1
|
Romanova A, Rubinelli S, Diviani N. Improving health and scientific literacy in disadvantaged groups: A scoping review of interventions. PATIENT EDUCATION AND COUNSELING 2024; 122:108168. [PMID: 38301598 DOI: 10.1016/j.pec.2024.108168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/05/2023] [Accepted: 01/21/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVE To explore approaches for developing and implementing interventions aimed at improving health literacy and health-related scientific literacy in disadvantaged groups. METHODS A scoping review of literature published in 2012-2022 was conducted, followed by quality appraisal of eligible studies. RESULTS Interventions were conducted mainly in community settings, where the most popular venues were adult education facilities. The primary target groups were those with limited income or education, ethnic minorities, or immigrants. Programs were often held in-person using interactive and culturally appropriate methods. They were predominantly focused on functional and interactive health literacy dimensions rather than on critical and scientific ones. Evaluations measured knowledge, health literacy, behavioral and psychological outcomes using various quantitative and qualitative instruments. CONCLUSIONS The findings offer a comprehensive overview of the ways to design and evaluate health and scientific literacy interventions tailored to disadvantaged groups. PRACTICE IMPLICATIONS Future interventions should prioritize participatory designs, culturally appropriate materials, and shift focus to critical and scientific health literacy, as well as to program scalability in less controlled conditions.
Collapse
Affiliation(s)
- Anna Romanova
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland; Swiss Paraplegic Research, Person-Centered Healthcare & Health Communication Group, Guido A, Zäch-Strasse 4, 6207 Nottwil, Switzerland
| | - Sara Rubinelli
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland; Swiss Paraplegic Research, Person-Centered Healthcare & Health Communication Group, Guido A, Zäch-Strasse 4, 6207 Nottwil, Switzerland
| | - Nicola Diviani
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland; Swiss Paraplegic Research, Person-Centered Healthcare & Health Communication Group, Guido A, Zäch-Strasse 4, 6207 Nottwil, Switzerland.
| |
Collapse
|
2
|
Esgin T, Macniven R, Crouch A, Martiniuk A. At the cultural interface: A systematic review of study characteristics and cultural integrity from twenty years of randomised controlled trials with Indigenous participants. DIALOGUES IN HEALTH 2023; 2:100097. [PMID: 38515470 PMCID: PMC10953858 DOI: 10.1016/j.dialog.2023.100097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/07/2022] [Accepted: 01/05/2023] [Indexed: 03/23/2024]
Abstract
Purpose and aim To identify and describe characteristics of Randomised Control Trial (RCT) design, implementation, and interpretation with a view tostrengtheningen the cultural integrity and scientific quality of this genre of research when used with, for and by Indigenous peoples. Issue RCTs are widely regarded as the 'gold standard' method for evaluating the efficacy of an intervention. However, issues of cultural acceptability and higher attrition rates among RCT participants from diverse populations, including Indigenous participants, have been reported. A better understanding of cultural acceptability and attrition rates of RCTs has the potential to impact the translation of findings into effective policies, programs and practice. Method A search of four electronic databases identified papers describing RCTs enrolling exclusively Australian Indigenous peoples over a 20-year period. The RCTs were assessed using: The Effective Public Health Practice Project's Quality Assessment Tool (EPHPP) and the Aboriginal & Torres Strait Islander Quality Appraisal Tool (QAT). The scores for each paper and the average scores of all papers were visualised using a Microsoft Excel™ Filled Radar Plot. Results Seventeen trials met the inclusion criteria. There was wide variation in the quality of the included trials as assessed by the EPHPP and almost universally poor results when assessed for cultural appropriateness and integrity by the QAT. Conclusion The value of the RCT research method, when applied to ultimately improve Australian Indigenous peoples' health, is diminished if issues of cultural integrity are not intrinsic to study design and execution. Our review found that it is feasible to have an RCT with both strong cultural integrity and high scientific quality. Attention to cultural integrity and community engagement, along with methodological rigour, may strengthen community ownership and contribute to more successful study adherence and potentially more effective translation of study findings into policy and practice.
