Document Type : Original Article

Authors

Abstract

BACKGROUND: A proper measurement instrument is selected based on the suggested use of
the instrument, the target concept of measurement, and features of measurement (e.g. internal
consistency, reproducibility, content and construct validity, responsiveness, and interpretability).
Concerning the design and features of measurement, there are not any adequately specific standards
for instrumentation to measure oral health literacy (OHL). The present study proposes a protocol
that attempts to fill this gap by introducing the psychometrics of a standard questionnaire which
measures OHL.
MATERIALS AND METHODS: The present research employs a methodological design and is carried
out in Tehran, with data collected through interviews that are held face to face. The data collection
procedure involves a review of the related literature, cognitive interviews, fuzzy Delphi Method, and
focal groups with participants with OHL work experience for item generation. The target participants
of this research are the Iranian adult population and experts working professionally in different
health domains. For qualitative data analysis, the content analysis strategy and in the instrument
Psychometrics COSMIN checklist will use.
CONCLUSIONS: Achievement of the present research  will be used to evaluate the capability of
the Iranian adult population in searching, processing, and deciding on healthcare services. This
instrument will focus on evaluating both clinical and nonclinical settings. The present research can
vastly improve our knowledge of the state of OHL in the Iranian adult population.

Keywords

  1. Dadipoor S, Ramezankhani A, Alavi A, Aghamolaei T,
    Safari‑Moradabadi A. Pregnant women’s health literacy in the
    South of Iran. J Family Reprod Health 2017;11:211‑8.
    2. Safari Moradabadi A, Aghamolaei T, Ramezankhani A,
    Dadipoor S. The health literacy of pregnant women in Bandar
    Abbas, Iran. J Sch Public Health Inst Public Health Res
    2017;15 (2):121‑32.
    3. Dadipoor S, Ramezankhani A, Aghamolaei T, Rakhshani F,
    Safari‑Moradabadi A. Evaluation of health literacy in the Iranian
    population. J Family Reprod Health 2018;7:e62212.
    4. Baur C, Comings J, Evans C, Garcia R, Horowitz A, Ismail A,
    et al. The invisible barrier: Literacy and its relationship with oral
    health. J Public Health Dent 2005;65:174‑82.
    5. Hassani L, Aghamolaei T, Ghanbarnejad A, Madani A,
    Alizadeh A, Safari Moradabadi A. The effect of educational
    intervention based on BASNEF model on the students’ oral health.
    J Res Health 2016;5 (4):36‑44.
    6. Ghaffari M, Rakhshanderou S, Safari‑Moradabadi A, Torabi S.
    Oral and dental health care during pregnancy: Evaluating a
    theory‑driven intervention. Oral Dis 2018;24:1606‑14.
    7. Horowitz AM. The public’s oral health: The gaps between what
    we know and what we practice. Adv Dent Res 1995;9:91‑5.
    8. Horowitz AM, Kleinman DV. Oral health literacy: The
    new imperative to better oral health. Dent Clin North Am
    2008;52:333‑44, vi.
    9. Parker EJ, Jamieson LM. Associations between indigenous
    australian oral health literacy and self‑reported oral health
    outcomes. BMC Oral Health 2010;10:3.
    10. US Department of Health and Human Services. Healthy people
    2010:oral health toolkit. Washington, DC: U.S. Government
    Printing Office, 2000. [Cited 26 Oct 2011]. Available from: http://
    www.nidcr.nih.gov/EducationalResources/DentalHealthProf/
    HealthyPeople2010/.
    11. Davis TC, Michielutte R, Askov EN, Williams MV, Weiss BD.
