Abstract
In cross-sectional studies, parental health literacy (HL) is associated with children’s oral health. It is unclear, however, whether HL influences pediatric outcomes. We examined the relationship of HL with change over time in parental oral health knowledge, beliefs, and behaviors, as well as pediatric oral health outcomes. We used longitudinal data from a study designed to reduce dental decay in American Indian children (N = 579). At baseline and annually for three years, parents answered questions assessing HL; oral health knowledge, beliefs, and behaviors; and pediatric oral health status. The number of decayed, missing, and filled tooth surfaces (dmfs) was computed based on annual dental evaluations. Linear mixed models showed that HL was significantly associated with all constructs, except dmfs, at their reference time points and persistently across the three-year study period. HL predicted change over time in only one variable, parents’ belief that children’s oral health is determined by chance or luck. HL is strongly associated with oral health knowledge, beliefs, behaviors, and status prospectively but is not a key driver of change over time in these oral health constructs.
Highlights
Health literacy (HL) is “the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” [1]
We examined the association of parental health literacy (HL) with change in parental oral health knowledge, beliefs, and behaviors, as well as pediatric oral health outcomes over a three-year period in Indigenous families
That the main effect of HL was significant in the longitudinal models for most constructs indicates that parental HL was persistently associated with oral health knowledge, beliefs, behavior, and outcomes across the three-year study period
Summary
Health literacy (HL) is “the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” [1]. Compared to higher-literate parents, those with more limited HL perceive pediatric oral health problems to be less severe, perceive more barriers to and fewer benefits of recommended parental oral health behaviors, feel less confident that they can successfully engage in these practices, and are more likely to believe that their children’s oral health is under the control of the dentist or is a matter of chance or luck [3,5] and less likely to believe that they themselves are in control of their children’s oral health [3]. Parents with limited HL are less likely to follow recommended parental oral health practices (e.g., brushing child’s teeth with fluoride toothpaste) [3] and more likely to engage in behaviors that are harmful to pediatric oral health
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