71, 95% CI: 0.49-0.84), and it was significantly correlated with GSES (concurrent validity). Higher eHEALS scores were identified among (i) white and (ii) younger students, (iii) from health sciences courses, (iv) with more years of graduation, (v) who their fathers were working in specialized functions (discriminant validity), and (vi) among those who were frequently interested in digital health information (convergent validity). The students with higher eHealth literacy levels were more likely to seek health information in the last 24 h (predictive validity). In conclusion, the eHEALS demonstrated adequate psychometric properties to be applied for the Brazilian population.
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Affiliation(s)
- Matheus Lotto
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Al. Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, 17012-901Bauru, São Paulo, Brazil
| | - Kaiane Fátima Maschio
- Discipline of Public Health, School of Medicine, Federal University of Fronteira Sul, Rodovia SC 484 Km 02, Bairro Fronteira Sul, 89815-899, Chapecó, Santa Catarina, Brazil
| | - Kimberly Kamila Silva
- Discipline of Public Health, School of Medicine, Federal University of Fronteira Sul, Rodovia SC 484 Km 02, Bairro Fronteira Sul, 89815-899, Chapecó, Santa Catarina, Brazil
| | - Patricia Estefania Ayala Aguirre
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Al. Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, 17012-901Bauru, São Paulo, Brazil
| | - Agnes Cruvinel
- Discipline of Public Health, School of Medicine, Federal University of Fronteira Sul, Rodovia SC 484 Km 02, Bairro Fronteira Sul, 89815-899, Chapecó, Santa Catarina, Brazil
| | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Al. Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, 17012-901Bauru, São Paulo, Brazil
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Agarahari P, Jain A, Mohan Pandey S, Agrahari AK, Yadav J, Srivastava R, Dalai S, Kumari T, Singh AK, Sharma Y. Exploring the Synergistic Association Between Oral Health Status and Oral Health Literacy Among College Students: A Cross-Sectional Study. Cureus 2023; 15:e41885. [PMID: 37581155 PMCID: PMC10423622 DOI: 10.7759/cureus.41885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/13/2023] [Indexed: 08/16/2023] Open
Abstract
INTRODUCTION Oral health is often viewed as a significant component for an indication of good general health or for good well-being together with a decent quality of life. Health literacy is considered a crucial factor in improvising a good life or excellent health. Oral health literacy (OHL) is the ability necessary for people to identify the factors that lead to poor oral health, learn and put into practice the essentials of effective oral self-care behaviors, and communicate with oral healthcare professionals in order to schedule appointments, put their names on waiting lists for dental care, and locate the dentist's office. AIM AND OBJECTIVES To evaluate students' oral health, their OHL, to determine the relationship between their oral health status and OHL, and finally to suggest preventive measures for the benefit of public health. MATERIALS AND METHOD At Teerthanker Mahaveer University, a cross-sectional study involving 1500 participants, ages 18 to 25, was conducted on students studying nursing, physiotherapy, paramedicine, engineering, and law. Their informed consent was obtained. The Rapid Estimate of Adult Literacy in Dentistry (REALD-99) was used to gauge OHL levels, and the WHO's 1997 Oral Health Survey was used for their clinical evaluation. RESULTS The mean REALD score was significantly higher in nursing students (88.32±6.46), followed by physiotherapy college (82.46±9.11), paramedical college (70.54±10.95), law college (46.52±7.74), and least in engineering college (38.80±10.65). The difference in the REALD score based on college was statistically significant. Along with this, the REALD score showed a correlation with gender and location too. Except for fluorosis, all the clinical parameters of dental caries, gingival bleeding, and pockets, loss of attachment, dental fluorosis, and dental enamel were associated with OHL. CONCLUSION The results of the current study showed a relationship between educational attainment, clinical parameters examined, and OHL, leading to the conclusion that higher OHL is related to better oral health. So, we can conclude that maintaining good oral health requires OHL.
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Affiliation(s)
- Priya Agarahari
- Department of Public Health Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
| | - Ankita Jain
- Department of Public Health Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
| | - Souvir Mohan Pandey
- Department of Prosthodontics, Hazaribag College of Dental Sciences and Hospital, Hazaribag, IND
| | - Ajay Kumar Agrahari
- Department of Anaesthesiology and Critical Care Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, IND
| | - Jagriti Yadav
- Department of Public Health Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
| | - Rangoli Srivastava
- Department of Public Health Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
| | - Sasmita Dalai
- Department of Public Health Dentistry, Adesh Institute of Dental Sciences and Research, Bhatinda, IND
| | - Tannu Kumari
- Department of Public Health Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
| | - Ashutosh K Singh
- Department of Public Health Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
| | - Yashi Sharma
- Department of Public Health Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
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Tian CY, Mo PKH, Dong D, Cheung AWL, Wong ELY. Development and validation of a comprehensive health literacy tool for adults in Hong Kong. Front Public Health 2023; 10:1043197. [PMID: 36703842 PMCID: PMC9871493 DOI: 10.3389/fpubh.2022.1043197] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction Health literacy (HL) refers to an individual's ability to process and use health information to make health-related decisions. However, previous HL scales did not fully cover all aspects of this concept. This study aimed to develop a comprehensive Hong Kong HL scale (HLS-HK) and evaluate its psychometric properties among Chinese adults. Methods A scale of 31-item covering Nutbeam's framework, namely functional and interactive HL (FHL and IHL), and critical HL (CHL) within three subdomains: critical appraisal of information, understanding of social determinants of health, and actions to address social determinants of health, was developed based on previous literature review and Delphi survey. Cognitive interviews were performed to examine all items' face validity in terms of three aspects: comprehensiveness, clarity, and acceptability. A cross-sectional survey was conducted to investigate the scale's psychometric properties, including its internal consistency reliability, factorial structure validity, convergent validity, and predictive validity. Results Nine interviewees participated in the cognitive interviews in October 2021. Based on the input from respondents, two items were deleted, two items were combined, and several items' wording was revised. The other items were clear and readable. Finally, 28 items remained. A total of 433 adults completed the questionnaire survey between December 2021 and February 2022. After excluding one item with low inter-item correlations, the scale's internal consistency reliability was acceptable, with a Cronbach's alpha of 0.89. Exploratory factor analysis produced a five-factor model, as shown in the original theoretical framework. These factors accounted for 53% of the total variance. Confirmatory factor analysis confirmed that the fit indices for this model were acceptable (comparative fit index = 0.91, root mean square error of approximation = 0.06, and root mean square residual = 0.06). The scale is also significantly correlated with theoretically selected variables, including education and self-rated health. Conclusion The HLS-HK is a valid and reliable tool for evaluating HL. Compared with existing tools, this scale extended the operationalization of FHL, IHL, and CHL and fully operationalized the CHL via three subdomains. It can be used to understand the difficulties and barriers that people may encounter when they use health-related information and services.
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Affiliation(s)
- Cindy Yue Tian
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Phoenix Kit-Han Mo
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,JC School of Public Health and Primary Care, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Dong Dong
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,JC School of Public Health and Primary Care, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Annie Wai-ling Cheung
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,JC School of Public Health and Primary Care, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,JC School of Public Health and Primary Care, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,*Correspondence: Eliza Lai-Yi Wong ✉
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Tian CY, Wong EL, Xu RH, Cheung AW, Dong D, Mo PK. Developing a Health Literacy Scale for adults in Hong Kong: A modified e-Delphi study with healthcare consumers and providers. Health Expect 2022; 26:245-255. [PMID: 36345702 PMCID: PMC9854330 DOI: 10.1111/hex.13651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/12/2022] [Accepted: 10/23/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Health literacy (HL) refers to individuals' abilities to process and use health information to promote health. This study aimed to develop the first HL measurement tool for the Chinese Hong Kong population. METHODS A two-phase methodology was adopted. In Phase I, evidence synthesis with a deductive method was conducted to formulate the item list from the literature. In Phase II, a modified e-Delphi survey was conducted among stakeholders (i.e., healthcare providers and healthcare consumers) to confirm the content validity of the item list. The stakeholders were invited to rate the relevance of each draft item on a 4-point scale and provide suggestions for revisions, removal or adding new items. RESULTS In Phase I, a total of 34 items covering functional, interactive and critical HL were generated. In Phase II, to obtain a balanced view from experts and laypeople, healthcare professionals (n = 12) and consumers (n = 12) were invited to participate in the Delphi panel. The response rates of the three rounds were 100%. After the third round, the consensus was reached for 31 items, and no further comments for adding or revising items were received. All items exhibited excellent content validity (item content validity index: 0.79-1.00; K*: 0.74-1.00). CONCLUSIONS A Health Literacy Scale for Hong Kong was developed. Compared with existing HL scales, the scale fully operationalized the skills involved in functional, interactive and critical HL. The Delphi study shows evidence supporting the high content validity of all items in the scale. In future studies, these items should undergo rigorous testing to examine their psychometric properties in our target population groups. By illuminating the details in the development process, this paper provides a deeper understanding of the scale's scope and limitations for others who are interested in using this tool. PATIENT OR PUBLIC CONTRIBUTION Public as healthcare consumers, in addition to healthcare providers, were involved in developing a new HL scale for this study. The input from the public contributed to examining the scale's content validity by judging whether all items reflected the skills that they need to find and use health-related information in their daily life.