    Practical assessment of adult literacy in health care. Health Educ
    Behav 1998;25:613‑24.
    12. Doak CC, Doak LG, RootJH. Teaching Patients With Low Literacy
    Skills. 2nd edn. Philadelphia: J.B.Lippincott; 1996.
    13. Davis TC, Crouch MA, Wills G, Miller S, Abdehou DM. The gap
    between patient reading comprehension and the readability of
    patient education materials. J Fam Pract 1990;31:533‑8.
    14. Davis TC, Mayeaux EJ, Fredrickson D, Bocchini JA Jr., JacksonRH,
    Murphy PW. Reading ability of parents compared with reading
    level of pediatric patient education materials. Pediatrics
    1994;93:460‑8.
    15. Kirsch IS. Adult Literacy in America: A First Look at the Results
    of the National Adult Literacy Survey. Washington: ERIC; 1993.
    16. Health literacy: Report of the council on scientific affairs. Ad hoc
    committee on health literacy for the council on scientific affairs,
    American Medical Association. JAMA 1999;281:552‑7.
    17. Richman JA, Lee JY, Rozier RG, Gong DA, Pahel BT, Vann WF Jr.,
    et al. Evaluation of a word recognition instrument to test health
    literacy in dentistry: The REALD‑99. J Public Health Dent
    2007;67:99‑104.
    18. Lee JY, Rozier RG, Lee SY, Bender D, Ruiz RE. Development of a
    word recognition instrument to test health literacy in dentistry:
    The REALD‑30 – A brief communication. J Public Health Dent
    2007;67:94‑8.
    19. Gong DA, Lee JY, Rozier RG, Pahel BT, Richman JA, Vann WF Jr.
    Development and testing of the test of functional health literacy
    in dentistry (TOFHLiD). J Public Health Dent 2007;67:105‑12.
    20. Sabbahi DA, Lawrence HP, Limeback H, Rootman I. Development
    and evaluation of an oral health literacy instrument for adults.
    Community Dent Oral Epidemiol 2009;37:451‑62.
    21. Atchison KA, Gironda MW, Messadi D, Der‑Martirosian C.
    Screening for oral health literacy in an Urban dental clinic. J Public
    Health Dent 2010;70:269‑75.
    22. Macek MD, Haynes D, Wells W, Bauer‑Leffler S, Cotten PA,
    Parker RM. Measuring conceptual health knowledge in the
    context of oral health literacy: Preliminary results. J Public Health
    Dent 2010;70:197‑204.
    23. Macek MD, Manski MC, Schneiderman MT, Meakin SJ, Haynes D,
    Wells W, et al. Knowledge of oral health issues among low‑income
    Baltimore adults: A pilot study. J Dent Hyg 2011;85:49‑56.
    24. Wong HM, Bridges SM, Yiu CK, McGrath CP, Au TK,
    Parthasarathy DS. Development and validation of Hong Kong
    rapid estimate of adult literacy in dentistry. J Investig Clin Dent
    2012;3:118‑27.
    25. Lee J, Stucky B, Rozier G, Lee SY, Zeldin LP. Oral health literacy
    assessment: Development of an oral health literacy instrument
    for spanish speakers. J Public Health Dent 2013;73:1‑8.
    26. Gironda M, Der‑Martirosian C, Messadi D, Holtzman J,
    Atchison K. A brief 20‑item dental/medical health literacy
    screen (REALMD‑20). J Public Health Dent 2013;73:50‑5.
    27. Wong HM, Bridges SM, Yiu CK, McGrath CP, Au TK,
    Parthasarathy DS. Validation of the hong kong oral health literacy
    assessment task for paediatric dentistry (HKOHLAT‑P). Int J
    Paediatr Dent 2013;23:366‑75.
    28. Jones K, Parker E, Mills H, Brennan D, Jamieson LM. Development
    and psychometric validation of a health literacy in dentistry
    scale (HeLD). Community Dent Health 2014;31:37‑43.
    29. Stucky BD, Lee JY, Lee SY, Rozier RG. Development of the
    two‑stage rapid estimate of adult literacy in dentistry. Community
    Dent Oral Epidemiol 2011;39:474‑80.
