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Table 3 Overview of studies using oral health literacy tools 2007-2013

From: Measuring oral health literacy: a scoping review of existing tools

Authors

Year

Title

Journal

Aim

Sample

n=

Setting

Tool used

Gong, D., Lee, J., Rozier, G., Pahel, B., Richman, J., Vann, W.

2007

Development and testing of the Test of Functional Health Literacy in Dentistry (ToFHLiD)

Journal of Public Health Dentistry

To evaluate the reliability and validity of the ToFHLiD

Parents of paediatric patients

102

Caregivers of paediatric dental patients seeking care in two dental clinics in North Carolina

ToFHLiD

Jones, M., Lee, J., Rozier, G.

2007

Oral health literacy among adult patients seeking dental care

Journal of the American Dental Association

To examine the association of knowledge, dental care visits and oral health status with oral health literacy in dental patients

Adult patients

101

Convenience sample of adult patients presenting for treatment at private dental practices in North Carolina

REALD-30 and short interview

Lee, J., Rozier, G., Lee, S., Bender, D., Ruiz, R.

2007

Development of a word recognition instrument to test health literacy in dentistry: The REALD-30- A brief communication

Journal of Public Health Dentistry

To develop and pilot test a dental word recognition instrument

Adult patients

200

Ambulatory Care Centre at the University of North Carolina Hospital

REALD-30 and interview that included the TOFHLA & REALM & OHIP-14

Richman, K., Lee, J., Rozier, G., Gong, D., Pahel, B., Vann, W.

2007

Evaluation of a word recognition instrument to test health literacy in dentistry: The REALD-99

American Association of Public Health Dentistry

To evaluate a dental health literacy word recognition instrument

Parents of paediatric patients

102

Parents and caregivers of paediatric dental patients from the UNC-CH School of Dentistry Paediatric Dental Clinics and from Orange County Dental Clinics

REALD-99

Jackson, R., Eckert, G.

2008

Health literacy in an adult dental research population: A pilot study

American Association of Public Health Dentistry

To gather data concerning the level of health literacy in adults who frequently volunteer for clinical research programs

Adults enrolled in the Oral Health Research Institute School of Dentistry

100

Oral Health Research Institute of Indiana University School of Dentistry

S-ToFHLA

Sabbahi.D., Lawrence, H., Limeback, H., Rootman, I.

2009

Development and evaluation of an oral health literacy instrument for adults

Community Dentistry and Oral Epidemiology

To develop and validate an instrument to measure functional oral health literacy of adults

Adult patients

100

Convenience sample of patients attending the Faculty of Dentistry clinics at the University of Toronto

Oral Health Knowledge test, OHLI, ToHFLA

Atchison, K., Gironda, M., Messadi, D., Der-Martirosian, C.

2010

Screening for oral health literacy in an urban dental clinic

Journal of Public Health Dentistry

To evaluate a health literacy instrument based on the REALM that incorporates dental and medical terms into one 84-item REALM-D measure and determine its association with patient characteristics of a culturally diverse dental clinic population

Adult patients

200

Oral health clinic urban centre Los Angeles, California

REALM-D

Macek, M., Haynes, D., Wells, W., Bauer-Leffler, S., Cotten, P., Parker, R.

2010

Measuring conceptual health knowledge in the context of oral health literacy: preliminary results

Journal of Public Health Dentistry

To assess the validity and reliability of a new instrument and describe conceptual oral health knowledge among a sample of low-income adults

Adult residents of Baltimore

100

Baltimore residents randomly selected from a list of those that had landlines

REALM and the S-ToFHLA to develop CMOHK

Parker, E., Jamieson, L.

2010

Associations between Indigenous Australian oral health literacy and self-reported oral health outcomes

BMC Oral Health

To determine oral health literacy (REALD-30) and oral health literacy-related outcome associations, and to calculate if oral health literacy-related outcomes are risk indicators for poor self-reported oral health among rural-dwelling Indigenous Australians

Indigenous adults

468

Convenience sample of Indigenous adults living in the Port Augusta region of Australia

REALD-30 and measures from OHL-14

Vann, W., Lee, J., Baker, D., Divaris, K.

2010

Oral health literacy among female caregivers: Impact on oral health outcomes in early childhood

Journal of Dental Research

To investigate the association of female caregivers’ oral health literacy with their knowledge, behaviours and the reported oral health status of their young children

Child/ caregiver dyads from the Carolina Oral Health Literacy Project

1273

Caregivers and children enrolled in the Women’s Infants and Children’s (WIC)Supplemental Nutrition Program in North Carolina

REALD-30 and oral hygiene behaviours

Wells, P., Caplan, D., Strauss, R., Bell, D., George, M.

2010

An oral health survey of the Lumbee tribe in South-eastern North Carolina

The Journal of Dental Hygiene

To evaluate access to dental care issues, oral health knowledge and oral health-related quality of life of the Lumbee tribe

Adult Lumbee tribe members

118

Convenience sample of American Indian attending the Lumbee Tribe Homecoming in North Carolina

OHIP-14 and survey

Lee, Y., Divaris, K., Baker, A. Vann, W.

