Development and validation of an instrument to assess oral health literacy in Norwegian adult dental patients

Abstract

Objective. To develop and validate an interview instrument to assess oral health literacy in Norwegian adult dental patients. Materials and methods. The instrument, Adult Health Literacy Instrument for Dentistry (AHLID), was based on an OECD instrument used to assess general literacy in adults. One hundred and thirty Norwegian adults (mean age = 48 years; 57% women) participated. AHLID included a selection of oral health-related printed texts that ranged from 1–5 with respect to difficulty. A questionnaire regarding socio-demographic variables and knowledge of risk factors for oral disease was used. DMFT, stimulated salivary flow rate and streptococcus mutans and lactobacillus in saliva was also examined. Results. The Cronbach’s alpha values of AHLID were 0.98 for internal consistency reliability (p < 0.01) and 0.81 for test–re-test reliability (p < 0.05). AHLID score 3 was most frequent while very few fulfilled the criteria for score 1 and 5. Linear multiple regression analysis showed that lactobacillus in saliva and knowledge of risk factors for periodontitis and caries were predictor variables of AHLID score. Conclusions. AHLID appears to be reliable and valid to assess oral health literacy in Norwegian adults and suggests a method for country-specific health literacy instruments.

Key Words:

• Health literacy
• health literacy instrument
• instrument validation
• oral health literacy

Acknowledgements

The authors are grateful to the staff at the Public Dental Service Competence Centre of Northern Norway, Tromsø, Norway as well as the staff at the University Dental Clinic, Tromsø, Norway. We sincerely thank dental hygienist Hilde Nyborg for being research assistant in the data collection period.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.