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Affiliation(s)
- Cindy Yue Tian
- JC School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
| | - Eliza Lai‐Yi Wong
- JC School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong KongChina,Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong KongChina
| | - Richard H. Xu
- Department of Rehabilitation SciencesThe Hong Kong Polytechnic UniversityHong KongChina
| | - Annie Wai‐Ling Cheung
- JC School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong KongChina,Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong KongChina
| | - Dong Dong
- JC School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong KongChina,Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong KongChina
| | - Phoenix K.‐H. Mo
- JC School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong KongChina,Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong KongChina
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Wang Y, Inglehart MR, Yuan C. Impact of Parents' Oral Health Literacy on Their Own and Their Children's Oral Health in Chinese Population. Front Public Health 2022; 10:809568. [PMID: 35345505 PMCID: PMC8957213 DOI: 10.3389/fpubh.2022.809568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Oral health literacy (OHL) has been recognized as a component of oral health disparities; however, the precise relationship between literacy and oral health outcomes has not been established. To explore the role of parents' OHL for their own subjective oral health, related behavior, and for the proxy assessment of their child's oral health, oral health-related behavior. Methods Survey data were collected from 406 parents of 4- to 7-year-old children in Beijing, China. The background characteristics, oral health assessment, oral health-related behavior, knowledge and attitudes, and diet-related questions of parents and their children were surveyed by a questionnaire. OHL was assessed with the Hong Kong Rapid Estimate of Adult Literacy in Dentistry (HKREAL-30) Scale and a revised version that asked the respondents to indicate if they understood the words (HKREALD-30-Understand). Results The HKREALD-30 responses correlated with the HKREALD-30-Understand responses. The higher the parents' HKREALD-30-Understand scores, the better they described the health of their own teeth and gums, the greater their child's diet was influenced by the protein, sugar and calories of the food, and the more positive their oral health-related attitudes were. The higher the parent's HKREALD-30 scores, the healthier they described their child's teeth and gums. Conclusions Both the HKREALD-30 and HKREALD-30-Understand Scores correlate with parents' self and proxy oral health-related responses. Chinese parents could understand that the word would add predictive value to the prediction of how parents' oral health literacy affects their own oral health care, children's oral health and other related aspects.
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Affiliation(s)
- Yu Wang
- Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China.,International Trained Dentist Program, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Marita R Inglehart
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Chao Yuan
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
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Nagarajappa R, Mahapatra I, Satyarup D, Mohanty S. Oral Health Literacy – Adult Questionnaire: Psychometric Properties and its Influence on Oral Health Status of School Teachers in Bhubaneswar, India. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Rath A, Wong M, Pannuti CM, Hesarghatta Ramamurthy P, Fernandes B, Shelton A, Muttalib KA. Cross-cultural adaptation and validation of Malay version of Rapid Estimate of Adult Literacy in Dentistry (MREALD-30) among Orang Asli population in Malaysia. BMC Oral Health 2021; 21:519. [PMID: 34641831 PMCID: PMC8513292 DOI: 10.1186/s12903-021-01866-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/28/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The aim of this study was to adapt, translate and validate the Rapid Estimate of Adult Literacy in Dentistry (MREALD-30) instrument for the Orang Asli population in Malaysia. METHODS After translation and cross-cultural adaptation, interviews were conducted with 326 participants of the Temuan tribe from village Kampung Tering in Johol, Negeri Sembilan, Malaysia. The instrument's validity was assessed using the scores of MREALD-30, which were compared based on occupation, monthly household income, educational attainment, general literacy, use of dental services, and three dental outcomes. A questionnaire containing socio-behavioral information and validated Malay Oral Health Impact Profile (M-OHIP-14) was also administered. The reliability of the MREALD-30 was assessed by re-administering it to 30 subjects after two weeks. Its correlations evaluated convergent and discriminative validity of MREALD-30 with the level of education and dental visiting habits, monthly household income, respectively. Predictive validity was assessed with M-OHIP-14, while construct validity was evaluated by exploratory factor analysis using the Rasch model. RESULTS The internal consistency of the MREALD-30 measured by Cronbach's alpha was 0.89. The test-retest reliability was excellent (ICC 0.95, k = 0.85). MREALD-30 exhibited good construct validity. Rasch analysis showed two factors, and infit mean-square statistics for MREALD-30 were all within the desired range of 0.50-2.0. The discriminant validity and predictive validity were statistically significant (p < 0.05). CONCLUSIONS MREALD-30 showed very strong reliability, good construct, discriminant, and predictive validity, but poor convergent validity. Overall, it showed good psychometric properties and can be used in these community settings.
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Affiliation(s)
- Avita Rath
- Faculty of Dentistry, SEGi University, No. 9 Jalan Teknologi PJU5, 47810, Kota Damansara, Selangor, Malaysia.
| | - Melissa Wong
- Faculty of Dentistry, SEGi University, No. 9 Jalan Teknologi PJU5, 47810, Kota Damansara, Selangor, Malaysia
| | | | | | - Bennete Fernandes
- Faculty of Dentistry, SEGi University, No. 9 Jalan Teknologi PJU5, 47810, Kota Damansara, Selangor, Malaysia
| | | | - Khairiyah Abdul Muttalib
- Faculty of Dentistry, SEGi University, No. 9 Jalan Teknologi PJU5, 47810, Kota Damansara, Selangor, Malaysia
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Praveen S, Parmar J, Chandio N, Arora A. A Systematic Review of Cross-Cultural Adaptation and Psychometric Properties of Oral Health Literacy Tools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10422. [PMID: 34639729 PMCID: PMC8508111 DOI: 10.3390/ijerph181910422] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/22/2021] [Accepted: 09/29/2021] [Indexed: 12/21/2022]
Abstract
The aims of this systematic review were to critically appraise the quality of the cross-cultural adaptation and the psychometric properties of the translated versions of oral health literacy assessment tools. CINAHL (EBSCO), Medline (EBSCO), EMBASE (Ovid), and ProQuest Dissertation and Thesis were searched systematically. Studies focusing on cross-cultural adaptation and psychometric properties of oral health literacy tools were included. The methodological quality of included studies was assessed according to the COSMIN Risk of Bias checklist. Sixteen oral health literacy instruments in 11 different languages were included in this systematic review. However, only seven instruments met the criteria for an accurate cross-cultural adaptation process, while the remaining tools failed to meet at least one criterion for suitable quality of cross-cultural adaptation process. None of the studies evaluated all the aspects of psychometric properties. Most of the studies reported internal consistency, reliability, structural validity, and construct validity. Despite adequate ratings for some reported psychometric properties, the methodological quality of studies on translated versions of oral health literacy tools was mostly doubtful to inadequate. Researchers and clinicians should follow standard guidelines for cross-cultural adaptation and assess all aspects of psychometric properties for using oral health literacy tools in cross-cultural settings.
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Affiliation(s)
- Sobiya Praveen
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (S.P.); (J.P.); (N.C.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
| | - Jinal Parmar
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (S.P.); (J.P.); (N.C.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
| | - Navira Chandio
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (S.P.); (J.P.); (N.C.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (S.P.); (J.P.); (N.C.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Clinical School Child and Adolescent Health, The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia
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Pavão ALB, Werneck GL. [Health literacy in low- and middle-income countries: a systematic review]. CIENCIA & SAUDE COLETIVA 2021; 26:4101-4114. [PMID: 34586263 DOI: 10.1590/1413-81232021269.05782020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 07/19/2020] [Indexed: 11/21/2022] Open
Abstract
Health literacy (HL) is linked to individual capacities of access, understanding, assessment and application of health information to make decisions in everyday life, in order to maintain or improve health. The scope of this article is to review studies on HL conducted in low- and middle-income countries, with an emphasis on the definition used for HL. It involved a systematic search in the Medline, Embase, Scopus, LILACS and SciELO databases. It included studies that showed the definition of HL, studies in countries with low- and middle-income economies and Latin American studies. Initially, a selection of studies was made by reading the titles and/or abstracts. Two independent evaluators conducted the reading of the full text. Disagreements were discussed by consensus. A total of 6,025 references were located and 36 were selected for the final sample. Most studies (58.3%) were from countries on the Asian continent, followed by studies from South American countries (27.8%), including Brazil. Most studies (58.3%) evaluated the functional dimension of the HL (FHL). The most frequent definitions were from the Institute of Medicine and from the World Health Organization. Approximately 30% of the studies that evaluated FHL used broader definitions of HL as theoretical frameworks.
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Affiliation(s)
- Ana Luiza Braz Pavão
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4.365 Pavilhão Haity Moussatché, Manguinhos. 21040-900 Rio de Janeiro RJ Brasil.
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Sun Y, Sun J, Zhao Y, Cheng A, Zhou J. A new comprehensive oral health literacy scale: development and psychometric evaluation. BMC Oral Health 2021; 21:429. [PMID: 34482838 PMCID: PMC8419934 DOI: 10.1186/s12903-021-01795-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 08/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It has been widely accepted that oral health status is related to oral health literacy. The need to measure oral health literacy has led to the development of measurement instruments. This study aimed to develop a comprehensive instrument for adults and to examine its reliability and validity in China. METHODS A three-step design process was used. First, a literature review and expert panel discussion were used to draw up a 37-item pool covering oral health knowledge, belief, practice, skill, and functional oral health literacy. The Delphi method was used to delete and modify questions in the item pool. The draft instrument was evaluated by nine experts and the consensus among them was calculated using the content validity index. The scale was then used to conduct a psychometric study among 370 participants from community health centers in Beijing. Construct validity, discriminant validity and concurrent validity were examined. The Cronbach's alpha coefficient, and test-retest methods were used to assess reliability. RESULTS The final scale included 30 items across four dimensions. The item-level content validity index was 0.90. Exploratory factor analysis extracted four fixed factors, and the result of the Kaiser-Meyer-Olkin and Bartlett's tests was 0.752, with the model explaining 35.21% of the total variance. The four dimensions were associated with oral health knowledge, perceptions of oral health issues, oral health practice and skills, and functional oral health literacy. The mean score of the lowest 27% was significantly lower than the highest 27% (P < 0.01), suggesting adequate discriminant validity. The associations between comprehensive oral health literacy scores and educational level, income and self-reported literacy level were significant (P < 0.001), showing adequate overall concurrent validity. Internal consistency and test-retest reliability were acceptable, with a Cronbach's alpha of 0.72 and a total test-retest reliability coefficient of 0.979. CONCLUSIONS Initial testing of the comprehensive oral health literacy instrument suggested that it is a valid and reliable instrument to evaluate individuals' oral health literacy, with four dimensions for evaluating knowledge, belief, skills, and functional oral health literacy.