Collapse
Affiliation(s)
- Tuguy Esgin
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, Discipline of Strategy, Innovation and Entrepreneurship, Business School, The University of Sydney, Sydney, New South Wales 2006, Australia
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia
- School of Management and Governance UNSW Business School, University of New South Wales Sydney, Kensington, New South Wales 2052, Australia
| | - Rona Macniven
- School of Population Health, Faculty of Medicine and Health, University of New South Wales Sydney, Kensington, New South Wales 2052, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales 2019, Australia
| | - Alan Crouch
- Department of Rural Health, The University of Melbourne, Ballarat Campus, Ballarat, Victoria 3350, Australia
| | - Alexandra Martiniuk
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales 2006, Australia
- Centre for Global Health Epidemiology Division, University of Toronto, Toronto, Ontario M5S 1A1, Canada
| |
Collapse
|
3
|
Yan W, Li M, Luo L, Ju X, Jamieson L, Liu F. Oral health literacy and its associated factors among nurses: A cross-sectional study. J Clin Nurs 2023. [PMID: 37157136 DOI: 10.1111/jocn.16750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/11/2023] [Accepted: 04/20/2023] [Indexed: 05/10/2023]
Abstract
AIMS AND OBJECTIVES To investigate the oral health literacy (OHL) of nurses and explore the factors affecting their OHL. BACKGROUND OHL is important for improving the oral health outcomes. Nurses' OHL may affect the oral health of themselves, families, and patients. Few studies have examined the OHL and its related factors among nurses. DESIGN A cross-sectional design following the STROBE guideline. METHODS A total of 449 nurses were recruited from tertiary hospitals in the minority areas of southwest China. The participants completed an online questionnaire, which contained questions related to the OHL, sociodemographic factors, general health, oral health and related behaviours, oral health knowledge, attitudes, and oral health-related quality of life. OHL was measured using the validated Chinese version of the short-form Health Literacy of Dentistry (HeLD-14) scale. Descriptive statistics, the Mann-Whitney U test, Spearman's correlation, and multiple linear regression analysis were used to analyse the data. RESULTS The median HeLD-14 score (p25-p75) was 50.0 (44.0-54.0). The regression model for OHL was found to be significant. The factors that influenced OHL included oral health knowledge, oral health attitudes, self-reported oral health, annual household income, and dental flossing; these factors accounted for 13.9% of the variance in OHL. CONCLUSIONS The nurse' OHL has room for improvement. Nurses' OHL could be improved by enriching their oral health knowledge, promoting their positive oral health attitudes, increasing their household income, and helping them build correct oral health behaviours. RELEVANCE TO CLINICAL PRACTICE The findings of the study could be used to make a case for changing nursing curricula. Oral health knowledge curriculum or programmes targeted towards nurses should be developed to improve their OHL. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
Collapse
Affiliation(s)
- Wen Yan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Min Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ling Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Fan Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Nursing, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
4
|
McGuffog R, Bryant J, Booth K, Collis F, Brown A, Hughes JT, Chamberlain C, McGhie A, Hobden B, Kennedy M. Exploring the Reported Strengths and Limitations of Aboriginal and Torres Strait Islander Health Research: A Narrative Review of Intervention Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3993. [PMID: 36901001 PMCID: PMC10001772 DOI: 10.3390/ijerph20053993] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
High quality intervention research is needed to inform evidence-based practice and policy for Aboriginal and Torres Strait Islander communities. We searched for studies published from 2008-2020 in the PubMed database. A narrative review of intervention literature was conducted, where we identified researcher reported strengths and limitations of their research practice. A total of 240 studies met inclusion criteria which were categorised as evaluations, trials, pilot interventions or implementation studies. Reported strengths included community engagement and partnerships; sample qualities; Aboriginal and Torres Strait Islander involvement in research; culturally appropriate and safe research practice; capacity building efforts; providing resources or reducing costs for services and communities; understanding local culture and context; and appropriate timelines for completion. Reported limitations included difficulties achieving the target sample size; inadequate time; insufficient funding and resources; limited capacity of health workers and services; and inadequate community involvement and communication issues. This review highlights that community consultation and leadership coupled with appropriate time and funding, enables Aboriginal and Torres Strait Islander health intervention research to be conducted. These factors can enable effective intervention research, and consequently can help improve health and wellbeing outcomes for Aboriginal and Torres Strait Islander people.
