Abstract
BackgroundThe 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.MethodsAfter 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.ResultsThe 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).ConclusionsMREALD-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.
Highlights
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
The present study demonstrated that low oral health literacy measured by MREALD-30 was correlated to poor oral health outcomes, such as change of dental health status and oral health-related quality of life (OHRQoL) measured by Oral health impact profile (OHIP-14) [42]
The MREALD-30 scores for female participants were significantly better than the male participants in our study, which agrees with the findings reported in Romania, Persia, and Iran [38, 55, 56]
Summary
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. The United Nations stated a few causes, which were insufficient state funding accompanied by high expenses, substandard quality of services in rural geographical areas, racism or bias towards indigenous populations’ culture, knowledge and environment [5]. This can be observed as the majority of the indigenous populations are situated far from the urban populations and nearby facilities [6]. The complexity of the terms involved in communication has shown to be a setback in improving oral health, which can be overcome by focusing on oral health literacy [1, 9] In this context, word recognition tools have demonstrated a strong association between an individuals’ established reading ability and reading comprehension skills [10]. The need to measure and improve the dental literacy skills of the community is crucial as a healthy oral health status benefits the overall health [12]
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