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Affiliation(s)
- Yue Sun
- Department of Nursing, Peking University First Hospital, Beijing, China
| | - Jing Sun
- Department of Community Nursing, School of Nursing, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, China.
| | - Yan Zhao
- The School of Biomedicine, Beijing City University, Beijing, China
| | - Aixiao Cheng
- Department of Stomatology, Beijing Zhongguancun Hospital, Beijing, China
| | - Junhong Zhou
- Department of Stomatology, Beijing Zhongguancun Hospital, Beijing, China
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Zhou N, Wong HM, McGrath CP. Parental Compliance towards Oral Health Education among Preschoolers with Special Healthcare Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147323. [PMID: 34299771 PMCID: PMC8307991 DOI: 10.3390/ijerph18147323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/22/2021] [Accepted: 07/06/2021] [Indexed: 11/25/2022]
Abstract
Background: Young children with special needs greatly rely on their parents to support their daily living activities; parental compliance may have great impact on the implementation of health promotion activities among those children. This study aimed to investigate the parental compliance towards oral health education (OHE) among children with special healthcare needs (SHCN). Method: The participants were 306 parents whose children had participated in a 24-month OHE program for preschool children with SHCN. The primary outcome of this cross-sectional study was parental compliance towards the OHE program. Parents’ oral health literacy (OHL) was assessed by a validated tool. Parents’ socioeconomic status, attitudes towards OHE topics, perceptions of children’s oral hygiene status, and usefulness of OHE materials were collected via questionnaires. Results: A higher dropout rate was observed among parents who perceived that their children had unfavorable oral hygiene status (p = 0.038), or parents who had poor OHL skills (p = 0.015). Parental noncompliance was more likely to be observed among parents who perceived that the OHE materials were not useful for their children (OR = 3.63, 95% CI 1.56 to 8.47, p = 0.003), or parents whose children had been diagnosed with developmental delays (OR = 5.45, 95% CI 1.59 to18.74, p = 0.007). Conclusion: Non-compliance existed among parents whose children had received OHE intervention. Parental compliance towards OHE intervention might be associated with parents’ OHL skills, usefulness of OHE materials, and children’s developmental conditions. OHE programs should be individually tailored to support children whose parents are at a higher risk of noncompliant behaviors.
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Affiliation(s)
- Ni Zhou
- School of Stomatology, Kunming Medical University, Kunming 650000, China;
| | - Hai Ming Wong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;
- Correspondence:
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Sfeatcu R, Lie SA, Funieru C, Åström AN, Virtanen JI. The reliability and validity of the Romanian rapid estimate of adult literacy in dentistry (RREALD-30). Acta Odontol Scand 2021; 79:132-138. [PMID: 32881604 DOI: 10.1080/00016357.2020.1814405] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study aimed to translate and adapt the Rapid Estimate of Adult Literacy in Dentistry (RREALD-30) instrument for Romanian urban adults and to test its reliability and validity for oral health literacy studies. MATERIAL AND METHODS The study examined urban adult patients (n = 224) who attended the dental school clinic at the Faculty of Dental Medicine, Bucharest. We collected data through face-to-face interviews utilising the REALD-30 instrument. The interviews enquired about the Oral Health Impact Profile (OHIP-14), background characteristics, oral health-related knowledge, visits to dentists and self-rated oral health status. We applied principal component analysis for factor structure and Item Response Theory models to discriminate ability. A structural equation model (SEM) evaluated whether knowledge, perceived oral health, and visits to the dentist mediate the effect of RREALD on OHIP-14. RESULTS Of the 224 participants, 113 (50.4%) were males. The internal consistency of the RREALD-30 measured by Cronbach's alpha was 0.88. The test-retest reliability was excellent (Spearman's correlation coefficient 0.98, ICC 0.90). RREALD-30 exhibited good concurrent and predictive validity. SEM demonstrated that RREALD mediated the effect of visits to dentist on OHIP-14. CONCLUSION The RREALD-30 proved satisfactory psychometric properties and may serve to evaluate dental health literacy among Romanian adults.
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Affiliation(s)
- R. Sfeatcu
- Oral Health and Community Dentistry Department, Faculty of Dental Medicine, Carol Davila University, Bucharest, Romania
| | - S. A. Lie
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - C. Funieru
- Preventive Dentistry Department, Faculty of Dental Medicine, Carol Davila University, Bucharest, Romania
| | - A. N. Åström
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - J. I. Virtanen
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
- Institute of Dentistry, University of Turku, Turku, Finland
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Pattanaik S, John MT, Kohli N, Davison ML, Chung S, Self K, Naik A, Flynn PM. Item and scale properties of the Oral Health Literacy Adults Questionnaire assessed by item response theory. J Public Health Dent 2020; 81:214-223. [PMID: 33305385 DOI: 10.1111/jphd.12434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 10/21/2020] [Accepted: 11/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES a) To evaluate the item and scale properties of the Oral Health Literacy Adults Questionnaire (OHL-AQ) in an adult general population. b) To determine precision or accuracy of the respondents' estimated scores along the Oral Health Literacy (OHL) spectrum using item response theory (IRT) modeling. METHODS Survey data were collected from a convenience sample of 405 adult attendees of the 2014 Minnesota State Fair. We used the two-parameter logistic (2PL) model for the item response theory (IRT) analyses of OHL-AQ data and calibrated items to estimate model-based item difficulty and discrimination parameters. Item and scale properties were also assessed by plotting and interpreting item characteristic curves (ICCs), test characteristic curve (TCC), and test information function (TIF). RESULTS Based on interpretation of model coefficients, statistical testing, and model fit criteria, we deemed the 2PL model superior and selected this model to examine item and scale properties. Scale reliability was shown to be good through the test information function (TIF). TIF from our analysis showed that higher levels of OHL were measured less precisely than lower levels of OHL. CONCLUSION We demonstrated OHL-AQ as a whole has promising psychometric properties. However, for equiprecise measurement across the scale range, the scale needs more items for measuring higher levels of OHL.
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Affiliation(s)
- Swaha Pattanaik
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Mike T John
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Nidhi Kohli
- Department of Educational Psychology, College of Human Development, University of Minnesota, Minneapolis, MN, USA
| | - Mark L Davison
- Department of Educational Psychology, College of Human Development, University of Minnesota, Minneapolis, MN, USA
| | - Seungwon Chung
- Department of Educational Psychology, College of Human Development, University of Minnesota, Minneapolis, MN, USA
| | - Karl Self
- Department of Primary Dental Care, University of Minnesota School of Dentistry, Minneapolis, MN, USA
| | - Amruta Naik
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Priscilla M Flynn
- Department of Primary Dental Care, University of Minnesota School of Dentistry, Minneapolis, MN, USA
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Ghaffari M, Rakhshanderou S, Ramezankhani A, Mehrabi Y, Safari-Moradabadi A. Systematic review of the tools of oral and dental health literacy: assessment of conceptual dimensions and psychometric properties. BMC Oral Health 2020; 20:186. [PMID: 32620108 PMCID: PMC7333397 DOI: 10.1186/s12903-020-01170-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 06/19/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This article aims to provide a description of conceptual dimensions and psychometric properties of the tools of oral and dental health literacy. METHODS Two authors in this study conducted electronic searches in the Medline (via PubMed), and Embase databases to find relevant articles from 1990 to present day. Evaluation of the tools was carried out in two parts; general evaluation of the tools using skills introduced by Sørensen et al., and qualitative assessment of psychometric properties using COSMIN checklist. RESULTS After reviewing 1839 articles on oral and dental health literacy and evaluating 33 full text articles for eligibility, 21 articles entered the study. The sample size varied from 20 to 1405 subjects and the items of each tool ranged from 11 to 99 items. Of the 21 tools examined, 16 tools were evaluated for word recognition. For the studies examined, the evaluation of COSMIN scores was often fair or good. Of the 21 tools examined, 9 tools at least in one dimension were in the category of "poor", 19 tools were in the category of "fair", 20 tools were in the category of "good", and 4 tools were in the category of "excellent" in at least one dimension. CONCLUSION The findings of this study showed that some aspects of oral and dental health literacy are being ignored in the existing tools. Therefore, the authors of present study emphasize on the necessity to design and develop a comprehensive tool and take into account two characteristics of simplicity and briefness for international use.
