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.
Highlights
Oral diseases pose a significant health burden for many countries and remain to be a major global public health challenge [1]
Since it is possible that the measurement properties of oral health literacy (OHL) tools vary between nationalities, this review evaluates OHL tools according to language to reduce the inconsistencies resulting from cultural differences
Despite poor translation and cross-cultural adaptation processes, most tools had high reliability and internal consistency reflected by the Intraclass Correlation Coefficient (ICC) and Cronbach’s α values, respectively
Summary
Oral diseases pose a significant health burden for many countries and remain to be a major global public health challenge [1]. Has reported an estimated 3.5 billion people suffering from oral diseases worldwide [2]. According to the Global Burden of Disease Study 2017, oral diseases are the most common health conditions among both males and females [3]. 2015, the number of people with untreated oral diseases increased from 2.5 to 3.5 billion, causing a 64% increase in disability-adjusted life years [4]. Oral diseases affect people throughout the life course, causing pain, discomfort, sepsis, sleep loss [2], and may lead to social disruption and reduced employment potential [5]. Oral diseases disproportionally affect marginalized communities [6] and are associated with social determinants of health such as socioeconomic status, education, income, language, and health literacy [7,8,9,10]
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