Oral Health Literacy Assessment

Development of an Oral Health Literacy Instrument for Spanish Speakers

Published in: Journal of Public Health Dentistry, v. 73, no. 1, Winter 2013, p. 1-8

Posted on RAND.org on January 01, 2013

by Jessica Y. Lee, Brian D. Stucky, R. Gary Rozier, Shoou-Yih D. Lee, Leslie Zeldin

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OBJECTIVE: To develop an oral health literacy instrument for Spanish-speaking adults, evaluate its psychometric properties, and determine its comparability to an English version. METHODS: The Oral Health Literacy Assessment in Spanish (OHLA-S) and English (OHLA-E) are designed with a word recognition section and a comprehension section using the multiple-choice format developed by an expert panel. Validation of OHLA-S and OHLA-E involved comparing the instrument with other health literacy instruments in a sample of 201 Spanish-speaking and 204 English-speaking subjects. Comparability between Spanish and English versions was assessed by testing for differential item functioning (DIF) using item response theory. RESULTS: We considered three OHLA-S scoring systems. Based on validity and reliability comparisons, 24 items were retained in the OHLA-S instrument. OHLA-S was correlated with another health literacy instrument, Spanish Test of Functional Health Literacy in Adults (P  < 0.05). Significant correlations were also found between OHLA-S and years of schooling, oral health knowledge, overall health, and an understanding of written health-care materials (P < 0.05). OHLA-S displayed satisfactory reliability with a Cronbach Alpha of 0.70-0.80. DIF results suggested that OHLA-S and OHLA-E scores were not comparable at a given level of oral health literacy.CONCLUSIONS: OHLA-S has acceptable reliability and validity. OHLA-S and OHLA-E are two different measurement tools and should not be used to compare oral health literacy between English- and Spanish-speaking populations.

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