Oral health conceptual knowledge and its relationships with oral health outcomes: Findings from a Multi-site Health Literacy Study

• Type of Material: Article
• Authors: Mark D. Macek, University of Maryland; Kathryn A. Atchison, University of California Los Angeles; Haiyan Chen, University of Maryland; Wiliiam Wells, University of Baltimore; Don Haynes, University of Baltimore; Ruth M Parker, Emory University; Shurouk Azzo, NYU Langone
• Language: English
• Date: 2017-08-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
• Final Published Version (URL): http://dx.doi.org/10.1111/cdoe.12294
• Title of Journal or Parent Work: Community Dentistry and Oral Epidemiology
• ISSN: 0301-5661
• Volume: 45
• Issue: 4
• Start Page: 323
• End Page: 329
• Grant/Funding Information: This project was funded by the National Institute of Dental and Craniofacial Research, National Institutes of Health (R01 DE020858).
• Keywords: Dentistry, Oral Surgery & Medicine; Science & Technology; INSTRUMENTS; Public, Environmental & Occupational Health; oral health; dental care; CARE; adult; health services accessibility; Life Sciences & Biomedicine; health literacy
• Research Categories: Health Sciences, Public Health; Health Sciences, Dentistry; Health Sciences, Medicine and Surgery

Abstract

Objectives: In 2010, a health literacy instrument designed to measure oral health conceptual knowledge was introduced. This developmental work was limited in that it included a relatively small and homogeneous study population and few oral health measures against which to test concurrent validity. The purpose of the present investigation is to expand upon the earlier work by utilizing a larger study sample and additional outcome variables. Methods: Data for this report came from the Multi-site Oral Health Literacy Research Study (MOHLRS), a large, cross-sectional survey conducted at two university-based dental clinics in the United States. MOHLRS included multiple assessments administered during face-to-face interviews. Conceptual knowledge was measured with the Comprehensive Measure of Oral Health Knowledge (CMOHK). Questions about self-efficacy, utilization, and dental beliefs and attitudes were also asked. Covariates included recruitment site, age, gender, race/ethnicity, education level, and languages spoken. Results: Overall, 18% of 909 adult participants exhibited “low” conceptual knowledge. CMOHK scores were significantly associated with three health literacy instruments, the REALM, Short-test of functional health literacy in adults (TOFHLA), and confidence filling out forms. In both bivariate and multivariable analyses, CMOHK scores were also significantly associated with dental beliefs and attitudes and self-efficacy to prevent both dental caries and periodontal disease. CMOHK scores were not associated with utilization, measured either as having a dental visit or a dental cleaning in the last year. Conclusions: The present investigation provides additional support for the CMOHK's validity. Researchers are encouraged to incorporate oral health conceptual knowledge into their theoretical frameworks, especially as it relates to beliefs and self-efficacy.