2011

The relationship of oral health literacy with oral health-related quality of life in a multi-racial sample of low-income female caregivers

Health and Quality of Life Outcomes

To investigate the association between oral health literacy (OHL) and Oral-Health Related Quality of Life (OHRQoL) and explore the racial differences therein among a low-income community-based group of female WIC participants.

Low income adult females enrolled in WIC program

1405

Community setting of adult women enrolled in the Women, Infants and Children’s(WIC) Supplemental Nutrition Program in 7 counties in North Carolina.

OHIP-14, REALD-30

Lee, J., Divaris, K., Baker, A., Rozier. R., Lee, S., Vann, W.

2011

Oral health literacy levels among a low-income WIC population

Journal of Public Health Dentistry

To determine oral health literacy (OHL) levels and explore potential racial differences in a low-income population

Care givers of paediatric patients

1405

Community setting of adult women enrolled in the Women, Infants and Children’s(WIC) Supplemental Nutrition Program in 7 counties in North Carolina.

REALD-30 and survey

Macek, M., Manski, M., Schneiderman, T., Meakin, S., Haynes, D., Wells, W., Bauer-Leffler, S., Cotton, A. Parker, R.

2011

Knowledge of oral health issues among low-income Baltimore adult: A pilot study

Journal of Dental Hygiene

Pilot study to document conceptual knowledge of oral health among low income adults in Baltimore

Low income adults in Baltimore

100

Baltimore residents randomly selected from a list of those that had landlines

BHLOHKP

Stucky, B., Lee, J., Lee, S., Rozier, R.,

2011

Development of the two-stage Rapid Estimate of Adult Literacy in Dentistry

Community Dentistry and Oral Epidemiology

To revise the 30 item Rapid Estimate of Adult Literacy in Dentistry (REALD-30) into a more efficient and easier-to-use two-stage model

Low income adults (primarily women) enrolled in the WIC program

1405

Low income adults (primarily women) enrolled in the North Carolina WIC supplemental nutrition program

REALD-30, TS-REALD

Lee, J., Divaris, K., Baker, A., Rozier, R., Vann, W.

2012

The relationship of oral health literacy and self-efficacy with oral health status and dental neglect

American Journal of Public Health

To examine the association of oral health literacy (OHL) with oral health status (OHS) and dental neglect (DN) and whether self efficacy mediated or modified these associations

Female caregivers

1280

Community setting of adult women enrolled in the Women, Infants and Children’s WIC Supplemental Nutrition Program (in 7 counties in North Carolina.

REALD-30

Lee, J., Stucky, B., Rozier, G., Lee, S., Zeldin, L.

2012

Oral health literacy assessment: development of an oral health literacy instrument for Spanish speakers

Journal of Public Health Dentistry

To develop an oral health literacy instrument for Spanish-speaking adults , evaluate its psychometric properties and determine its comparability to the English version

Adults fluent in English or Spanish at various sites in North Carolina

405

Sites that included WIC clinics in various regions of North Carolina, Early Head Start Centre and a continuity care clinic in North Carolina

OHLA, OHLA-S

Parker, E., Misan, G., Chong, A., Mills, A., Roberts-Thomson, K., Horowitz, A., Jamieson, L.

2012

An oral health literacy intervention for Indigenous adults living in a rural setting in Australia

BMC Public Health

To determine if implementation of a functional, context-specific oral health literacy intervention improves oral health literacy-related outcomes measured by use of dental services, and assessment of oral health knowledge, oral health self-care and oral health-related self-efficacy

Indigenous adults

400

RCT with randomisation

Adaptation of the HeLM

Wehmeyer, M., Corwin, C., Guthmiller, J., Lee, J.,

2012

The impact of oral health literacy on periodontal health status

American Association of Public Health Dentistry

To describe the oral health literacy (OHL) among periodontal patients and to examine its association with periodontal health status

Adult patients

121

Convenience sample of adult patients presenting for initial consultation appointment to the University of North Carolina Graduate Periodontology Clinic

REALD-30 and survey and periodontal exam

Wong, H., Bridges, S., You. C., McGrath, C., Au, T., Parthasarathy, D.

2012

Development and validation of Hong Kong Rapid Estimate of Adult Literacy in Dentistry

Journal of Investigative and Clinical Dentistry

To develop and validate an instrument , the Hong Kong Rapid Estimate of Adult Literacy in Dentistry

Parents of paediatric dental patients

200

Convenience sample of parents of paediatric patients attending the Paediatric Dentistry Clinic in Hong Kong

REALD-99 translated to Chinese and modified to the HKREALD-30 and clinical examination

Bridges, S., Parthasarathy, D., Au, T., Wong, H., Yiu, C., McGrath, C.

2013

Development of functional oral health literacy assessment instruments: Application of literacy and cognitive theories

Journal of Public Health Dentistry

Development of a new literacy assessment instrument to establish content and face validity.

care givers of paediatric patients

Not specified

Various clinics and community settings in Hong Kong

HKOHLAT-P

Bridges, S., Parthasarathy, D., Wong, H., Yiu, C., Au, T., McGrath, C.