Collapse
Affiliation(s)
- Romany McGuffog
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Jamie Bryant
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Kade Booth
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Felicity Collis
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Alex Brown
- Indigenous Genomics, Australia National University, Canberra, ACT 2601, Australia
- Telethon Kids Institute, Nedlands, WA 6009, Australia
| | - Jaquelyne T. Hughes
- Rural and Remote Health, College of Medicine and Public Health, Flinders University, Darwin, NT 0810, Australia
| | - Catherine Chamberlain
- Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
| | - Alexandra McGhie
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Breanne Hobden
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW 2308, Australia
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Michelle Kennedy
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW 2308, Australia
| |
Collapse
|
5
|
Tian Z, Wang Y, Li Y, Lu J, Song L, Ding L, Guo X, Zheng J. Defining the Connotations of Oral Health Literacy Using the Conceptual Composition Method. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3518. [PMID: 36834212 PMCID: PMC9960088 DOI: 10.3390/ijerph20043518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/10/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Due to advancements in research, the concept of oral health literacy (OHL) has become rich in connotations, with over 250 definitions present in the literature and government and organizational reports. The diversity of OHL definitions and connotations not only produces conflicting results but also limits the production of accurate OHL measurement and assessment tools while simultaneously hindering the construction of health literacy intervention policies. To clarify the connotations of OHL and establish a scientific basis for evaluation, we conducted a systematic review, searching and analyzing the literature related to the conceptual connotations of OHL. Additionally, we extracted basic, methodological, and OHL conceptual connotation information from the literature. With reference to the review framework, we classified the conceptual connotations of OHL into antecedents of OHL, the core of OHL, mediators, and outcomes of OHL. The comprehensive conceptual connotations of OHL were obtained through a systematic review and concept mapping based on the related literature. Our analysis revealed that the antecedents of OHL can be classified in two categories: personal factors and external factors. The core conceptual connotations of OHL include three core dimensions (with 16 subdimensions): (1) basic skills-literacy, reading comprehension, numeracy, hearing, oral expression, communication, and knowledge; (2) information-related abilities-information acquisition, information understanding, information communication, information evaluation, information utilization, and information decision-making; and (3) oral health maintenance abilities-interpersonal skills, self-regulation, and goal achievement. The mediator of these connotations is oral health behaviors, with oral health being the result of OHL. This study further clarifies the conceptual connotations of OHL, serving as a reference for future OHL-related studies.
Collapse
Affiliation(s)
- Zhiqiang Tian
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, China
- School of Health Management, Shanxi Technology and Business College, Taiyuan 030036, China
| | - Yanjun Wang
- Comprehensive Service Center of Shanxi Medical and Health Institutions (Shanxi Province Blood Center), Changfeng Street, Taiyuan 030006, China
| | - Yang Li
- School of Health Management, Shanxi Technology and Business College, Taiyuan 030036, China
| | - Jiao Lu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China
| | - Li Song
- School of Public Health, Shanxi Medical University, South Xinjian Road, Taiyuan 030001, China
| | - Ling Ding
- School of Public Health, Shanxi Medical University, South Xinjian Road, Taiyuan 030001, China
| | - Xinyu Guo
- School of Public Health, Shanxi Medical University, South Xinjian Road, Taiyuan 030001, China
| | - Jianzhong Zheng
- School of Public Health, Shanxi Medical University, South Xinjian Road, Taiyuan 030001, China
| |
Collapse
|
6
|
Soares GH, Bado FMR, Tenani CF, Ribeiro Santiago PH, Jamieson LM, Mialhe FL. A psychometric network perspective to oral health literacy: Examining the replicability of network properties across the general community and older adults from Brazil. J Public Health Dent 2022; 82:321-329. [PMID: 35836363 PMCID: PMC9545626 DOI: 10.1111/jphd.12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/01/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022]
Abstract
Objectives To evaluate the replicability of oral health literacy (OHL) network models across the general community and a sample of older adults from Brazil. Methods Data were obtained from two oral health surveys conducted with a total of 1138 participants. OHL was measured using the short form Health Literacy in Dentistry scale (HeLD‐14). A regularized partial correlation network was estimated for each sample. Dimensionality and structural stability were examined via exploratory graph analysis. Network properties compared included global strength, edge weights, and centrality estimates. Model replicability was examined fitting the general community model to the older participants' data. Results Six dimensions with the exact same item composition were detected in both network models. Only the Receptivity domain in the older adults sample yielded low structural stability. Strong correlations were observed between edge weights (τ: 0.68; 95% CI: 0.62–0.74) and between node strength estimates (τ: 0.63; 95% CI: 0.36–0.89). No statistically significant differences were found for global strength. The fit of the older adults sample to the HeLD‐14 network structure of the general community sample was satisfactory. Conclusion Network models OHL replicated across the general community and a sample of older adults. The psychometric network approach is a useful tool to evaluate the measurement equivalence of OHL instruments across populations.
