Oral Health Literacy Instrument Research Articles

Promoting Health Literacy in the Workplace Among Civil Servants: Cross-Sectional Study.

In 2022, the World Health Organization highlighted the alarming state of oral health (OH) worldwide and urged action to include OH in initiatives on noncommunicable diseases. The population needs improved OH skills and attitudes and an adequate level of OH literacy (OHL) and general health literacy (HL). The implementation of health promotion actions in the workplace, which is a part of most people's lives, appears to be an opportunity. In France, civil servants have several socioprofessional levels and represent an excellent model with results transposable to the population. This study aimed at determining the OHL and HL level of civil servants in France in order to implement specific prevention actions in their workplaces. A cross-sectional study of French civil servants was conducted in France from October 2023 to February 2024. Participants completed three validated questionnaires in French: (1) a questionnaire on OH knowledge, (2) the Oral Health Literacy Instrument, French version (OHLI-F; this is composed of reading comprehension and numeracy sections) to assess the OHL level, and (3) the Short Test of Functional Health Literacy in Adults, French version (s-TOFHLA-F) to assess the HL level. The scores for OH knowledge, the OHLI-F, and the s-TOFHLA-F were reported as means (SD) and the 95% CI. These scores were classified into 3 categories: adequate (75-100), marginal (60-74) and inadequate (0-59). ANOVA and binary logistic regression were performed. The OHLI-F reading comprehension and OHLI-F numeracy scores were compared using the Welch 2-sample t test and a paired t test (both 2-tailed). For the correlation matrix, the Pearson correlation and related tests were computed. A total of 1917 persons completed the 3 questionnaires, with adequate levels of OHL (n=1610, 84%), OH knowledge (n=1736, 90.6%), and HL (n=1915, 99.9%). The scores on the s-TOFHLA-F (mean 98.2, SD 2.8) were higher than the OHLI-F (mean 80.9, SD 7.9) and OH knowledge (mean 87.6, SD 10.5). The OHLI-F was highly correlated with OH knowledge (P<.001), but the OHLI-F and OH knowledge had a low correlation with s-TOFHLA-F (P=.43). The OHLI-F reading comprehension score was significantly higher than the OHLI-F numeracy score (P<.001). Age, education level, and professional category impacted the 3 scores (P<.001). The professional category was a determinant of adequate OHLI-F and OH knowledge scores. Some French civil servants had inadequate or marginal levels of OH knowledge (n=181, 9.5%) and OHL (n=307, 16%) but none had an inadequate level of HL. Results highlighted the relevance of implementing OH promotion programs in the workplace. They should be nonstandardized, adapted to the literacy level of professional categories of workers, and focused on numeracy skills. Thus, appropriate preventive communication and improved literacy levels are the means to achieve greater disease equity and combat the burden of noncommunicable diseases.

Supporting health education policies: translation, cross-cultural adaptation and validation of a health literacy instrument, in French.

Oral health is a fundamental human right and is inseparable and indivisible from overall health and well-being. Oral Health Literacy (OHL) has been proved to be fundamental to promoting oral health and reducing oral health inequalities. To our knowledge, no OHL instrument to evaluate OHL level is currently validated in French language despite the fact it is the fifth most widely spoken languages on the planet. The Oral health literacy Instrument (OHLI) appears to be the most interesting OHL instrument to adapt into French because it is already available in English, Spanish, Russian, Malaysian, and it contains both reading comprehension and numeracy sections. Its psychometric properties have been rated as adequate. The aim of this study was to translate and adapt cross-culturally the OHLI into French, to evaluate its psychometric properties and to compare its results to oral health knowledge. This study followed and applied well-established processes of translation, cross-cultural adaptation and validation, based on the recommendations of the World Health Organization guidelines and on the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) study design checklist for patient-reported outcomes. Two psychometric assessments were planned, the comparison of OHLI-F scores according to education level and frequency of dental visits, and the test-retest reliability of the OHLI-F. A total of 284 participants answered the OHLI-F. The OHLI-F scores were significantly different between participants with different levels of education and frequency of dental visits (p < 0.001). Participants with an education level lower than the baccalaureate, and those who never visit the dentist or only in case of pain, had significantly lower OHLI-F scores. Internal consistency was excellent (Cronbach's alpha = 0.881-0.914). Test-retest reliability was very high (intraclass correlation = 0.985 to 0.996). The OHLI-F has demonstrated adequate psychometric properties and can therefore be used to measure oral health literacy in French-speaking populations.