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Affiliation(s)
- Mohtasham Ghaffari
- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sakineh Rakhshanderou
- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Ramezankhani
- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Safari-Moradabadi
- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Das D, Menon I, Gupta R, Arora V, Ashraf A, Ahsan I. Oral health literacy: A practical strategy towards better oral health status among adult population of Ghaziabad district. J Family Med Prim Care 2020; 9:764-770. [PMID: 32318417 PMCID: PMC7113944 DOI: 10.4103/jfmpc.jfmpc_1049_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 01/24/2020] [Accepted: 01/31/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND AIMS Despite tremendous considerable effort by health professionals to promote oral health to create beautiful smiles, gap between oral health knowledge and practice undoubtedly still remains. Thus the aim of this study was to assess the Oral health literacy level and its impact on socioeconomic and oral health status among adult population in Ghaziabad district. METHODS A total of 600 study subjects aged 18-64 years from all 4 blocks of Ghaziabad visiting various outreach programmes using a multistage random sampling technique were included in the study. A specially designed questionnaire assessed the demographic variables. Oral health literacy level (OHL) was assessed with help of a bilingually adapted Hindi OHL tool. Clinical examination was recorded using WHO (World Health Organization) Oral Health Assessment Form 2013. RESULTS The mean age of the study subjects was 43.9 ± 14.36 years. Majority 300 (50%) study subjects had inadequate oral health literacy level followed by Marginal oral health literacy level which was seen among 180 (30%) subjects and 120 (20%) subjects had adequate oral health literacy level. Oral health literacy level was slightly higher among females as compared to male subjects although the results were not statistically significant. A statistically significant difference was found between oral health literacy and oral health status as well as socioeconomic status. (P value ≤ 0.05). CONCLUSION A significant association between OHL and oral health status was found stating Oral health literacy as an efficient role in influencing oral health outcome of any individual.
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Affiliation(s)
- Dipshikha Das
- Department of Public Health Dentistry, I.T.S Centre for Dental Studies and Research, Delhi- Meerut Road, Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Ipseeta Menon
- Department of Public Health Dentistry, I.T.S Centre for Dental Studies and Research, Delhi- Meerut Road, Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Ritu Gupta
- Department of Public Health Dentistry, I.T.S Centre for Dental Studies and Research, Delhi- Meerut Road, Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Vikram Arora
- Department of Public Health Dentistry, I.T.S Centre for Dental Studies and Research, Delhi- Meerut Road, Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Asifa Ashraf
- Department of Public Health Dentistry, I.T.S Centre for Dental Studies and Research, Delhi- Meerut Road, Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Iram Ahsan
- Department of Public Health Dentistry, I.T.S Centre for Dental Studies and Research, Delhi- Meerut Road, Murad Nagar, Ghaziabad, Uttar Pradesh, India
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Taoufik K, Divaris K, Kavvadia K, Koletsi-Kounari H, Polychronopoulou A. Development of a Greek Oral health literacy measurement instrument: GROHL. BMC Oral Health 2020; 20:14. [PMID: 31941482 PMCID: PMC6964004 DOI: 10.1186/s12903-020-1000-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 01/03/2020] [Indexed: 11/23/2022] Open
Abstract
Background Oral health literacy is an important construct for both clinical and public health outcomes research. The need to quantify and test OHL has led to the development of measurement instruments and has generated a substantial body of recent literature. A commonly used OHL instrument is REALD-30, a word recognition scale that has been adapted for use in several languages. The objective of this study was the development and testing of the Greek language oral health literacy measurement instrument (GROHL). Methods Data from 282 adult patients of two private dental clinics in Athens, Greece were collected via in-person interviews. Forty-four words were initially considered and tested for inclusion. Item response theory analysis (IRT) and 2-parameter logistic models assessing difficulty and discriminatory ability were used to identify an optimal scale composition. Internal consistency was examined using Cronbach’s alpha and test-retest reliability was measured using intraclass correlation coefficient (ICC) in a subset of 20 participants over a two-week period. Convergent validity was tested against functional health literacy screening (HLS) items, dental knowledge (DK), oral health behaviors (OHBs), oral health-related quality of life (OHRQoL; OHIP-14 index), as well as self-reported oral and general health status. Results From an initial item pool of 44 items that were carried forward to IRT, 12 were excluded due to no or little variance, 10 were excluded due to low item-test correlation, and 2 due to insignificant contribution to the scale, i.e., difficulty parameter estimate with p > 0.05. The twenty remaining items composed the final index which showed favorable internal consistency (alpha = 0.80) and test-retest reliability (ICC = 0.95). The summary score distribution did not depart from normality (p = 0.32; mean = 11.5; median = 12; range = 1–20). GROHL scores were positively correlated with favorable oral hygiene behaviors and dental attendance, as well as HLS, DK and education level. Conclusion The GROHL demonstrated good psychometric properties and can be used for outcomes research in clinical and public health settings.
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Affiliation(s)
- Konstantina Taoufik
- Department of Community and Preventive Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Kimon Divaris
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.,Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Katerina Kavvadia
- Department of Pediatric Dentistry, School of Dentistry, University of Louisville, Louisville, KY, USA
| | - Haroula Koletsi-Kounari
- Department of Community and Preventive Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Argy Polychronopoulou
- Department of Community and Preventive Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Sermsuti-Anuwat N, Pongpanich S. Validation of Thai version of the Health Literacy in Dentistry scale: Validation among Thai adults with physical disabilities. ACTA ACUST UNITED AC 2019; 10:e12474. [PMID: 31612641 DOI: 10.1111/jicd.12474] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 08/25/2019] [Accepted: 09/13/2019] [Indexed: 11/28/2022]
Abstract
AIM To validate the Thai version of the Health Literacy in Dentistry scale (HeLD-Th) among Thai adults with physical disabilities. METHODS The original Health Literacy in Dentistry (HeLD) was translated into Thai (HeLD-Th). The final version of the HeLD-Th was evaluated through a cross-sectional study of 160 participants in Thailand. Interview questionnaires and oral examination were performed. The reliability and validity of the HeLD-Th were determined. RESULTS The internal consistency was acceptable, with an overall Cronbach's alpha of 0.76. The face and content validity were confirmed. Sufficient construct validity was revealed by exploratory factor analysis. The convergent validity (P ≤ .013) and discriminant validity (P = .017) were estimated. The concurrent validity and predictive validity were confirmed by significantly higher HeLD-Th scores (P < .001). Multiple linear regression analyses indicated that approximately 60% of the variation in the HeLD-Th scores was explained by the final model. CONCLUSION The HeLD-Th has sufficient psychometric properties to assess the oral health literacy of Thai adults with mild to moderate disabilities. There are some limitations of the study due to the small sample size, and the results are specific to Thai adults with disabilities. Future studies using the HeLD-Th scale are recommended.
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Development and validation of the Dental Nutrition Knowledge Competency Scale for low-income women. Public Health Nutr 2019; 23:691-700. [PMID: 31588884 DOI: 10.1017/s1368980019002714] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To develop and validate a Dental Nutrition Knowledge Competency Scale to assess dental health-related nutrition knowledge of low-income women. DESIGN This is a cross-sectional study. A literature search for foods/dietary practices related to dental caries was conducted and the items were incorporated into an initial questionnaire. A panel of ten nutrition experts evaluated it for its content, readability and relevance, and a focus group of six low-income women determined its readability and comprehension. Then the questionnaire was administered to 150 low-income women. Construct validity was evaluated by item difficulty, item discrimination and factor analysis. Internal consistency reliability was tested via Cronbach's α. In a sub-sample of forty women, test-retest reliability was established. Paired-sample t tests were conducted to examine differences between test scores at the two time points, 2 weeks apart. SETTINGS Community centres in low-income housing in Central Texas, USA. PARTICIPANTS A total of 150 low-income women, aged 18-50 years; annual household income <250 % of the federal poverty level. RESULTS Item difficulty and discrimination analysis resulted in elimination of eight questions. Factor analysis identified twenty-four items that loaded on three factors related to knowledge. These included foods/dietary practices that affect dental caries, added sugars in foods and on food labels, and recommended frequency of oral hygiene practices. The subscales and the completed scale exhibited good internal consistency (mean 0·7 (sd 0·97)) and test-retest reliability (mean 0·8 (sd 0·013)). CONCLUSIONS The Dental Nutrition Knowledge Competency Scale is a validated and reliable instrument to assess nutrition knowledge related to dental health in low-income women.
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Lima LCMD, Neves ÉTB, Dutra LDC, Firmino RT, Araújo LJSD, Paiva SM, Ferreira FM, Granville-Garcia AF. Psychometric properties of BREALD-30 for assessing adolescents' oral health literacy. Rev Saude Publica 2019; 53:53. [PMID: 31432910 PMCID: PMC6703894 DOI: 10.11606/s1518-8787.2019053000999] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/24/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the psychometric properties of the Brazilian Portuguese version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) administered to adolescents. METHODS The study included 750 adolescents: 375 aged 12 years and 375 aged 15–19 years, attending public and private schools in Campina Grande, state of Paraíba, Brazil, in 2017. Reliability was measured based on internal consistency and test-retest reliability. Convergent validity was measured based on correlations between BREALD-30 and Functional Literacy Indicator scores. Divergent validity was measured by comparing BREALD-30 scores with sociodemographic variables. For predictive validity, the association between BREALD-30 scores and the presence of cavitated carious lesions was tested using a multiple logistic regression model. All statistical tests were performed with a significance level of 5%. RESULTS BREALD-30 showed good internal consistency for the 12 year olds and 15 to19 year olds (Cronbach’s alpha = 0.871 and 0.834, respectively) and good test-retest reliability [intraclass correlation coefficient (ICC) = 0.898 and 0.974; kappa = 0.804 and 0.808, respectively]. Moreover, item-total correlation was satisfactory for all items. BREALD-30 had convergent validity with the Functional Literacy Indicator for 12 year olds (rs = 0.558, p < 0.001) and for 15 to 19 year olds (rs = 0.652, p < 0.001). Participants with higher oral health literacy levels who attended private schools (p < 0.001), belonged to economic classes A and B2 (p < 0.001), and who had parents with higher education levels (p < 0.001) were included, indicating the divergent validity of the BREALD-30. Participants with lower BREALD-30 scores were more likely to have cavitated carious lesions [12 year olds: odds ratio (OR) = 2.37; 95% confidence interval (95%CI): 1.48–3.80; 15 to 19 year olds: OR = 1.96; 95%CI 1.24–3.11]. CONCLUSIONS BREALD-30 shows satisfactory psychometric properties for use on Brazilian adolescents and can be applied as a fast, simple, and reliable measure of oral health literacy.