Collapse
Affiliation(s)
- Gustavo Hermes Soares
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | | | | | | | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | | |
Collapse
|
7
|
Ju X, Jamieson LM, Mejia GC, Mittinty MN. Effect of oral health literacy on self-reported tooth loss: A multiple mediation analysis. Community Dent Oral Epidemiol 2021; 50:445-452. [PMID: 34561880 DOI: 10.1111/cdoe.12699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 09/06/2021] [Accepted: 09/15/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aims to investigate the mediating pathways of oral health literacy (OHL) and oral health-related behaviours on the relationship between education and self-reported tooth loss among Australian adults. METHODS Data used for studying the effects of mediating pathways are from the National Dental Telephone Interview Survey 2013, a random sample survey of Australian adults aged 18+ years. To study the mediating effects, we use counterfactual-based analysis. To decompose the effect of multiple mediator's alternate, to natural effect, methods such as interventional effects have been proposed. In this paper, we use these approaches to decompose the effect between education, OHL and oral health-related behaviours on self-reported tooth loss. Sensitivity analysis was performed for unmeasured confounding with multiple mediators. RESULTS Data were available for 2936 Australian adults. The prevalence of persons with ≥12 self-reported tooth loss was approximately 15%. The average total causal effect from the low education group was nearly 150%, and the interventional indirect effect through OHL and the dependence of oral health-related behaviours on OHL to more than 12 missing teeth were 20% and 120%, respectively, higher than in the high education group. Sensitivity analysis indicated if the difference in the prevalence of unmeasured confounder is as big as 6% the direct effect and the indirect effect remains as observed. CONCLUSIONS An additional two-fifths reduction on having more than 12 missing teeth for Australian adults with lower education level could be achieved if the proportion of lower OHL was decreased and optimal dental behaviours were increased.
Collapse
Affiliation(s)
- Xiangqun Ju
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Gloria C Mejia
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia.,SA Aboriginal Chronic Disease Consortium, Wardliparingga, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Murthy N Mittinty
- School of Public Health, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
8
|
Liu HZ, Lyu X, Liu Y, Han Z, Ye J. Validation of the Chinese version of the Short-Form Health Literacy in Dentistry (HeLD) scale. Community Dent Oral Epidemiol 2021; 49:550-556. [PMID: 34245045 DOI: 10.1111/cdoe.12675] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES As an important part of health literacy, oral health literacy has been adapted to dental practice and research. The 14-item short version of the Health Literacy in Dentistry (HeLD) scale demonstrated excellent reliability, validity and precision when tested among English-speaking populations. However, an appropriate and reliable assessment of this scale in other language contexts remains lacking. The reliability and validity of the Chinese version of HeLD (HeLD-C) for the Chinese population must therefore be examined. METHODS The short version of HeLD was translated into Chinese, and one item was deleted because of its unsuitability for the Chinese healthcare system. The psychometric properties of HeLD-C were evaluated in a sample of 404 Chinese participants aged from 19 to 72 years. The item selection analyses were performed by comparing the difference of each item between the high- and low-score groups. The internal consistency reliability was assessed using the Cronbach's alpha coefficient. Construct validity was assessed using exploratory structural equation modelling. For the criterion validity, correlations between the HeLD-C and the criterion validity scales, including the eHealth Literacy Scale (eHEALS), oral hygiene maintenance habits, and oral health status were tested using Pearson's correlation. RESULTS Results of item selection reveal significant differences among all items between the high- and low-score groups (Ps < .001). The internal consistency reliability of HeLD-C was measured using Cronbach's α (0.92), whereas its construct validity was measured using χ2 [df] (3.30), comparative fit index (0.95), Tucker-Lewis index (0.94), root mean square error of approximation (0.08), and standardized root mean square residual (0.05). The criterion validity analyses show that HeLD-C is correlated with the criterion validity scales, including eHEALS, oral hygiene maintenance habits and oral health status (Ps < .001). CONCLUSIONS Chinese version of HeLD is a reliable and valid instrument for measuring the oral health literacy of the Chinese adult population.