Validation of the HeLD-14 functional oral health literacy instrument in a general population.

Oral health literacy (OHL) is recognized as an important determinant of oral outcomes. Measuring OHL with a valid and reliable instrument that accurately captures the functional nature of this construct across cultures is needed. The short version of the Health Literacy in Dentistry scale (HeLD-14) shows promise as an appropriate instrument due to its inclusion of comprehensive domains hypothesized to comprise OHL. While studies validating the instrument in several languages have occurred, the number of dimensions in the various analyses range from one to seven. Validation of the HeLD-14 in a general English-speaking population is also lacking. The purpose of this study was to explore and confirm the dimensionality of the HeLD-14 in a general US English-speaking population. The psychometric properties of HeLD-14 were evaluated in a sample of 631 participants attending the Minnesota State Fair. Construct validity was assessed using exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA) on the data set split into two groups. Internal consistency reliability was assessed using the Cronbach's alpha coefficient. Concurrent validity was established between the HeLD-14 and the Oral Health Inventory Profile (OHIP-5) using Pearson's correlation. EFA found, and CFA reinforced, a unidimensional structure of the HeLD-14. Cronbach's alpha was acceptable at 0.92. Fit assessment also supported a unidimensional structure, comparative fit index = 0.992, Tucker-Lewis index = 0.991, root mean square error of approximation = 0.065, and standardized root mean square residual = 0.074. Concurrent validity analyses showed that the HeLD-14 correlated with the OHIP-5. The HeLD-14 is a unidimensional reliable and valid instrument for measuring the oral health literacy in the general US English-speaking adult population.

Orthodontic and oral health literacy in adults.

ObjectiveThe primary aim of the study was to determine levels of literacy in both oral health and orthodontics in an adult population. The secondary study aim was to investigate differences in literacy between males and females.MethodsParticipants included individuals 18 years or older seeking dental treatment at the East Carolina University (ECU) School of Dental Medicine. To determine levels of oral health literacy (OHL) and orthodontic literacy (OrthoL), validated instruments were administered, including the Rapid Estimate of Adult Literacy in Medicine and Dentistry, the Oral Health Literacy Instrument and its separate scales, and a questionnaire on orthodontic literacy. Summary statistics were computed, and statistical significance was set at 0.05.ResultsOne hundred seventy-two individuals participated in the study and had a mean age of 55.03 (range:18–88). Greater than 70% of the sampled population exhibited inadequate or marginal oral health knowledge. Additionally, greater than 70% of the sample possessed no more than an 8th grade reading level, with regard to basic medical and dental terms. Higher education was weakly associated with higher OrthoL and OHL. Higher age was also weakly associated with lower OrthoL and OHL. Males on average exhibited significantly higher OHL (p < .05) but there were no OrthoL differences between males and females. Dental visit frequency was not associated with OrthoL or OHL.ConclusionLow levels of OrthoL and OHL were observed in the study. While males demonstrated a higher level of OHL than females, neither age nor the occurrence of dental appointments significantly influenced levels of literacy.

Predictors of oral health literacy in pregnant women

We determined factors associate with oral health literacy of pregnant women. A total of 203 pregnant women attending Hospital Universiti Sains Malaysia (USM) for antenatal care participated in this cross-sectional study. The Malay version of Oral Health Literacy Instrument (OHLI-M) and a structured self-administered questionnaire were used to obtain variables of interest. The mean OHLI-M score was 73.6 (SD 12.59). Only slightly more than half of our participants had adequate oral health literacy (54.2%), while others were marginal (31.0%) and inadequate (14.8%). Our findings revealed that women with adequate oral health literacy were more likely to be those with higher education qualification and were very satisfied or satisfied with their oral health status. The identification of these predictors highlighted the importance to keep oral health education messages simple and clear for the benefit of individuals with low educational attainment.

