Development of a Greek Oral health literacy measurement instrument: GROHL
Abstract Background Oral health literacy is an important construct for both clinical and public health outcomes research. The need to quantify and test OHL has led to the development of measurement instruments and has generated a substantial body of recent literature. A commonly used OHL instrument...
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doaj-a833005b93694ad884c6b82ffdf246d12021-01-17T12:51:51ZengBMCBMC Oral Health1472-68312020-01-0120111110.1186/s12903-020-1000-5Development of a Greek Oral health literacy measurement instrument: GROHLKonstantina Taoufik0Kimon Divaris1Katerina Kavvadia2Haroula Koletsi-Kounari3Argy Polychronopoulou4Department of Community and Preventive Dentistry, School of Dentistry, National and Kapodistrian University of AthensDepartment of Pediatric Dentistry, School of Dentistry, University of North Carolina-Chapel HillDepartment of Pediatric Dentistry, School of Dentistry, University of LouisvilleDepartment of Community and Preventive Dentistry, School of Dentistry, National and Kapodistrian University of AthensDepartment of Community and Preventive Dentistry, School of Dentistry, National and Kapodistrian University of AthensAbstract Background Oral health literacy is an important construct for both clinical and public health outcomes research. The need to quantify and test OHL has led to the development of measurement instruments and has generated a substantial body of recent literature. A commonly used OHL instrument is REALD-30, a word recognition scale that has been adapted for use in several languages. The objective of this study was the development and testing of the Greek language oral health literacy measurement instrument (GROHL). Methods Data from 282 adult patients of two private dental clinics in Athens, Greece were collected via in-person interviews. Forty-four words were initially considered and tested for inclusion. Item response theory analysis (IRT) and 2-parameter logistic models assessing difficulty and discriminatory ability were used to identify an optimal scale composition. Internal consistency was examined using Cronbach’s alpha and test-retest reliability was measured using intraclass correlation coefficient (ICC) in a subset of 20 participants over a two-week period. Convergent validity was tested against functional health literacy screening (HLS) items, dental knowledge (DK), oral health behaviors (OHBs), oral health-related quality of life (OHRQoL; OHIP-14 index), as well as self-reported oral and general health status. Results From an initial item pool of 44 items that were carried forward to IRT, 12 were excluded due to no or little variance, 10 were excluded due to low item-test correlation, and 2 due to insignificant contribution to the scale, i.e., difficulty parameter estimate with p > 0.05. The twenty remaining items composed the final index which showed favorable internal consistency (alpha = 0.80) and test-retest reliability (ICC = 0.95). The summary score distribution did not depart from normality (p = 0.32; mean = 11.5; median = 12; range = 1–20). GROHL scores were positively correlated with favorable oral hygiene behaviors and dental attendance, as well as HLS, DK and education level. Conclusion The GROHL demonstrated good psychometric properties and can be used for outcomes research in clinical and public health settings.https://doi.org/10.1186/s12903-020-1000-5Oral health literacyLiteracy instrumentOral healthHealth literacyValidityREALD-30 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Konstantina Taoufik Kimon Divaris Katerina Kavvadia Haroula Koletsi-Kounari Argy Polychronopoulou |
spellingShingle |
Konstantina Taoufik Kimon Divaris Katerina Kavvadia Haroula Koletsi-Kounari Argy Polychronopoulou Development of a Greek Oral health literacy measurement instrument: GROHL BMC Oral Health Oral health literacy Literacy instrument Oral health Health literacy Validity REALD-30 |
author_facet |
Konstantina Taoufik Kimon Divaris Katerina Kavvadia Haroula Koletsi-Kounari Argy Polychronopoulou |
author_sort |
Konstantina Taoufik |
title |
Development of a Greek Oral health literacy measurement instrument: GROHL |
title_short |
Development of a Greek Oral health literacy measurement instrument: GROHL |
title_full |
Development of a Greek Oral health literacy measurement instrument: GROHL |
title_fullStr |
Development of a Greek Oral health literacy measurement instrument: GROHL |
title_full_unstemmed |
Development of a Greek Oral health literacy measurement instrument: GROHL |
title_sort |
development of a greek oral health literacy measurement instrument: grohl |
publisher |
BMC |
series |
BMC Oral Health |
issn |
1472-6831 |
publishDate |
2020-01-01 |
description |
Abstract Background Oral health literacy is an important construct for both clinical and public health outcomes research. The need to quantify and test OHL has led to the development of measurement instruments and has generated a substantial body of recent literature. A commonly used OHL instrument is REALD-30, a word recognition scale that has been adapted for use in several languages. The objective of this study was the development and testing of the Greek language oral health literacy measurement instrument (GROHL). Methods Data from 282 adult patients of two private dental clinics in Athens, Greece were collected via in-person interviews. Forty-four words were initially considered and tested for inclusion. Item response theory analysis (IRT) and 2-parameter logistic models assessing difficulty and discriminatory ability were used to identify an optimal scale composition. Internal consistency was examined using Cronbach’s alpha and test-retest reliability was measured using intraclass correlation coefficient (ICC) in a subset of 20 participants over a two-week period. Convergent validity was tested against functional health literacy screening (HLS) items, dental knowledge (DK), oral health behaviors (OHBs), oral health-related quality of life (OHRQoL; OHIP-14 index), as well as self-reported oral and general health status. Results From an initial item pool of 44 items that were carried forward to IRT, 12 were excluded due to no or little variance, 10 were excluded due to low item-test correlation, and 2 due to insignificant contribution to the scale, i.e., difficulty parameter estimate with p > 0.05. The twenty remaining items composed the final index which showed favorable internal consistency (alpha = 0.80) and test-retest reliability (ICC = 0.95). The summary score distribution did not depart from normality (p = 0.32; mean = 11.5; median = 12; range = 1–20). GROHL scores were positively correlated with favorable oral hygiene behaviors and dental attendance, as well as HLS, DK and education level. Conclusion The GROHL demonstrated good psychometric properties and can be used for outcomes research in clinical and public health settings. |
topic |
Oral health literacy Literacy instrument Oral health Health literacy Validity REALD-30 |
url |
https://doi.org/10.1186/s12903-020-1000-5 |
work_keys_str_mv |
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