Collapse
Affiliation(s)
- Hong-Zhi Liu
- Computational Social Science Laboratory, Nankai University, Tianjin, China.,Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Xiaokang Lyu
- Computational Social Science Laboratory, Nankai University, Tianjin, China.,Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Ying Liu
- School of Vocational Education, Tianjin University of Technology and Education, Tianjin, China
| | | | - Jingjing Ye
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China.,Health Supervision Institute of Xiangshan Municipal Health Bureau, Ningbo, China
| |
Collapse
|
9
|
Nash S, Arora A. Interventions to improve health literacy among Aboriginal and Torres Strait Islander Peoples: a systematic review. BMC Public Health 2021; 21:248. [PMID: 33516186 PMCID: PMC7847024 DOI: 10.1186/s12889-021-10278-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/19/2021] [Indexed: 12/28/2022] Open
Abstract
Background Aboriginal and Torres Strait Islander peoples continue to experience poorer health outcomes than other population groups. While data specific to Indigenous Australians are scarce, a known social health literacy gradient exists linking low health literacy and poor health outcomes within many minority populations. Improving health literacy among Indigenous Australians is an important way to support self-determination and autonomy in both individuals and communities, by enhancing knowledge and improving health outcomes. This review aims to rigorously examine the effectiveness of health literacy interventions targeting Aboriginal and Torres Strait Islander peoples. Methods A systematic review across six databases (The Cochrane Library, PubMed, Embase, SCOPUS, ProQuest Dissertation and Thesis and Web of Science) was performed for publications evaluating interventions to improve health literacy among Indigenous Australian adults using search terms identifying a range of related outcomes. Results Of 824 articles retrieved, a total of five studies met the eligibility criteria and were included in this review. The included studies evaluated the implementation of workshops, structured exercise classes and the provision of discounted fruit and vegetables to improve nutrition, modify risk factors for chronic diseases, and improve oral health literacy. All interventions reported statistically significant improvement in at least one measured outcome. However, there was limited involvement of the Aboriginal and Torres Strait Islander community members in the research process and participant retention rates were sub-optimal. Conclusion There is limited evidence on interventions to improve health literacy in Indigenous Australian adults. Participation in interventions was often suboptimal and loss to follow-up was high. Future studies co-designed with Aboriginal and Torres Strait Islander community members are needed to improve health literacy in this population. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10278-x.
Collapse
Affiliation(s)
- Simone Nash
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, Westmead, NSW, 2145, Australia. .,Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW, 2010, Australia.
| |
Collapse
|
10
|
Soares GH, Santiago PHR, Michel-Crosato E, Jamieson L. The utility of network analysis in the context of Indigenous Australian oral health literacy. PLoS One 2020; 15:e0233972. [PMID: 32492049 PMCID: PMC7269264 DOI: 10.1371/journal.pone.0233972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/17/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The study of oral health literacy (OHL) is likely to gain new and interesting insights with the use of network analysis, a powerful analytical tool that allows the investigation of complex systems of relationships. Our aim was to investigate the relationships between oral health literacy and oral health-related factors in a sample of Indigenous Australian adults using a network analysis approach. METHODS Data from 400 Indigenous Australian adults was used to estimate four regularised partial correlation networks. Initially, a network with the 14 items of the Health Literacy in Dentistry scale (HeLD-14) was estimated. In a second step, psychosocial, sociodemographic and oral health-related factors were included in the network. Finally, two networks were estimated for participants with high and low oral health literacy. Participants were categorised into 'high' or 'low' OHL networks based on a median split. Centrality measures, clustering coefficients, network stability, and edge accuracy were evaluated. A permutation-based test was used to test differences between networks. RESULTS Solid connections among HeLD-14 items followed the structure of theoretical domains across all networks. Oral health-related self-efficacy, sporting activities, and self-rated oral health status were the strongest positively associated nodes with items of the HeLD-14 scale. HeLD-14 items were the four most central nodes in both HeLD-14 + covariates network and high OHL network, but not in the low OHL network. Differences between high and low OHL models were observed in terms of overall network structure, edge weight, and clustering coefficient. CONCLUSION Network models captured the dynamic relationships between oral health literacy and psychosocial, sociodemographic and oral health-related factors. Discussion on the implications of these findings for informing the development of targeted interventions to improve oral health literacy is presented.
Collapse
Affiliation(s)
| | | | | | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
11
|
Nurash P, Kasevayuth K, Intarakamhang U. Learning programmes and teaching techniques to enhance oral health literacy or patient-centred communication for healthcare providers: A systematic review. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:134-144. [PMID: 31675468 DOI: 10.1111/eje.12477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/07/2019] [Accepted: 10/30/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To investigate the learning programmes and teaching techniques used in interventions to enhance oral health literacy (OHL) or patient-centred communication (PCC) for healthcare providers. MATERIALS AND METHODS A systematic review of OHL and PCC were obtained from four electronic databases (PubMed, ScienceDirect, ProQuest and Scopus) was undertaken. These searches covered the period from January 2008 to December 2017. The quality assessment tool was the Joanna Briggs Institute Critical Appraisal tool for systematic reviews of effectiveness. RESULTS The final review included nine studies amongst a total of 1475 studies. They showed three learning programmes (workshops, training and community-based rotation) and 17 related teaching techniques to promote OHL and PCC. The most commonly used learning programmes to enhance OHL and PCC for healthcare providers were workshops, and the teaching techniques included feedback and reflection. The intervention periods of the programmes took 20 minutes to half a day. The three studies did not have a follow-up, whilst the rest showed a follow-up range of 2 months to 3 years. Interestingly, there was one study, which applied double follow-ups to show the effectiveness of the programme. CONCLUSION Either workshops or training programmes with a combination of teaching techniques were effective in terms of enhancing their OHL or PCC. The more frequent follow-up might increase the long-term effectiveness of the learning programme.