Factors Associated with Oral Health Literacy among Patients with Type 2 Diabetes Mellitus Attending Hospital Universiti Sains Malaysia

Objective: To determine the oral health literacy (OHL) level and its associated factors among patients with type 2 diabetes mellitus attending Hospital Universiti Sains Malaysia (USM). Material and Methods: This cross-sectional study involved 135 diabetic patients with a mean age of 62.6 years old (SD=9.05) who attended the Diabetes Outpatient Clinic at Hospital USM, a teaching hospital in the north-eastern corner of Peninsular Malaysia. The Malay version of the Oral Health Literacy Instrument (OHLI-M) was used to assess the level of OHL among respondents. An additional self-administered questionnaire was used to obtain other variables of interest. Systematic random sampling was applied in this study. The data were analyzed using an independent t-test and ANOVA to determine factors associated with oral health literacy among respondents. Results: Most respondents have at least one oral health problem (62.2%). The most common problem was cavitated tooth (42.2%). Other problems include toothache (17.8%), mobile tooth (17.8%), and swollen gums (16.3%). OHL level for most respondents (40.7%) was inadequate. The mean total OHLI-M score was 67.9 (SD=17.74). The OHL score was significantly lower in respondents with the following characteristics: female, no formal education or had primary education, unemployed, lower income group, never visited a dentist, and had swollen gums. Conclusion: The OHL of most patients with type 2 diabetes mellitus attending the Diabetes Outpatient Clinic, Hospital USM still need to be improved. Oral health problems were common in patients with type 2 diabetes mellitus in this study. This study also highlighted the link between OHL and socio-demographic factors. Improving the OHL of patients may increase their capability to obtain and understand oral health messages needed to take appropriate actions that will eventually prevent oral diseases associated with diabetes mellitus.

A NEW CONCEPTUAL ORAL HEALTH LITERACY INSTRUMENT IN TURKISH: T-CMOHK

Evaluating the oral health literacy (OHL) of individuals with appropriate instruments is necessary for public dental health prevention programs. To our knowledge, there has been no comprehensive OHL instrument in Turkish up to date. This study aimed at the adaptation of the Comprehensive Measure of Oral Health Knowledge (CMOHK) to Turkish and evaluating the OHL of participants. The first stage of this methodological study was the cultural adaptation process with forward and back translations, cognitive interviewing, and pilot test followed by psychometric evaluation. A three-part questionnaire containing sociodemographic questions, oral health behaviors, and Turkish CMOHK (T-CMOHK) was administered among 314 volunteered students in a vocational school in Ankara, in 2019. Validity was evaluated with linguistic, content, and construct validity. Internal consistency coefficients were analyzed. p≤0.05 was considered significant. Back-translation comparisons and content validity index (1.00) were good, cognitive pre-test showed the final translation was suitable and understandable. The mean age of 307 participants included was 20.51±1.49 with a majority of women (62.9%). Cronbach’s alpha (0.70), Kuder-Richardson-20 (0.71) and split-half (0.71) coefficients were satisfactory. Of the group, 38.8% had poor; 33.9% had fair and 27.3% had good OHL (mean score=14.21±3.49). Scores were significantly higher among the participants who visited the dentist in case of a dental problem than those who did not (p=0.022) and who recently visited a dentist than those who never had (p=0.007). T-CMOHK met the reliability and validity criteria for further research of the OHL of adults.

A new comprehensive oral health literacy scale: development and psychometric evaluation

BackgroundIt 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.MethodsA 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.ResultsThe 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.ConclusionsInitial 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.

Trends and developments in oral health literacy: a scientometric research study (1991\u20132020)

ObjectiveThis study aimed to establish the current situation, intellectual base, hotspots, development trends, and frontiers of oral health literacy (OHL) from the literature.MethodsWe analyzed 1505 bibliographic records dated between January 1990 and December 2020 retrieved from the Web of Science Core Collection and the Scopus database. We used CiteSpace for word frequency analysis, co-occurrence analysis, co-citation analysis, clustering analysis, and burst analysis.ResultsThe total number of publications increased year-on-year, with the majority of publications coming from the USA. Most studies focused on the relationship between (oral) health literacy and oral health, and the development of OHL instruments. The top 10 keywords by frequency were “health literacy”, “oral health”, “attitude to health”, “dental caries”, “adult”, “children”, “dental care”, “knowledge”, “questionnaire”, and “adolescent”. The keyword with the highest burst intensity was “dental health education”.ConclusionsOHL research is a thriving field. The field is focused on the development of an OHL instrument and health promotion practice. Strategic cooperation among countries, institutions, authors, hospitals, and communities will be important to encourage further OHL research and address oral health problems.

