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

Abstract

Background It 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. Methods A 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. Results The 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. Conclusions Initial 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.

Exploring the Relationships between Children’s Oral Health and Parents’ Oral Health Knowledge, Literacy, Behaviours and Adherence to Recommendations: A Cross-Sectional Survey

“…Apart from the scarcity of available educational interventions in Poland [ 1 ], a failure to adjust them to the targets’ health literacy might be the reason why recommendations are not adhered to closely enough. While several tools measuring general and oral health literacy have been developed [ 25 , 29 , 30 ], it might be useful to develop or adapt a Polish culture- and context-sensitive scale measuring parents’ oral health literacy so as to find out which of its dimensions represent the biggest challenge. We believe it is an important next step and a joint task for dental professionals, public health specialists, and health promoters and educators.…”

“…Conversely, low health literacy, defined as an inability to read, understand, and act on health information [ 24 ], is associated with poorer health outcomes and a lower use of prevention [ 25 , 26 , 27 , 28 ]. Oral health literacy (OHL) is an important component of health competence [ 29 ]. OHL may translate into oral health behaviours [ 30 ] and oral health status [ 29 ].…”

“…Oral health literacy (OHL) is an important component of health competence [ 29 ]. OHL may translate into oral health behaviours [ 30 ] and oral health status [ 29 ]. Moreover, the OHL of caregivers was found to be associated with the oral health status of their 5-year-old children [ 31 ].…”

Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021

“…Neck pain-specific Health Behavior in Office Workers (NHBOW) [141] Mental Health Literacy Scale for Healthcare Students (MHLS-HS) [153] The Comprehensive Oral Health Literacy (COHL) [154] Mental Health Literacy Scale for Depression Affecting the Help-Seeking Process [162] Mandarin Health Literacy Scale (MHLS) [169] eHealth Literacy Scale (eHLS-Web 3.0) [198] Frequently translated or validated (more than ten)…”

Oral Health Behaviours, Knowledge, and Literacy of Expectant Mothers: A Cross-Sectional Study among Maternity Ward Patients

“…Moreover, due to the high prevalence of dental caries worldwide [ 18 ], there is increased interest in the relationships between oral health outcomes, literacy, knowledge, and behaviours [ 19 , 20 , 21 , 22 , 23 ]. It has been suggested that oral health knowledge and literacy (OHKL) strongly influence oral health status [ 24 ], particularly in paediatric populations [ 8 , 25 ], which is why these aspects need to be examined before any public health interventions are considered.…”