Collapse
Affiliation(s)
- Pariyawit Nurash
- Behavioral Science Research Institute, Srinakharinwirot University, Bangkok, Thailand
| | | | | |
Collapse
|
12
|
Beks H, Binder MJ, Kourbelis C, Ewing G, Charles J, Paradies Y, Clark RA, Versace VL. Geographical analysis of evaluated chronic disease programs for Aboriginal and Torres Strait Islander people in the Australian primary health care setting: a systematic scoping review. BMC Public Health 2019; 19:1115. [PMID: 31412846 PMCID: PMC6694647 DOI: 10.1186/s12889-019-7463-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/08/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Targeted chronic disease programs are vital to improving health outcomes for Indigenous people globally. In Australia it is not known where evaluated chronic disease programs for Aboriginal and Torres Strait Islander people have been implemented. This scoping review geographically examines where evaluated chronic disease programs for Aboriginal people have been implemented in the Australian primary health care setting. Secondary objectives include scoping programs for evidence of partnerships with Aboriginal organisations, and use of ethical protocols. By doing so, geographical gaps in the literature and variations in ethical approaches to conducting program evaluations are highlighted. METHODS The objectives, inclusion criteria and methods for this scoping review were specified in advance and documented in a published protocol. This scoping review was undertaken in accordance with the Joanna Briggs Institute (JBI) scoping review methodology. The search included 11 academic databases, clinical trial registries, and the grey literature. RESULTS The search resulted in 6894 citations, with 241 retrieved from the grey literature and targeted organisation websites. Title, abstract, and full-text screening was conducted by two independent reviewers, with 314 citations undergoing full review. Of these, 74 citations evaluating 50 programs met the inclusion criteria. Of the programs included in the geographical analysis (n = 40), 32.1% were implemented in Major Cities and 29.6% in Very Remote areas of Australia. A smaller proportion of programs were delivered in Inner Regional (12.3%), Outer Regional (18.5%) and Remote areas (7.4%) of Australia. Overall, 90% (n = 45) of the included programs collaborated with an Aboriginal organisation in the implementation and/or evaluation of the program. Variation in the use of ethical guidelines and protocols in the evaluation process was evident. CONCLUSIONS A greater focus on the evaluation of chronic disease programs for Aboriginal people residing in Inner and Outer Regional areas, and Remote areas of Australia is required. Across all geographical areas further efforts should be made to conduct evaluations in partnership with Aboriginal communities residing in the geographical region of program implementation. The need for more scientifically and ethically rigorous approaches to Aboriginal health program evaluations is evident.
Collapse
Affiliation(s)
- Hannah Beks
- Deakin Rural Health, Deakin University, School of Medicine, Geelong, Victoria, Australia
| | - Marley J Binder
- Deakin Rural Health, Deakin University, School of Medicine, Geelong, Victoria, Australia
| | - Constance Kourbelis
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia, Australia
| | - Geraldine Ewing
- Deakin Rural Health, Deakin University, School of Medicine, Geelong, Victoria, Australia
| | - James Charles
- Institute of Koorie Education, Deakin University, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Yin Paradies
- Faculty of Arts and Education, Deakin University, Burwood, Victoria, Australia
| | - Robyn A Clark
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia, Australia
| | - Vincent L Versace
- Deakin Rural Health, Deakin University, School of Medicine, Geelong, Victoria, Australia.
- National Centre for Farmer Health, Western District Health Service, Hamilton, Victoria, Australia.