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Affiliation(s)
| | | | - Laio da Costa Dutra
- Universidade Estadual da Paraíba. Programa de Pós-Graduação em Odontologia. Campina Grande, PB, Brasil
| | - Ramon Targino Firmino
- Universidade Federal de Minas Gerais. Faculdade de Odontologia. Programa de Pós-Graduação em Odontologia. Belo Horizonte, MG, Brasil
| | | | - Saul Martins Paiva
- Universidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Odontopediatria e Ortodontia. Belo Horizonte, MG, Brasil
| | - Fernanda Morais Ferreira
- Universidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Odontopediatria e Ortodontia. Belo Horizonte, MG, Brasil
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Bado FMR, Rebustini F, Jamieson L, Cortellazzi KL, Mialhe FL. Evaluation of the psychometric properties of the Brazilian version of the Oral Health Literacy Assessment in Spanish and development of a shortened form of the instrument. PLoS One 2018; 13:e0207989. [PMID: 30496226 PMCID: PMC6264477 DOI: 10.1371/journal.pone.0207989] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/10/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The objective of this study was to investigate the psychometric properties of the Oral Health Literacy Assessment in Spanish (OHLA-S) for the Brazilian-Portuguese language using robust analysis and with the results disclose possibilities to develop a shorter and more valid instrument. METHODS OHLA-S is an oral health literacy instrument comprising a word recognition section and a comprehension section. It consists of 24 dental words. It was translated into the Brazilian-Portuguese language (OHLA-B) and its psychometric properties were evaluated in a random sample of 250 adults aged 20-59 years. To assess the dimensionality and factor structure were tested by means of Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Reliability was assessed using two indicators: Cronbach's alpha and McDonald's Omega. RESULTS EFA and CFA demonstrated that the OHLA-B with 24 items did not present an adequate adjustment of the model, compromising its validity. In addition, reliability values at 0.50 for Cronbach's alpha and 0.67 for McDonald's omega were below the minimum acceptable rate of 0.70. As no support was found for the original structure, we decided to proceed with the withdrawal of individual items and successive reanalysis of the model until the indicators were adjusted in a shorter instrument. A new structure with 15 items produced an instrument with two dimensions and a better goodness of fit than the original instrument. The Alpha and Omega reliability index values increased to 0.83 and 0.80, respectively, and all scores were better in the OLHA-B with 15 items than in the instrument with 24 items. CONCLUSION OLHA-B with the original structure composed by 24 items did not show acceptable construct validity. The shorter version with 15 items showed more promising results for assessing oral health literacy levels in the Brazilian population.
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Affiliation(s)
- Fernanda Maria Rovai Bado
- Department of Community Dentistry, University of Campinas, Piracicaba Dental School, Piracicaba, São Paulo, Brazil
| | - Flávio Rebustini
- Department of Gerontology (EACH), University of São Paulo, São Paulo, Brazil
| | - Lisa Jamieson
- Indigenous Oral Health Unit, The University of Adelaide, Adelaide, South Australia, Australia
| | - Karine Laura Cortellazzi
- Department of Community Dentistry, University of Campinas, Piracicaba Dental School, Piracicaba, São Paulo, Brazil
| | - Fábio Luiz Mialhe
- Department of Community Dentistry, University of Campinas, Piracicaba Dental School, Piracicaba, São Paulo, Brazil
- * E-mail:
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Cartes-Velásquez RA, Luengo Machuca L. Adaptation and validation of the oral health literacy instrument for the Chilean population. Int Dent J 2017; 67:215-220. [DOI: 10.1111/idj.12288] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Ju X, Brennan D, Parker E, Mills H, Kapellas K, Jamieson L. Efficacy of an oral health literacy intervention among Indigenous Australian adults. Community Dent Oral Epidemiol 2017; 45:413-426. [DOI: 10.1111/cdoe.12305] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 04/02/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Xiangqun Ju
- Australian Research Centre for Population Oral Health; Adelaide Dental School; University of Adelaide; Adelaide South Australia Australia
| | - David Brennan
- Australian Research Centre for Population Oral Health; Adelaide Dental School; University of Adelaide; Adelaide South Australia Australia
| | - Eleanor Parker
- Australian Research Centre for Population Oral Health; Adelaide Dental School; University of Adelaide; Adelaide South Australia Australia
| | - Helen Mills
- Australian Research Centre for Population Oral Health; Adelaide Dental School; University of Adelaide; Adelaide South Australia Australia
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health; Adelaide Dental School; University of Adelaide; Adelaide South Australia Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health; Adelaide Dental School; University of Adelaide; Adelaide South Australia Australia
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Atchison KA, Macek MD, Markovic D. The value of a combined word recognition and knowledge measure to understand characteristics of our patients' oral health literacy. Community Dent Oral Epidemiol 2017; 45:380-388. [PMID: 28444905 DOI: 10.1111/cdoe.12301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 03/09/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of the analysis was to examine the association between sociodemographic and dental understanding and utilization characteristics and lower oral health literacy (HL) and knowledge. METHODS The cross-sectional Multicenter Oral Health Literacy Research Study (MOHLRS) recruited and interviewed 923 English-speaking, initial care-seeking adults. The questionnaire included participant sociodemographic characteristics, measures of the participant's understanding and utilization of dentistry, and two oral HL measures, the Rapid Estimate of Adult Literacy in Medicine and Dentistry (REALM-D) and the Comprehensive Measure of Oral Health Knowledge (CMOHK), which were combined into a new composite HL and knowledge measure, the MOHLR-K. RESULTS In adjusted multivariable analysis, persons who reported more understanding of dentist instructions had higher mean scores for all HL measures. Subjects reporting the highest level of understanding had greater scores by an average of 1.6 points for the MOHLR-K (95% CI: 0.85-2.40, P<.01), 2.11 points for REALMD-20 (95% CI: 0.75-3.48, P<.01) and 2.20 points for CMOHK (95% CI: 1.01-3.40, P<.01) after controlling for demographic and other dental understanding and utilization factors. Persons who reported history of tooth decay had higher MOHLR-K scores by an average of about 0.77 points (95% CI: 0.49-1.04, P<.01), higher REALMD-20 scores by 0.54 points (95% CI: 0.12-0.95, P=.01) and higher CMOHK scores by 1.22 points (95% CI: 0.82-1.63, P<.01) as compared to persons without tooth decay history after controlling for the other factors. Persons who had support all of the time for travel to the dentist had higher scores by an average of about 0.5 points for the MOHLR-K (95% CI: 0.04-0.96, P=.03) and about 0.89 points for the REALMD-20 (95% CI: 0-1.79, P=.05) as compared to subjects with no support after controlling for other factors. Report of periodontal history, financial challenges to delay a dental visit and dental utilization were not significantly associated with any of the HL measures once the other factors were adjusted for in the model. CONCLUSION The analysis confirmed that pronunciation of medical and dental terms may not fully reflect comprehension and revealed that understanding both patients' sociodemographic and dental understanding and utilization factors, such as transportation to the dental office associated with lower oral HL and knowledge, could help the profession develop appropriate clear language programmes to improve access to dental care for vulnerable populations.
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Affiliation(s)
- Kathryn A Atchison
- Los Angeles School of Dentistry, University of California, Los Angeles, CA, USA
| | - Mark D Macek
- University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Daniela Markovic
- Department of Biomathematics, University of California, Los Angeles, CA, USA
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Peker K, Köse TE, Güray B, Uysal Ö, Erdem TL. Reliability and validity of the Turkish version of the Rapid Estimate of Adult Literacy in Dentistry (TREALD-30). Acta Odontol Scand 2017; 75:198-207. [PMID: 28093024 DOI: 10.1080/00016357.2016.1278079] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To culturally adapt the Turkish version of Rapid Estimate of Adult Literacy in Dentistry (TREALD-30) for Turkish-speaking adult dental patients and to evaluate its psychometric properties. MATERIAL AND METHODS After translation and cross-cultural adaptation, TREALD-30 was tested in a sample of 127 adult patients who attended a dental school clinic in Istanbul. Data were collected through clinical examinations and self-completed questionnaires, including TREALD-30, the Oral Health Impact Profile (OHIP), the Rapid Estimate of Adult Literacy in Medicine (REALM), two health literacy screening questions, and socio-behavioral characteristics. Psychometric properties were examined using Classical Test Theory (CTT) and Rasch analysis. RESULTS Internal consistency (Cronbach's Alpha = 0.91) and test-retest reliability (Intraclass correlation coefficient = 0.99) were satisfactory for TREALD-30. It exhibited good convergent and predictive validity. Monthly family income, years of education, dental flossing, health literacy, and health literacy skills were found as stronger predictors of patients'oral health literacy (OHL). Confirmatory factor analysis (CFA) confirmed a two-factor model. The Rasch model explained 37.9% of the total variance in this dataset. In addition, TREALD-30 had eleven misfitting items, which indicated evidence of multidimensionality. The reliability indeces provided in Rasch analysis (person separation reliability = 0.91 and expected-a-posteriori/plausible reliability = 0.94) indicated that TREALD-30 had acceptable reliability. CONCLUSION TREALD-30 showed satisfactory psychometric properties. It may be used to identify patients with low OHL. Socio-demographic factors, oral health behaviors and health literacy skills should be taken into account when planning future studies to assess the OHL in both clinical and community settings.