Attention-deficit/hyperactivity disorder and oral health literacy exert an influence on the occurrence of dental caries in early adolescence.

Little is known regarding the influence of psychosocial factors on dental caries at early adolescence. The study aimed to investigate associations between family environment, attention-deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) with dental caries experience in early adolescence. A cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents at public and private schools in North-eastern Brazil. Parents/guardians and teachers answered the Brazilian version of the inattention and hyperactivity/impulsivity subscales (SNAP- IV) for the evaluation of ADHD and a sociodemographic questionnaire. An OHL instrument (BREALD-30) and the Family Adaptability and Cohesion Scales (FACES III) were administered to the adolescents. Caries experience (DMFT) was the dependent variable. Data analysis involved Poisson regression with robust variance (α=5%). Adolescents with more symptoms of ADHD (teachers' reports) (RR: 1.73; 95% CI: 1.31-2.28), those with lower OHL (RR: 1.59; 95% CI: 1.01-2.51), those with a lower family income (RR: 1.38; 95% CI: 1.03-1.83), and those from families with a greater number of residents in the home (RR: 1.18; 95% CI: 1.06-1.31) had greater caries experience. Family adaptability and cohesion were not associated with caries experience. Dental caries experience in early adolescence was influenced by symptoms of ADHD, OHL, and sociodemographic factors.

Cross-Cultural Adaptation and Validation of Oral Health Literacy Instrument (OHLI) for Malaysian Adults.

Currently, the availability of a functional oral health literacy instrument in the Malay language is limited. This study aimed to cross-culturally adapt Oral Health Literacy Instrument (OHLI) into the Malay language and to determine its psychometric properties in Malaysian adults. Cross-cultural adaptation of the OHLI into the Malay version (OHLI-M) was conducted according to a guideline, followed by a cross-sectional study among outpatients in a selected health clinic. The psychometric evaluations were the comparison of the OHLI-M scores by education levels and last dental visits, the correlation of the reading comprehension section of OHLI-M with the Malay version of the Short Test of Functional Health Literacy in Adults (S-TOFHLA-M), the correlation of OHLI-M with decayed, missing, and filled teeth (DMFT) and Community Periodontal Index (CPI), and the test-retest reliability of OHLI-M. A total of 195 outpatients participated in this study. The OHLI-M scores were significantly different between participants with different levels of education and timing since last dental visit. Participants with lower secondary school qualification and below, and those whose last dental visit was more than two years ago or never, had significantly lower OHLI-M scores. There was a positive correlation between the reading comprehension scores of the OHLI-M and the S-TOFHLA-M (Spearman’s rho = 0.37, p < 0.001). There was no significant correlation between the OHLI-M scores and the DMFT index scores or the CPI scores. The internal consistency was good (Cronbach’s alpha = 0.83 to 0.88). The test-retest reliability was excellent (intraclass correlation = 0.80 to 0.86). The OHLI-M showed good validity and reliability among adults in Malaysia.

Measuring Oral Health Literacy for Nurses and Dental Assistants

Objectives: to measure and compare level of oral health literacy (OHL), dental knowledge (DK) for dental assistants (DA) and nurses (MN) working at the King Abdulaziz University Medical and Dental Hospitals (KAUH and UDH), Jeddah, Saudi Arabia. Material and Methods: This study was conducted using a convenient sample. Participants were asked to fill-out a questionnaire about demographic data, oral health behavior, and dental services usage and to complete a previously validated DK test and Oral Health Literacy Instrument (OHLI). Descriptive statistics were used to summarize the data. Bivariate non-parametric tests followed by logistic regression were used to analyze the data (α=0.05). Results: Forty-eight MN and 58 DA participated in this study with a mean age of 35 8.7 years. The majority of the participants were female (81%), non-Saudi (77%), and had college/university education or higher (90%). The mean OHLI and DK test scores for the DA were significantly higher than MN (p<0.001). DK test score was the only statistically significant predictor for the OHLI level at the multivariate level, as it whipped the association of the participants’ group (DA/MN), after controlling for the demographic variables. Conclusion: This study sheds the light on the DK and OHL inadequacy among some of the MN at KAUH. More effort should be directed towards educating medical personnel about oral health by incorporating oral health-related materials in their curriculum and continuing education courses.