| |
Collapse
|
13
|
Wright KM, Dono J, Brownbill AL, Pearson Nee Gibson O, Bowden J, Wycherley TP, Keech W, O'Dea K, Roder D, Avery JC, Miller CL. Sugar-sweetened beverage (SSB) consumption, correlates and interventions among Australian Aboriginal and Torres Strait Islander communities: a scoping review. BMJ Open 2019; 9:e023630. [PMID: 30819702 PMCID: PMC6398687 DOI: 10.1136/bmjopen-2018-023630] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 11/18/2018] [Accepted: 11/20/2018] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Sugar-sweetened beverage (SSB) consumption in Australian Aboriginal and Torres Strait Islander people is reported to be disproportionally high compared with the general Australian population. This review aimed to scope the literature documenting SSB consumption and interventions to reduce SSB consumption among Australian Aboriginal and Torres Strait Islander people. Findings will inform strategies to address SSB consumption in Aboriginal and Torres Strait Islander communities. METHODS PubMed, SCOPUS, CINAHL, Informit, Joanna Briggs Institute EBP, Mura databases and grey literature were searched for articles published between January 1980 and June 2018. Studies were included if providing data specific to an Australian Aboriginal and/or Torres Strait Islander population's SSB consumption or an intervention that focused on reducing SSB consumption in this population. DESIGN Systematic scoping review. RESULTS 59 articles were included (1846 screened). While reported SSB consumption was high, there were age-related and community-related differences observed in some studies. Most studies were conducted in remote or rural settings. Implementation of nutrition interventions that included an SSB component has built progressively in remote communities since the 1980s with a growing focus on community-driven, culturally sensitive approaches. More recent studies have focused exclusively on SSB consumption. Key SSB-related intervention elements included incentivising healthier options; reducing availability of less-healthy options; nutrition education; multifaceted or policy implementation (store nutrition or government policy). CONCLUSIONS There was a relatively large number of studies reporting data on SSB consumption and/or sales, predominantly from remote and rural settings. During analysis it was subjectively clear that the more impactful studies were those which were community driven or involved extensive community consultation and collaboration. Extracting additional SSB-specific consumption data from an existing nationally representative survey of Aboriginal and Torres Strait Islander people could provide detailed information for demographic subgroups and benchmarks for future interventions. It is recommended that a consistent, culturally appropriate, set of consumption measures be developed.
Collapse
Affiliation(s)
- Kathleen M Wright
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Joanne Dono
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Aimee L Brownbill
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Odette Pearson Nee Gibson
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Sansom Institute, University of South Australia, Adelaide, South Australia, Australia
| | - Jacqueline Bowden
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Thomas P Wycherley
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Wendy Keech
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Health Translation SA, Adelaide, South Australia, Australia
| | - Kerin O'Dea
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - David Roder
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Jodie C Avery
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Caroline L Miller
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
14
|
Soldani FA, Lamont T, Jones K, Young L, Walsh T, Lala R, Clarkson JE. One-to-one oral hygiene advice provided in a dental setting for oral health. Cochrane Database Syst Rev 2018; 10:CD007447. [PMID: 30380139 PMCID: PMC6516798 DOI: 10.1002/14651858.cd007447.pub2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Effective oral hygiene measures carried out on a regular basis are vital to maintain good oral health. One-to-one oral hygiene advice (OHA) within the dental setting is often provided as a means to motivate individuals and to help achieve improved levels of oral health. However, it is unclear if one-to-one OHA in a dental setting is effective in improving oral health and what method(s) might be most effective and efficient. OBJECTIVES To assess the effects of one-to-one OHA, provided by a member of the dental team within the dental setting, on patients' oral health, hygiene, behaviour, and attitudes compared to no advice or advice in a different format. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 10 November 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 10) in the Cochrane Library (searched 10 November 2017); MEDLINE Ovid (1946 to 10 November 2017); and Embase Ovid (1980 to 10 November 2017). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing trials (10 November 2017). No restrictions were placed on the language or date of publication when searching the electronic databases. Reference lists of relevant articles and previously published systematic reviews were handsearched. The authors of eligible trials were contacted, where feasible, to identify any unpublished work. SELECTION CRITERIA We included randomised controlled trials assessing the effects of one-to-one OHA delivered by a dental care professional in a dental care setting with a minimum of 8 weeks follow-up. We included healthy participants or participants who had a well-defined medical condition. DATA COLLECTION AND ANALYSIS At least two review authors carried out selection of studies, data extraction and risk of bias independently and in duplicate. Consensus was achieved by discussion, or involvement of a third review author if required. MAIN RESULTS Nineteen studies met the criteria for inclusion in the review with data available for a total of 4232 participants. The included studies reported a wide variety of interventions, study populations, clinical outcomes and outcome measures. There was substantial clinical heterogeneity amongst the studies and it was not deemed appropriate to pool data in a meta-analysis. We summarised data by categorising similar interventions into comparison groups.Comparison 1: Any form of one-to-one OHA versus no OHAFour studies compared any form of one-to-one OHA versus no OHA.Two studies reported the outcome of gingivitis. Although one small study had contradictory results at 3 months and 6 months, the other study showed very low-quality evidence of a benefit for OHA at all time points (very low-quality evidence).The same two studies reported the outcome of plaque. There was low-quality evidence that these interventions showed a benefit for OHA in plaque reduction at all time points.Two studies reported the outcome of dental caries at 6 months and 12 months respectively. There was very low-quality evidence of a benefit for OHA at 12 months.Comparison 2: Personalised one-to-one OHA versus routine one-to-one OHAFour studies compared personalised OHA versus routine OHA.There was little evidence available that any of these interventions demonstrated a difference on the outcomes of gingivitis, plaque or dental caries (very low quality).Comparison 3: Self-management versus professional OHAFive trials compared some form of self-management with some form of professional OHA.There was little evidence available that any of these interventions demonstrated a difference on the outcomes of gingivitis or plaque (very low quality). None of the studies measured dental caries.Comparison 4: Enhanced one-to-one OHA versus one-to-one OHASeven trials compared some form of enhanced OHA with some form of routine OHA.There was little evidence available that any of these interventions demonstrated a difference on the outcomes of gingivitis, plaque or dental caries (very low quality). AUTHORS' CONCLUSIONS There was insufficient high-quality evidence to recommend any specific one-to-one OHA method as being effective in improving oral health or being more effective than any other method. Further high-quality randomised controlled trials are required to determine the most effective, efficient method of one-to-one OHA for oral health maintenance and improvement. The design of such trials should be cognisant of the limitations of the available evidence presented in this Cochrane Review.