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Affiliation(s)
- Kadriye Peker
- Department of Dental Public Health, Faculty of Dentistry, Istanbul University, Capa, Istanbul, Turkey
| | - Taha Emre Köse
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Istanbul University, Capa, Istanbul, Turkey
| | - Beliz Güray
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Istanbul University, Capa, Istanbul, Turkey
| | - Ömer Uysal
- Department of Medical Statistics and Informatics, Medical School, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Tamer Lütfi Erdem
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Okan University, Tuzla, Istanbul, Turkey
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Junkes MC, Fraiz FC, Sardenberg F, Lee JY, Paiva SM, Ferreira FM. Validity and Reliability of the Brazilian Version of the Rapid Estimate of Adult Literacy in Dentistry--BREALD-30. PLoS One 2015; 10:e0131600. [PMID: 26158724 PMCID: PMC4497720 DOI: 10.1371/journal.pone.0131600] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 06/03/2015] [Indexed: 11/18/2022] Open
Abstract
Objective The aim of the present study was to translate, perform the cross-cultural adaptation of the Rapid Estimate of Adult Literacy in Dentistry to Brazilian-Portuguese language and test the reliability and validity of this version. Methods After translation and cross-cultural adaptation, interviews were conducted with 258 parents/caregivers of children in treatment at the pediatric dentistry clinics and health units in Curitiba, Brazil. To test the instrument's validity, the scores of Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) were compared based on occupation, monthly household income, educational attainment, general literacy, use of dental services and three dental outcomes. Results The BREALD-30 demonstrated good internal reliability. Cronbach’s alpha ranged from 0.88 to 0.89 when words were deleted individually. The analysis of test-retest reliability revealed excellent reproducibility (intraclass correlation coefficient = 0.983 and Kappa coefficient ranging from moderate to nearly perfect). In the bivariate analysis, BREALD-30 scores were significantly correlated with the level of general literacy (rs = 0.593) and income (rs = 0.327) and significantly associated with occupation, educational attainment, use of dental services, self-rated oral health and the respondent’s perception regarding his/her child's oral health. However, only the association between the BREALD-30 score and the respondent’s perception regarding his/her child's oral health remained significant in the multivariate analysis. Conclusion The BREALD-30 demonstrated satisfactory psychometric properties and is therefore applicable to adults in Brazil.
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Affiliation(s)
- Monica C. Junkes
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Fabian C. Fraiz
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Fernanda Sardenberg
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Jessica Y. Lee
- Department of Pediatric Dentistry, University of North Caroline, Chapel Hill, North Carolina, United States of America
| | - Saul M. Paiva
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda M. Ferreira
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
- Department of Pediatric Dentistry, University of North Caroline, Chapel Hill, North Carolina, United States of America
- * E-mail:
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Mantwill S, Schulz PJ. Health literacy in Mainland China: Validation of a functional health literacy test in simplified Chinese. Health Promot Int 2015; 31:742-748. [PMID: 26071605 DOI: 10.1093/heapro/dav043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Health literacy tests in the Chinese-speaking parts of the world have been mainly developed in traditional Chinese to be used in Hong Kong or Taiwan. So far no validated tool in simplified Chinese to assess functional health literacy in Mainland China has been developed. The aim of the study was to validate the simplified Chinese version of the Short Test of Functional Health Literacy in Adults (S-TOFHLA). The traditional Chinese version was translated into simplified Chinese and 150 interviews in an outpatient department of a public hospital in Mainland China were conducted. Predictive validity was assessed by known predictors for health literacy and convergent validity by three health literacy screening questions. The Cronbach's α for the reading comprehension part was 0.94 and 0.90 for the numeracy items. Participants with lower education and men had significantly lower levels of health literacy. The reading comprehension part was significantly correlated with two of the health literacy screening questions. Our results indicate that the simplified Chinese version of the S-TOFHLA is a reliable measure of health literacy to be used in Mainland China.
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Affiliation(s)
- Sarah Mantwill
- Institute of Communication and Health, University of Lugano, Via Giuseppe Buffi 13, Lugano 6900, Switzerland
| | - Peter J Schulz
- Institute of Communication and Health, University of Lugano, Via Giuseppe Buffi 13, Lugano 6900, Switzerland
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Stein L, Pettersen KS, Bergdahl M, Bergdahl J. Development and validation of an instrument to assess oral health literacy in Norwegian adult dental patients. Acta Odontol Scand 2015; 73:530-8. [PMID: 25652174 DOI: 10.3109/00016357.2015.1007477] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To develop and validate an interview instrument to assess oral health literacy in Norwegian adult dental patients. MATERIALS AND METHODS The instrument, Adult Health Literacy Instrument for Dentistry (AHLID), was based on an OECD instrument used to assess general literacy in adults. One hundred and thirty Norwegian adults (mean age = 48 years; 57% women) participated. AHLID included a selection of oral health-related printed texts that ranged from 1-5 with respect to difficulty. A questionnaire regarding socio-demographic variables and knowledge of risk factors for oral disease was used. DMFT, stimulated salivary flow rate and streptococcus mutans and lactobacillus in saliva was also examined. RESULTS The Cronbach's alpha values of AHLID were 0.98 for internal consistency reliability (p < 0.01) and 0.81 for test-re-test reliability (p < 0.05). AHLID score 3 was most frequent while very few fulfilled the criteria for score 1 and 5. Linear multiple regression analysis showed that lactobacillus in saliva and knowledge of risk factors for periodontitis and caries were predictor variables of AHLID score. CONCLUSIONS AHLID appears to be reliable and valid to assess oral health literacy in Norwegian adults and suggests a method for country-specific health literacy instruments.
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Affiliation(s)
- Linda Stein
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway , Tromsø , Norway
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Dickson-Swift V, Kenny A, Farmer J, Gussy M, Larkins S. Measuring oral health literacy: a scoping review of existing tools. BMC Oral Health 2014; 14:148. [PMID: 25472659 PMCID: PMC4417207 DOI: 10.1186/1472-6831-14-148] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 11/19/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This article presents findings from a scoping review of tools used to measure oral health literacy. Internationally, interest in oral health literacy is driven by oral health disparities, particularly for disadvantaged groups, with conditions such as dental caries and periodontal disease contributing substantially to the global burden of disease. The increasing focus on measuring oral health literacy aligns with reasons for measuring broader health literacy, that is, by assessing oral health literacy, decisions can be made about instigating interventions at policy and practice level to improve individual and population level oral health. There are numerous tools available that measure oral health literacy using a range of indicators. METHODS A scoping review was designed to map the existing tools designed to measure oral health literacy (OHL). Key search terms were developed and mapped. Selected databases were used that identified 32 relevant studies reporting a range of OHL tools. RESULTS We identified 32 articles that reported a range of oral health literacy tools. Many of the studies used the Rapid Estimate of Adult Literacy in Dentistry (REALD) and/or the Test of Functional Health Literacy in Dentistry (ToFHLiD) that were developed from earlier tools designed to measure broader health literacy. These tools have been widely criticised for providing only an approximate measure of OHL based mainly on word recognition. A number of newer tools have included new measures of oral health literacy including numeracy and oral health conceptual knowledge however tools that measure important indicators of oral health literacy such as service navigation are rare. CONCLUSIONS Findings from this scoping exercise confirm our findings from preliminary scans that the majority of tools are heavily biased towards word recognition, numeracy and reading skills, rather than what this means in terms of health behaviours and service utilisation. More recent developments have attempted to incorporate other aspects considered important, including decision making and service navigation. The incorporation of these aspects into newer tools will provide oral health researchers and policy makers with further evidence of the importance of oral health literacy when designing interventions to improve oral health.
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Affiliation(s)
- Virginia Dickson-Swift
- La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, Vic, 3552, Australia.
| | - Amanda Kenny
- La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, Vic, 3552, Australia.
| | - Jane Farmer
- La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, Vic, 3552, Australia.
| | - Mark Gussy
- La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, Vic, 3552, Australia.
| | - Sarah Larkins
- School of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Townsville, QLD, 4811, Australia.