2013

The relationship between caregiver functional oral health literacy and child oral health status

Patient Education and Counselling

To describe the relationship between caregiver’s oral health literacy (OHL) and the oral health status of their children in an Asian population

care givers of paediatric patients

301

Child/caregiver dyads from kindergarten in Hong Kong

HKREALD-30 and HKOHLAT-P

Gironda, Der-Martirosian, C., Messadi, D., Holtzman, J. Atchinson, K.

2013

A brief 20-item dental/medical health literacy screen (REALMD-20)

Journal of Public Health Dentistry

To introduce a brief 20 item screener for limited dental/medical health literacy among adult dental patients

Adult patients seeking treatment for the first time

200

Patients seeking treatment for the first time at an Oral Diagnosis Clinic at a School of Dentistry in the US.

REALMD-20

Hom, J., Lee, J., Divaris, K., Baker, A., Vann, W.

2013

Oral health literacy and knowledge among patients who are pregnant for the first time

The Journal of the American Dental Association

To determine the levels of and examine the associations of oral health literacy (OHL) and oral health knowledge in low income patients who were pregnant for the first time

Low income women pregnant for the first time

119

Subset of women pregnant for the first time in WIC project in North Carolina

REALD-30 and OHL survey

Jamieson, L., Divaris, K., Parker, E., Lee, J.

2013

Oral health literacy comparisons between Indigenous Australians and American Indians

Community Dental Health

To compare oral health literacy (OHL) levels between two profoundly disadvantaged groups, Indigenous Australians and American Indians and to explore the differences in socio-demographic, dental service utilisation, self-reported oral health indicators, and oral health-related quality of life correlates of OHL among the above.

Indigenous adults (Australia), American Indians (North Carolina)

468 (Aus) 254 (USA)

Convenience sample of Indigenous adults living in the Port Augusta region of Australia and a convenience sample of caregivers attending the WIC clinics at selected sites in North Carolina

REALD-30 and OHP-14

Jones, K., Parker, E., Mills, H., Horowitz, A., Brennan, D., Jamieson, L.

2013

Development and psychometric validation of a Health Literacy in Dentistry scale (HeLD)

Community Dental Health

To develop and validate a culturally-appropriate Health Literacy in Dentistry (HeLD) instrument for use amongst Indigenous Australians

Indigenous adults

209

Convenience sample of Indigenous adults living in the Port Augusta region of Australia

HeLD

Sistani, M., Montazeri, A., Yazdani, R., Murtomaa, H.

2013

New oral health literacy instrument for public health: development and pilot testing

Journal of Investigative and Clinical Dentistry

To develop a functional oral health literacy (OHL) instrument for adults including new measures of literacy skills (OHL-AQ)

Adult citizens living in Tehran

97

Randomly selected households in Tehran

OHL-AQ

Sistani, M., Yazdani, R. Virtanen, J., Pakdaman,A., Murtomaa, H.

2013

Determinants of oral health: Does oral health literacy matter?

ISRN Dentistry

To evaluate oral health literacy, independent of other oral health determinants , as a risk indicator for self-reported oral health

Adults living in Tehran

1031

Random area sampling in Tehran

OHL-AQ

Sistani, M., Yazdani, R. Virtanen, J., Pakdaman,A., Murtomaa, H.

2013

Oral health literacy and information sources among adults in Tehran, Iran

Community Dental Health

To assess oral health literacy level and oral health information of Iranian adults in Tehran, and to determine the factors related to oral health literacy

Adults

1031

Multi-stage random sample from Tehran, Iran

OHL-AQ

Ueno, M. Takeuchi, S., Oshiro, A., Kawaguchi, Y.

2013

Relationship between oral health literacy and oral health behaviors and clinical status in Japanese adults

Journal of Dental Sciences

To investigate how oral health literacy relates to oral health behaviors, as well as clinical dental and periodontal conditions.

Adult residents of Akita in Japan

518

Adult residents aged older than 20 living in Akita, Japan

Self administered questionnaire and dental exam

Wong, H., Bridges, S., Yiu, C., McGrath, C., Au, T., Parthasarathy, D.,

2013

Validation of the Hong Kong Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P)

International Journal of Paediatric Dentistry

To validate an original instrument. The Hong Kong Oral Health Literacy Assessment Task (HKOHLAT-P) for paediatric dentistry

Parent/ Child dyads

200 pairs

Convenience sample of 200 pairs of parents/children attending the Paediatric Dentistry Clinic in Hong Kong

HKOHLAT-P, ToFHLiD, ECO-HIS and interviews using HKREALD-30

Holtzman, J., Atchison, J., Gironda, M., Radbod, R., Gornbein, J.

2013

The association between oral health literacy and failed appointments in adults attending a university-based general dental clinic

Community Dentistry and Oral Epidemiology

To determine the association between personal characteristics, a person’s oral health literacy and failing to show for dental appointments

Adults

200

Secondary analysis of 200 adult patients at a university dental clinic

REALM-D and socio-demographic survey