Development and evaluation of a new oral health literacy instrument among telugu speaking population: The indian oral health literacy measure.

Oral health literacy (OHL) is a relatively unexplored construct in the Indian context. Most of the few previous studies estimating OHL among different populations of India used instruments that were either previously validated in a different country or not tested for psychometric properties. With this background, the objective of this study was to develop an Indian oral health literacy measure and to evaluate the psychometric properties of the instrument among Telugu speaking population of Andhra Pradesh (IOHLM-T). The initial version of the instrument after evaluated for face and content validity was tested for psychometric properties among 200 adult patients visiting the outpatient department of SIBAR Institute of Dental Sciences. Predictive validity of the instrument was checked by the association between IOHLM-T score and oral health impact profile (OHIP-14), decayed-missing-filled teeth (DMFT) scores. Convergent validity was tested by assessing the correlation between IOHLM-T score and rapid estimate of adult literacy in dentistry (REALD-30) score. SPSS version 20 software was used to analyse the data. Independent samples t-test, Pearson's correlation, one-way ANOVA and stepwise multiple linear regression were done to analyse the data. IOHLM-T demonstrated good internal consistency reliability (Cronbach's alpha 0.75), convergent validity (r = 0.34 between Reald-30 and IOHLM-T scores) and predictive validity (significant negative correlation of IOHLM-T with OHIP-14 and DMFT scores). IOHLM-T demonstrates good face validity, content validity, predictive validity, convergent validity and internal consistency reliability and thus can be used among different populations in India after translation to the corresponding languages and evaluation of psychometric properties.

Application of a Visual Oral Health Literacy Instrument in Elementary School Children

Application of a Visual Oral Health Literacy Instrument in Elementary School Children

Tradução e validação para a lingua portuguesa de um instrumento de alfabetização em saúde bucal

Introdução: A quantificação do nível de alfabetização em saúde é um aspeto fundamental para a saúde pública, uma vez que os indivíduos que apresentam níveis limitados de alfabetização em saúde possuem dificuldades significativas em comunicar com sucesso na sociedade atual. Objetivos: Traduzir e validar a versão na língua portuguesa do Oral Health Literacy Instrument (OHLI) para avaliação da alfabetização em saúde bucal de adultos. Materiais e Métodos: A tradução e validação da versão na língua portuguesa do OHLI foi realizada em indivíduos com idade superior a 19 anos na região de Lisboa. Foram analisadas variáveis de caracterização da amostra e de alfabetização em saúde. O valor total do OHLI foi obtido pela soma das dimensões de leitura, compreensão e habilidade para contar. A consistência interna foi avaliada pelo ? de Cronbach, a validação do constructo foi efetuada pela análise fatorial das questões de uma mesma dimensão e a aplicação do teste estatístico Kaiser-Meyer-Olkin. Resultados: Dos 81 entrevistados, 76,5% eram mulheres. Obtiveram-se valores elevados de consistência interna, tanto para o OHLI (0,8) como para as suas dimensões (0,7). Para o teste de conhecimentos foi obtido um valor de 0,70. O valor final médio do OHLI foi de 81,21 tendo-se observado valores mais elevados nas pessoas com habilitações escolares superiores (p&lt;0,001). Conclusões: A versão na língua portuguesa do OHLI (P-OHLI) é um instrumento confiável e válido e pode ser aplicado em adultos de língua portuguesa, com as adaptações necessárias à identidade cultural, para avaliação da alfabetização em saúde bucal.

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.

ObjectiveThe 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.MethodsOHLA-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.ResultsEFA 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.ConclusionOLHA-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.

Oral Health Literacy Of First Year University Students

Introduction: Oral health literacy (OHL) can be different between science stream and non-science stream students as the exposure to knowledge of science is low among non-science stream. This situation can lead to unhealthy oral health behaviour and later increase the oral health problem among the non-science stream group. Thus, the study conducted aimed to compare the oral health literacy among science stream and non-science stream students and other factors associated, among first year students of Universiti Sains Islam Malaysia (USIM). Materials and Methods: A crosssectional study was conducted among 256 students from various faculties of USIM consisted of both science and non-science stream group. A validated Malay version, self-administered questionnaire of Oral Health Literacy Instrument (OHLI) was used to assess their OHL. Data gathered was later analysed using IBM SPSS version 21.0. Multiple logistics regression was used to determine the associated risk factors of OHL. Results: Study indicated that science stream students compared to non-science stream students have higher oral health literacy (OR= 6.98; 95% CI= 3.64, 13.39; p&lt; 0.001). Besides, students whom their mother's education level are high have higher OHL compared to their counterparts (OR= 2.31; 95%CI= 1.24, 4.28; p= 0.008). Conclusion(s): An exposure to indepth knowledge of science has an effect on OHL. Science stream students have high oral health literacy compared to non-science group. This finding give some ideas on suitable methods of oral health promotion that can be implemented among science and non-science stream background of students especially in school.