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Blizniuk A, Ueno M, Furukawa S, Kawaguchi Y. Evaluation of a Russian version of the oral health literacy instrument (OHLI). BMC Oral Health 2014; 14:141. [PMID: 25430803 PMCID: PMC4280741 DOI: 10.1186/1472-6831-14-141] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 11/20/2014] [Indexed: 11/11/2022] Open
Abstract
Background Oral health literacy has become a popular research area in the last decade; however, to date no health literacy instruments in the Russian language exist. The objectives of this study were to develop a Russian version of the Oral Health Literacy Instrument (OHLI) and to examine its reliability and validity. Methods A convenience sample of patients who visited the dental division of the district hospital in Belarus was used in the study. The OHLI, created originally in English, was modified to adapt it to characteristics of routine dental services in Belarus and then translated into Russian, followed by back-translation. Participants completed a self-administered socio-demographic questionnaire, an oral health knowledge test and the Russian version of the OHLI (R-OHLI). Bivariate and multivariate statistical analyses, including multiple regression modeling, were performed to examine reliability and validity of the R-OHLI. Results Participants were 281 adult patients aged from 18 to 60 years, with a mean age of 33.1 ± 12.2; 64.1% of them were women. Cronbach’s alpha values for the two sections (reading comprehension and numeracy) and the total R-OHLI were 0.853, 0.815 and 0.895, respectively. The mean total R-OHLI score was 77.2 ± 14.5; the mean reading comprehension and numeracy scores were 39.5 ± 7.5 and 37.8 ± 8.8, respectively. The R-OHLI was significantly correlated to the oral health knowledge test. Pearson’s correlation coefficients between the oral health knowledge test and the reading comprehension, numeracy and total R-OHLI were 0.401, 0.258, and 0.363, respectively (p < 0.001). Women, participants with a university degree, and those who visited a dentist at least once a year had significantly (p < 0.05) higher mean scores for each section (reading comprehension, numeracy) and for total R-OHLI compared to their counterparts. Conclusions The R-OHLI showed good internal consistency and test-retest reliability. It was significantly associated with the oral health knowledge test, socio-demographic and behavioral factors. Therefore, the R-OHLI was proved to be a reliable and valid oral health literacy instrument for Russian-speaking people.
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Affiliation(s)
| | - Masayuki Ueno
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
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Pakpour AH, Lawson DM, Tadakamadla SK, Fridlund B. Validation of Persian rapid estimate of adult literacy in dentistry. ACTA ACUST UNITED AC 2014; 7:198-206. [PMID: 25329835 DOI: 10.1111/jicd.12135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 08/26/2014] [Indexed: 11/30/2022]
Abstract
AIM The aim of the present study was to establish the psychometric properties of the Rapid Estimate of adult Literacy in Dentistry-99 (REALD-99) in the Persian language for use in an Iranian population (IREALD-99). METHODS A total of 421 participants with a mean age of 28 years (59% male) were included in the study. Participants included those who were 18 years or older and those residing in Quazvin (a city close to Tehran), Iran. A forward-backward translation process was used for the IREALD-99. The Test of Functional Health Literacy in Dentistry (TOFHLiD) was also administrated. The validity of the IREALD-99 was investigated by comparing the IREALD-99 across the categories of education and income levels. To further investigate, the correlation of IREALD-99 with TOFHLiD was computed. A principal component analysis (PCA) was performed on the data to assess unidimensionality and strong first factor. The Rasch mathematical model was used to evaluate the contribution of each item to the overall measure, and whether the data were invariant to differences in sex. Reliability was estimated with Cronbach's α and test-retest correlation. RESULTS Cronbach's alpha for the IREALD-99 was 0.98, indicating strong internal consistency. The test-retest correlation was 0.97. IREALD-99 scores differed by education levels. IREALD-99 scores were positively related to TOFHLiD scores (rh = 0.72, P < 0.01). In addition, IREALD-99 showed positive correlation with self-rated oral health status (rh = 0.31, P < 0.01) as evidence of convergent validity. The PCA indicated a strong first component, five times the strength of the second component and nine times the third. The empirical data were a close fit with the Rasch mathematical model. There was not a significant difference in scores with respect to income level (P = 0.09), and only the very lowest income level was significantly different (P < 0.01). CONCLUSIONS The IREALD-99 exhibited excellent reliability on repeated administrations, as well as internal consistency. The IREALD-99 can be used for the basic screening of oral health literacy among the Iranian population.
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Affiliation(s)
- Amir H Pakpour
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Douglas M Lawson
- Department of Chiropractic, D'Youville College, Buffalo, NY, USA
| | - Santosh K Tadakamadla
- Population & Social Health Research Program, Griffith Health Institute, School of Dentistry and Oral Health, Gold Coast, QLD, Australia
| | - Bengt Fridlund
- School of Health Sciences, Jönköping University, Jönköping, Sweden
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Tadakamadla SK, Quadri MFA, Pakpour AH, Zailai AM, Sayed ME, Mashyakhy M, Inamdar AS, Tadakamadla J. Reliability and validity of Arabic Rapid Estimate of Adult Literacy in Dentistry (AREALD-30) in Saudi Arabia. BMC Oral Health 2014; 14:120. [PMID: 25267119 PMCID: PMC4190341 DOI: 10.1186/1472-6831-14-120] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 09/26/2014] [Indexed: 11/17/2022] Open
Abstract
Background To evaluate the reliability and validity of Arabic Rapid Estimate of Adult Literacy in Dentistry (AREALD-30) in Saudi Arabia. Methods A convenience sample of 200 subjects was approached, of which 177 agreed to participate giving a response rate of 88.5%. Rapid Estimate of Adult Literacy in Dentistry (REALD-99), was translated into Arabic to prepare the longer and shorter versions of Arabic Rapid Estimate of Adult Literacy in Dentistry (AREALD-99 and AREALD-30). Each participant was provided with AREALD-99 which also includes words from AREALD-30. A questionnaire containing socio-behavioral information and Arabic Oral Health Impact Profile (A-OHIP-14) was also administered. Reliability of the AREALD-30 was assessed by re-administering it to 20 subjects after two weeks. Convergent and predictive validity of AREALD-30 was evaluated by its correlations with AREALD-99 and self-perceived oral health status, dental visiting habits and A-OHIP-14 respectively. Discriminant validity was assessed in relation to the educational level while construct validity was evaluated by confirmatory factor analysis (CFA). Results Reliability of AREALD-30 was excellent with intraclass correlation coefficient of 0.99. It exhibited good convergent and discriminant validity but poor predictive validity. CFA showed presence of two factors and infit mean-square statistics for AREALD-30 were all within the desired range of 0.50 - 2.0 in Rasch analysis. Conclusions AREALD-30 showed excellent reliability, good convergent and concurrent validity, but failed to predict the differences between the subjects categorized based on their oral health outcomes.
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Affiliation(s)
| | - Mir Faeq Ali Quadri
- Department of Preventive Dentistry, Faculty of Dentistry, Jazan University, P,O Box: 114, Jazan 45142, Saudi Arabia.
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S Parthasarathy D, Bridges SM, McGrath CP, Au TK, Wong HM, Yiu CK. The Relation Between Caregivers' Multiliterate Reading Habits and Their Children's Oral Health Status. Interact J Med Res 2014; 3:e13. [PMID: 25236188 PMCID: PMC4180347 DOI: 10.2196/ijmr.3210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 06/17/2014] [Accepted: 08/21/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Caregivers' oral health literacy (OHL) assessment results have been found to be related to their children's oral health status. A further aspect of this relationship may be the role of caregivers' reading habits. OBJECTIVE Our goal was to describe the relationship between caregivers' multimodal (digital and print) and multilingual (English and Chinese) reading habits, their OHL, and their child's oral health status in Hong Kong. METHODS A random sample of 301 child-caregiver dyads was recruited from kindergartens in Hong Kong. Data included sociodemographic information and caregivers' self-reported digital print and reading habits across two languages (Chinese and English). Caregivers' OHL levels were assessed by two locally developed and validated oral health literacy assessment tasks: Hong Kong Rapid Estimate of Adult Literacy in Dentistry-30 (HKREALD-30) and the Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry (HKOHLAT-P). Children's oral health status was assessed using two measures: dental caries experience (number of decayed, missing, and filled teeth) and oral hygiene status (Visible Plaque Index). RESULTS Bivariate variations revealed significant differences in mean OHL scores between caregivers with different reading habits (P<.01). Correlations revealed significant associations between caregivers' practices of reading multimodal (print/digital) and multilingual (English/Chinese) texts, their literacy levels, and their children's oral health status (P<.01). Adjusting for sociodemographics and all other reading habits in the regression analysis, the caregivers' habit of reading digital and print texts was significantly retained in the final model. Regression analysis revealed significant associations between caregivers' reading habits (digital Chinese) and their OHL word recognition scores: OR 5.00, 95% CI 1.10-3.65, P=.027. Significant associations were also evident for their OHL comprehension scores (digital Chinese: OR 2.30, 95% CI 1.30-4.20, P=.004; print Chinese: OR 2.50, 95% CI 1.40-4.30, P=.001). However, no significant associations were found between caregivers' reading habits and child's oral health status (P>.05). CONCLUSIONS Caregivers' habits of reading print and digital Chinese texts are significantly associated with their OHL scores. Their reading habits, however, do not affect their children's oral health status.