    30. Junkes MC, Fraiz FC, Sardenberg F, Lee JY, Paiva SM, Ferreira FM.
    Validity and reliability of the Brazilian version of the rapid
    estimate of adult literacy in dentistry – BREALD‑30. PLoS One
    2015;10:e0131600.
    31. Peker K, Köse TE, Güray B, Uysal Ö, Erdem TL. Reliability
    and validity of the Turkish version of the rapid estimate of
    adult literacy in dentistry (TREALD‑30). Acta Odontol Scand
    2017;75:198‑207.
    32. Tadakamadla SK, Quadri MF, Pakpour AH, Zailai AM, Sayed ME,
    Mashyakhy M, et al. Reliability and validity of Arabic rapid
    estimate of adult literacy in dentistry (AREALD‑30) in Saudi
    Arabia. BMC Oral Health 2014;14:120.
    33. Cruvinel AFP, Méndez DAC, Oliveira JG, Gutierres E, Lotto M,
    Machado MA, et al. The Brazilian version of the 20‑item rapid
    estimate of adult literacy in medicine and dentistry. PeerJ
    2017;5:e3744.
  2. 34. Bado FR, Ferreira FM, de Souza Barbosa T, Mialhe FL.
    Translation and cross‑cultural adaptation of the oral health
    literacy assessment‑Spanish to Brazilian portuguese. Pesqui Bras
    Odontopediatria Clin Integr 2017;17:1‑10.
    35. Naghibi Sistani MM, Montazeri A, Yazdani R, Murtomaa H. New
    oral health literacy instrument for public health: Development
    and pilot testing. J Investig Clin Dent 2014;5:313‑21.
    36. Streiner DL, Norman GR, Cairney J. Health Measurement Scales:
    A Practical Guide to their Development and Use. USA: Oxford
    University Press; 2015.
    37. Mohamad SA, Embi MA, Nordin NJ. Determining e‑portfolio
    elements in learning process using Fuzzy Delphi analysis. Int
    Educ Stud 2015;8:171‑6.
    38. Jackson JE. Principal components and factor analysis:
    Part I – Principal components. J Qual Technol 1980;12:201‑13.
    39. Asch DA, Jedrziewski MK, Christakis NA. Response rates to
    mail surveys published in medical journals. J Clin Epidemiol
    1997;50:1129‑36.
    40. Shapiro SS, Wilk MB. An analysis of variance test for
    normality (complete samples). Biometrika1965;52:591‑611.
    41. Terwee CB, Bot SD, de Boer MR, van der Windt DA,
    Knol DL, Dekker J, et al. Quality criteria were proposed for
    measurement properties of health status questionnaires. J Clin
    Epidemiol 2007;60:34‑42.
    42. Hobart J, Cano S. Rasch analysis. In: Jenkinson C, Peters M,
    Bromberg M, editor. Quality of Life Measurement in
    Neurodegenerative and Related Conditions. Cambridge, UK:
    Cambridge University Press; 2011.
    43. Pearson KJ. Containing papers of a mathematical or physical
    character. VII. mathematical contributions to the theory of
    evolution.–III. Regression heredity panmixia. Philos Trans R Soc
    Lond 1896;195:253‑318.
    44. Spearman C. The proof and measurement of association between
    two things. By C. Spearman, 1904. Am J Psychol 1987;100:441‑71.
    45. Cronbach LJ. Coefficient alpha and the internal structure of tests.
    Psychometrika 1951;16:297‑334.
    46. Shrout PE, Fleiss JL. Intraclass correlations: Uses in assessing rater
    reliability. Psychol Bull 1979;86:420‑8.
    47. Cohen J. Statistical Power Analysis for the Behavioral Sciences.
    2nd ed. Mahwah, NJ, USA: Lawrence Erlbaum; 1988.
    48. Schwandt TA, Lincoln YS, Guba EG. Judging interpretations: But
    is it rigorous? trustworthiness and authenticity in naturalistic
    evaluation. New Dir Eval 2007;2007:11‑25.
    49. World Medical Association. World medical association declaration
    of Helsinki. Ethical principles for medical research involving
    human subjects. Bull World Health Organ 2001;79:373‑4.