Validation for Brazilian Portuguese language of the Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (BOHLAT‐P)

Abstract

Background Oral health literacy (OHL) is associated with oral health outcomes. Aim To validate the Brazilian Portuguese version of the Hong Kong OHL Assessment Task for Paediatric Dentistry (HKOHLAT‐P). Design We performed cross‐cultural adaptation of the HKOHLAT‐P. A sample of 200 pre‐schoolers and caregivers from Campina Grande, Brazil completed the Brazilian HKOHLAT‐P (BOHLAT‐P), sociodemographic questionnaire, the Brazilian Early Childhood Oral Health Impact Scale (B‐ECOHIS), and the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD‐30). Child dental caries was assessed. Instrument reliability was measured by internal consistency (Cronbach's alpha) and test‐retest (ICC). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) evaluated dimensionality. Regression models tested associations between BOHLAT‐P and exploratory variables (P < .05). Results BOHLAT‐P demonstrated excellent reliability (Cronbach's alpha = 0.92; ICC = 0.95). BOHLAT‐P and BREALD‐30 scores (r = .71), number of schooling years (r = .60), and reading hours (r = .34) were positively correlated. BOHLAT‐P and B‐ECOHIS scores (r = −.22), and BOHLAT‐P scores and number of cavitated teeth (r = −.15) were negatively correlated. After controlling for confounding variables, BOHLAT‐P scores were not associated with caries or number of teeth with cavitated caries. Conclusion BOHLAT‐P is a valid and reliable instrument to assess the OHL of Brazilian parents.

A Systematic Review of Cross-Cultural Adaptation and Psychometric Properties of Oral Health Literacy Tools

“…The general overview of OHL instruments included in this review is illustrated in Table 1 . All 16 instruments [ 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ] were published between 2012 and 2020, indicating a recent increase in concerns regarding OHL among the non-English speaking populations. Over half of the instruments were word recognition tools [ 54 , 55 , 56 , 57 , 58 , 59 , 60 , 68 , 69 ], three were functional health literacy tools with reading comprehension and numeracy section [ 65 , 66 , 67 ], one tool was a word recognition tool with added comprehension [ 63 ], one tool encompassed comprehension, numeracy test, listening and decision-making domains [ 64 ], one tool assessed access, support, understanding, use, economic barriers, receptivity, and communication [ 61 ], and one tool assessed oral health knowledge, numeracy test and comprehension [ 62 ].…”

“…There are five OHL instruments that have been translated into the Brazilian-Portuguese language: REALD-30 [ 55 ], REALMD-20 [ 56 ], OHLA-S [ 63 ], HKOHLAT-P [ 62 ], and HeLD [ 61 ]. REALMD-20 is a singular tool containing 20 items designed to screen patients by their ability to read medical and dental words [ 72 ].…”

“…HKOHLAT-P is a tool originally developed to be used in Hong Kong [ 74 ]. It evaluates oral health knowledge, reading comprehension, and numeracy and is mainly focused on pediatric dentistry [ 62 ]. HeLD is a tool originally containing 29 items for assessing multiple dimensions for OHL encompassing communication, access, receptivity, understanding, use, support, and economic barriers [ 75 ].…”

“…The results showed that of the 15 studies that performed psychometric analysis, most studies examined internal consistency [ 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 64 , 65 , 66 , 67 , 68 , 69 ], reliability [ 54 , 55 , 56 , 57 , 58 , 59 , 60 , 62 , 64 , 65 , 66 , 67 , 68 , 69 ], construct validity [ 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 64 , 65 , 66 , 67 , 68 , 69 ], and structural validity [ 54 , 55 , 56 , 57 , 58 , 60 , 61 , 62 , 69 ]. None of the studies reported on the cross-cultural validity, measurement error, and responsiveness.…”

Métodos de mensuração do letramento em saúde bucal no Brasil: uma revisão integrativa

“…O BHKOHLAT-P é a única ferramenta validada para uso no Brasil que avalia o grau de LSB de adultos específico para a saúde da criança, bem como a que apresenta o método mais robusto para tal análise (FIRMINO RT, et al, 2020). As habilidades examinadas são ordenadas em 49 itens, distribuídos por três sessões do instrumento, e englobam o conhecimento em saúde bucal pediátrica, compreensão de leitura e numerácia, aplicados em situações hipotéticas do cotidiano (WONG HM, et al, 2013;FIRMINO RT, et al, 2020). No entanto, a longa extensão e complexidade da ferramenta podem dificultar a sua aplicabilidade na rotina clínica, tornando a administração exaustiva ao entrevistado e custosa aos serviços de saúde.…”