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Bridges SM, Parthasarathy DS, Wong HM, Yiu CKY, Au TK, McGrath CPJ. The relationship between caregiver functional oral health literacy and child oral health status. PATIENT EDUCATION AND COUNSELING 2014; 94:411-416. [PMID: 24308901 DOI: 10.1016/j.pec.2013.10.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 09/30/2013] [Accepted: 10/26/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To describe the relationship between caregivers' oral health literacy (OHL) and the oral health status of their children in an Asian population. METHODS A random sample of 301 child/caregiver dyads was recruited from kindergartens in Hong Kong. Two locally-developed and validated OHL assessment tasks were administered to caregivers with Hong Kong Rapid Estimate of Adult Literacy in Dentistry-30 (HKREALD-30) assessing word recognition and Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P) assessing comprehension. Their children's oral health status was assessed [dental caries experience - decayed, missing, filled teeth index - (dmft) and oral hygiene status - Visible Plaque Index (VPI)]. RESULTS Caregivers' literacy was associated with children's oral health status. The HKOHLAT-P had a stronger association with children's oral health than HKREALD-30. HKOHLAT-P and HKREALD-30 remained associated with dmft in the adjusted negative binomial regression models (accounting for socio-demographics), Incidence Rate Ratio (IRR) 0.97, p=0.02, and 0.96, p=0.03, respectively. In the adjusted model, HKOHLAT-P was associated with VPI (IRR 0.90, p<0.05), but no association between HKREALD-30 and VPI was evident. CONCLUSION The main conclusion of this study was that caregiver oral health literacy was associated with their child's oral health status. A comprehension instrument had a more robust association with children's oral status than a word recognition instrument. PRACTICE IMPLICATIONS This study has implications for general public health education for designing community-level interventions.
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Affiliation(s)
- Susan M Bridges
- Centre for the Enhancement of Teaching and Learning/Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region.
| | - Divya S Parthasarathy
- Centre for the Enhancement of Teaching and Learning/Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region.
| | - Hai Ming Wong
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Cynthia K Y Yiu
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Terry K Au
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Colman P J McGrath
- Periodontology & Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
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Bridges SM, Parthasarathy DS, Au TKF, Wong HM, Yiu CKY, McGrath CP. Development of functional oral health literacy assessment instruments: application of literacy and cognitive theories. J Public Health Dent 2013; 74:110-9. [PMID: 24015770 DOI: 10.1111/jphd.12033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 07/16/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This paper describes the development of a new literacy assessment instrument, the Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P). Its relationship to literacy theory is analyzed to establish content and face validity. Implications for construct validity are examined by analyzing cognitive demand to determine how "comprehension" is measured. METHODS Key influences from literacy assessment were identified to analyze item development. Cognitive demand was analyzed using an established taxonomy. RESULTS The HKOHLAT-P focuses on the functional domain of health literacy assessment. Items had strong content and face validity reflecting established principles from modern literacy theory. Inclusion of new text types signified relevant developments in the area of new literacies. Analysis of cognitive demand indicated that this instrument assesses the "comprehension" domain, specifically the areas of factual and procedural knowledge, with some assessment of conceptual knowledge. Metacognitive knowledge was not assessed. CONCLUSIONS Comprehension tasks assessing patient health literacy predominantly examine functional health literacy at the lower levels of comprehension. Item development is influenced by the fields of situated and authentic literacy. Inclusion of content regarding multiliteracies is suggested for further research. Development of functional health literacy assessment instruments requires careful consideration of the clinical context in determining construct validity.
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Affiliation(s)
- Susan M Bridges
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Wong HM, Bridges SM, Yiu CKY, McGrath CPJ, Au TK, Parthasarathy DS. Validation of the Hong Kong Oral Health Literacy Assessment Task for paediatric dentistry (HKOHLAT-P). Int J Paediatr Dent 2013; 23:366-75. [PMID: 23947421 DOI: 10.1111/ipd.12021] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Oral health literacy is a newly emerging field with considerable research potential. AIM To validate an original instrument, the Hong Kong Oral Health Literacy Assessment Task (HKOHLAT-P) for paediatric dentistry. DESIGN A convenient sample of 200 child/parent dyads attending a dental hospital in Hong Kong was selected. Convergent validity was tested by examining the association of HKOHLAT-P scores with those derived from the Test of Functional Health Literacy in Dentistry (TOFHLiD) and Hong Kong Rapid Estimate of Adult Literacy in Dentistry (HKREALD-30). The predictive validity of HKOHLAT-P was determined by testing the association between HKOHLAT-P and children's caries experience (dmft) and the Chinese Early Childhood Oral Health Impact Scale (ECOHIS). The test-retest reliability and internal consistency of HKOHLAT-P were also evaluated. RESULTS HKOHLAT-P was positively correlated with TOFHLiD and HKREALD-30 (P < 0.01), and was negatively correlated with children's dmft and ECOHIS. In the regression model, HKOHLAT-P was associated with TOFHLiD, HKEALD-30, children's dmft, and ECOHIS (P < 0.05) after controlling for participants' demographic characteristics. The intra-class correlation coefficient of HKOHLAT-P was 0.63 and the Cronbach's α was 0.71. CONCLUSION Initial testing of HKOHLAT-P suggested that it is a valid and reliable instrument.
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Affiliation(s)
- Hai Ming Wong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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Naghibi Sistani MM, Montazeri A, Yazdani R, Murtomaa H. New oral health literacy instrument for public health: development and pilot testing. ACTA ACUST UNITED AC 2013; 5:313-21. [PMID: 23559571 DOI: 10.1111/jicd.12042] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 02/02/2013] [Indexed: 11/30/2022]
Abstract
AIM The aim of the present study was to develop a functional oral health literacy (OHL) instrument for adults, including new measures of literacy skills (OHL Adults Questionnaire: OHL-AQ). METHODS An item pool was provided, and an expert panel evaluated the items by assessing the content validity index and content validity ratio. The reliability analysis, including internal consistency and reproducibility, were examined using Cronbach's alpha coefficient and intraclass correlation coefficient (ICC). In addition a known-groups comparison was performed to assess how well the questionnaire discriminates between individuals who differ in education and brushing behavior. RESULTS A total of 97 participants were studied. The mean age of the participants was 36.3 (standard deviation [SD] = 12.8) years; 34% had more than 12 years' formal education. Overall, 39.2% of interviewees had inadequate, 16.5% had marginal, and 44.3% had adequate OHL. The internal consistency, as measured by Cronbach's alpha, was found to be 0.72, and the ICC was 0.84. Participants who brushed more frequently had significantly higher OHL scores (P = 0.03). The association between OHL scores and years of education was also significant (P < 0.001). CONCLUSION The OHL-AQ is a valid and reliable measure of functional OHL, with additional sections for evaluating listening and decision-making skills.
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Affiliation(s)
- Mohammad M Naghibi Sistani
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral Public Health, Institute of Dentistry, University of Helsinki, Helsinki, Finland
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Determinants of oral health: does oral health literacy matter? ISRN DENTISTRY 2013; 2013:249591. [PMID: 23577262 PMCID: PMC3610341 DOI: 10.1155/2013/249591] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 02/16/2013] [Indexed: 11/22/2022]
Abstract
Objective. To evaluate oral health literacy, independent of other oral health determinants, as a risk indicator for self-reported oral health. Methods. A cross-sectional population-based survey conducted in Tehran, Iran. Multiple logistic regression analysis served to estimate the predictive effect of oral health literacy on self-reported oral health status (good versus poor) controlling for socioeconomic and demographic factors and tooth-brushing behavior. Results. In all, among 1031 participants (mean age 36.3 (SD 12.9); 51% female), women reported brushing their teeth more frequently (P < 0.001) and scored higher for oral health literacy (mean 10.9 versus 10.2, P < 0.001). In the adjusted model, high age (OR = 1.01, 95% CI 1.003–1.034), low education (OR = 1.88, 95% CI 1.23–2.87), small living area in square meters per person (OR = 1.85, 95% CI 1.003–3.423), poor tooth brushing behavior (OR = 3.35, 95% CI 2.02–5.57), and low oral health literacy scores (OR = 1.58, 95% CI 1.02–2.45) were significant risk indicators for poor self-reported oral health. Conclusions. Low oral health literacy level, independent of education and other socioeconomic determinants, was a predictor for poor self-reported oral health and should be considered a vital determinant of oral health in countries with developing health care systems.
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Samaranayake L. Research and its pitfalls. JOURNAL OF INVESTIGATIVE AND CLINICAL DENTISTRY 2012; 3:77-78. [PMID: 22522947 DOI: 10.1111/j.2041-1626.2012.00139.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Shaw SJ, Armin J, Torres CH, Orzech KM, Vivian J. Chronic disease self-management and health literacy in four ethnic groups. JOURNAL OF HEALTH COMMUNICATION 2012; 17 Suppl 3:67-81. [PMID: 23030562 PMCID: PMC3615891 DOI: 10.1080/10810730.2012.712623] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Research from several fields has explored health literacy as a multidimensional construct. The authors' multimethod study, "The Impact of Cultural Differences on Health Literacy and Chronic Disease Outcomes," assessed health literacy and chronic disease self-management among 296 patients from four ethnic groups (Vietnamese, African American, White, Latino) at a Massachusetts community health center between 2006 and 2010. Health literacy was assessed using the short form of the Test of Functional Health Literacy in Adults (S-TOFHLA), the Rapid Estimate of Adult Literacy in Medicine (REALM), and the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA) measures. Qualitative research methods, including in-depth interviews (n = 34), home visits (n = 12), chronic disease diaries (n = 15), and focus groups (n = 47), were completed with a subset of participants. Qualitative interviews indicated a wide range of interpretations of S-TOFHLA questions in which participants substituted their own illness or health care experiences for the abstract examples offered in the instrument, at times leading to incorrect responses. Situating these responses in a broader social and cultural context, this article describes examples of the wide range of chronic disease self-management abilities among participants with limited education and/or low health literacy. It also discusses the culturally variable health beliefs identified among participants interviewed that may play important roles in their chronic disease self-management practices.
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Affiliation(s)
- Susan J Shaw
- School of Anthropology, PO Box 210030, University of Arizona, Tucson, AZ 85721-0030, USA.
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