Adaptation and validation of the oral health literacy instrument for the Chilean population

To report the adaptation and cultural validation of the Oral Health Literacy Instrument (OHLI) for the adult Chilean population attending public and university health services. The original OHLI in English was translated to Spanish and back-translated, then a preliminary version was obtained following review by four experts. A pilot study was carried out in 30 patients, who were asked to assess their understanding of the questionnaire. The following variables were included: sociodemographic factors (sex, age, average monthly income, education and marital status); oral health (history of caries, periodontal disease and oral hygiene); oral health-related quality of life; health literacy; oral health literacy; and psychometric properties (internal consistency, temporal stability, convergent validity and predictive validity). Clinical examination and questionnaire administration were carried out at the public health centres where the participants were receiving treatment. A total of 482 persons participated in the study. The internal consistency was high; Cronbach's alpha values were 0.864 for the first section, 0.739 for the second section and 0.887 for the entire instrument. The temporal stability was good, and the intraclass correlation coefficient was >0.6. Regarding convergent validity, the correlation of Chilean version of OHLI (OHLI-cl) with health literacy was positively moderate to strong (r > 0.5 and ρ > 0.5) and statistically significant (P < 0.01). Regarding predictive validity, the correlation of OHLI with oral health damage was negatively weak to moderate (r < -0.2 and ρ < -0.2) and statistically significant (P < 0.01). The OHLI-cl demonstrates adequate psychometric properties for measuring the oral health literacy in Chilean populations attending public and university health services.

Oral health literacy and oral health outcomes in an adult population in Brazil

BackgroundTo investigate the association between critical and communicative oral health literacy (OHL) and oral health outcomes (status, oral health-related quality of life and practices) in adults.MethodsThis cross-sectional study examined a household probability sample of 248 adults, representing 149,635 residents (20–64 years old) in Piracicaba-SP, Brazil. Clinical oral health and socioeconomic and demographic data, as well as data on oral health-related quality of life (OHIP-14) and health practices were collected. The oral examinations were carried out in the participants’ homes, using the World Health Organization criteria for oral diseases. The critical and communicative OHL instrument was the primary independent variable, and it was measured using five Likert items that were dichotomized as ‘high’ (‘agree’ and ‘strongly agree’ responses for the 5 items) and ‘low’ OHL. Binary and multinomial logistic regressions were performed on each outcome (oral health status and practices), controlling for age, sex and socioeconomic status (SES).ResultsApproximately 71.5% presented low OHL. When adjusted for age and sex (first model) low OHL was associated with untreated caries (Odds Ratio = 1.92, 95% Confidence Interval = 1.07–3.45), tooth brushing <3 times a day (OR = 2.00, 1.11–3.62) and irregular tooth flossing (OR = 2.17, 1.24–3.80). After SES inclusion in the first model, significant associations were found for low OHL when the outcomes were: presence of biofilm (OR = 1.83, 1.08–3.33), dental care for emergency only (OR = 2.24, 1.24–4.04) and prevalence of oral health impact on quality of life (OR = 2.06, 1.15–3.69).ConclusionAdjusting for age, sex and SES, OHL is related to a risk factor (biofilm) and a consequence of poor oral health (emergency dental visits) and can interfere with the impact of oral diseases on quality of life. As low OHL can be modified, the results support oral health promotion strategies directed at improving critical and communicative oral health literacy in adult populations.

A motivational interview intervention delivered at home to improve the oral health literacy and reduce the morbidity of Chilean disadvantaged families: a study protocol for a community trial

IntroductionOral health education/promotion interventions have been identified as cost-efficient tools to improve the oral health of the population. These interventions are regularly made in contexts where the target population is...