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Vaccination induced complacency in adherence to COVID-19 precautionary measures among oral health care professionals in India and the United States: a retrospective pretest-posttest design

In the context of the COVID-19 pandemic, vaccination-induced behavioral complacency in adherence to COVID-19 appropriate behavior emerged as a significant concern. This study was conducted among a convenience sample of 540 oral health care professionals in India and the United States. This was a retrospective pretest-post-test design, a choice to eliminate response-shift bias, where the participants responded online on their adherence or otherwise to COVID-19 precautionary measures before and after vaccination. The difference between post-test and retrospective pretest scores was used in assessing the magnitude of complacency demonstrated by the individual as a function of getting vaccinated, and the process was validated using exploratory factor analysis (EFA) with principal axis factoring and confirmatory factor analysis (CFA) on two randomly split subsets of the overall sample. It was observed that there had been a decline in the adherence to all the considered COVID-19 precautionary measures from the time before vaccination to the time of achievement of the fully vaccinated status. EFA performed on the randomly split sub sample of 240 subjects returned a two factor solution with five items in factor 1 and seven items in factor 2. Items in both the factors demonstrated adequate internal consistency in reliability analysis (Cronbach's alpha 0.84 and 0.82, respectively). The two factor solution obtained in EFA demonstrated good model fit in CFA [RMSEA (90%CI) - 0.077 (0.063-0.092); TLI - 0.872; CFI - 0.897; SRMR - 0.056]. These results highlight the vaccination-induced complacency in observing COVID-19 appropriate behavior among oral health professionals in India and the United States.

CA-PROM: Validation of a general patient-reported outcomes measure for Chinese patients with cancer

BACKGROUND

Based the important role of patient-reported outcome in measuring patients' QoL, a general PRO instrument was designed for Chinese patients with cancer.

METHODS

The instrument was administered in eight hospitals. Based on PRO guidelines, a conceptual framework and item pool were generated after literature review and patients' interviews. Via two-item selection process, the original version of a cancer PRO measure (CA-PROM) was generated. Patients' responsiveness was evaluated in four disease systems by item response theory. The reliability, validity, and feasibility of CA-PROM were assessed. The minimum clinically important differences (MCIDs) and risk thresholds of PRO were calculated.

RESULTS

A total of 2213 valid questionnaires were collected. After expert opinions and cognitive tests, 11 items were deleted. In the pre-survey and formal survey, 19 items were deleted based on six methods of classical test theory. In the respiratory, digestive, hematological, and endocrine systems, four items with poor responsiveness were deleted by item response theory. The final CA-PROM included four domains, 13 subdomains, and 49 items. Reliability coefficients of 13 subdomain was > 0.7. The framework of CA-PROM met required criteria by CFA and OBID. The average response time was 14.2 min, indicating feasibility of CA-PROM. The MCIDs were 5.63, 3.42, 4.16 in the physiological, psychological, social domain, respectively. The risk thresholds of PRO for six subdomains were 71.74, 71.28, 66.29, 65.16, 59.56, 66.60, in that order.

CONCLUSION

The developed CA-PROM exhibited good reliability, validity, and feasibility, and can be used as an effective evaluation tool in cancer patients.

Measuring Nutrition Literacy in Spanish-Speaking Latinos: An Exploratory Validation Study

Nutrition is important for preventing and treating chronic diseases highly prevalent among Latinos, yet no tool exists for measuring nutrition literacy among Spanish speakers. This study aimed to adapt the validated Nutrition Literacy Assessment Instrument for Spanish-speaking Latinos. This study was developed in two phases: adaptation and validity testing. Adaptation included translation, expert item content review, and interviews with Spanish speakers. For validity testing, 51 participants completed the Short Assessment of Health Literacy-Spanish (SAHL-S), the Nutrition Literacy Assessment Instrument in Spanish (NLit-S), and socio-demographic questionnaire. Validity and reliability statistics were analyzed. Content validity was confirmed with a Scale Content Validity Index of 0.96. Validity testing demonstrated NLit-S scores were strongly correlated with SAHL-S scores (r = 0.52, p < 0.001). Entire reliability was substantial at 0.994 (CI 0.992-0.996) and internal consistency was excellent (Cronbach's α = 0.92). The NLit-S demonstrates validity and reliability for measuring nutrition literacy among Spanish-speakers.

The Nutrition Literacy Assessment Instrument is a Valid and Reliable Measure of Nutrition Literacy in Adults with Chronic Disease

OBJECTIVE

To test the reliability and validity of the Nutrition Literacy Assessment Instrument (NLit) in adult primary care and identify the relationship between nutrition literacy and diet quality.

DESIGN

This instrument validation study included a cross-sectional sample participating in up to 2 visits 1 month apart.

SETTING/PARTICIPANTS

A total of 429 adults with nutrition-related chronic disease were recruited from clinics and a patient registry affiliated with a Midwestern university medical center.

MAIN OUTCOME MEASURES

Nutrition literacy was measured by the NLit, which was composed of 6 subscales: nutrition and health, energy sources in food, food label and numeracy, household food measurement, food groups, and consumer skills. Diet quality was measured by Healthy Eating Index-2010 with nutrient data from Diet History Questionnaire II surveys.

ANALYSIS

The researchers measured factor validity and reliability by using binary confirmatory factor analysis; test-retest reliability was measured by Pearson r and the intraclass correlation coefficient, and relationships between nutrition literacy and diet quality were analyzed by linear regression.

RESULTS

The NLit demonstrated substantial factor validity and reliability (0.97; confidence interval, 0.96-0.98) and test-retest reliability (0.88; confidence interval, 0.85-0.90). Nutrition literacy was the most significant predictor of diet quality (β = .17; multivariate coefficient = 0.10; P < .001).

CONCLUSIONS

The NLit is a valid and reliable tool for measuring nutrition literacy in adult primary care patients.