Collapse
Affiliation(s)
- Francesca A Soldani
- Bradford District Care NHS Foundation TrustCommunity Dental ServiceBradfordUK
| | - Thomas Lamont
- University of Dundee, Dental School & HospitalPark PlaceDundeeTaysideUKDD1 4HN
| | | | - Linda Young
- NHS Education for ScotlandScottish Dental Clinical Effectiveness ProgrammeDundee Dental Education CentreSmall's WyndDundeeUKDD1 4HN
| | - Tanya Walsh
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Rizwana Lala
- School of Clinical Dentistry, University of SheffieldUnit of Dental Public HealthClaremont CrescentSheffieldUKS10 2TA
| | - Janet E Clarkson
- Dundee Dental School, University of DundeeDivision of Oral Health SciencesPark PlaceDundeeScotlandUKDD1 4HR
| | | |
Collapse
|
15
|
Baskaradoss JK. Relationship between oral health literacy and oral health status. BMC Oral Health 2018; 18:172. [PMID: 30355347 PMCID: PMC6201552 DOI: 10.1186/s12903-018-0640-1] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/15/2018] [Indexed: 11/10/2022] Open
Abstract
Background Health literacy has been found to be a strong predictor of an individuals’ health, health behavior and health outcomes. Lower literacy has been linked to problems with the use of preventive services, delayed diagnoses of medical conditions, poor adherence to medical instructions, poor self-management skills, increased mortality risks, poor health outcomes, and higher health care costs. The aim of this study is to determine the relationship between oral health literacy (OHL) and oral health status among patients attending a University-affiliated dental clinic. Methods A convenience sample of participants was drawn from the dental patients presenting at School of Dental Medicine (SODM), Case Western Reserve University (CWRU). Information about the subjects’ demographic details, income, family size, insurance type and smoking history were collected using a data collection form. Data about the patients’ periodontal and caries risk assessment, caries experience and periodontal status was extracted from the patients’ electronic dental records. The Comprehensive Measure of Oral Health Knowledge (CMOHK) was used to record the oral health literacy. The median CMOHK score was 18, and this was used to categorize the sample into limited OHL (≤18) and adequate OHL (> 18) groups. A multivariate logistic regression model was built to examine the associations between the various independent variables and OHL levels. Results Data of 150 respondents were analyzed. More than half of the participants were female (55.3%) and the majority were Caucasian (60%). The average age of participants was 53.3 years [standard deviation (SD) 16.8]. Higher percentage of African Americans and individuals with low education had limited OHL levels (p < 0.05). The mean decayed, missing, and filled teeth (DMFT) score for this population was 7.33 ± 2.68. Subjects with limited OHL had significantly higher mean values for missing teeth (p < 0.05) and lower mean values for filled teeth (p < 0.05) as compared with subjects with adequate OHL Significantly, higher percentage of subjects with limited OHL had severe periodontitis as compared with those with adequate OHL (p = 0.04). Multivariate analysis found that the periodontal status was significantly associated with the OHL scores (p = 0.015). Conclusion Subjects with limited OHL levels had poorer periodontal health. Improving the OHL of patients may help in the efforts to improve the adherence to medical instructions, self-management skills and the overall treatment outcomes. Future research could focus on assessing the impact of OHL interventions on the oral health, which could be valuable for clinical practitioners.
Collapse
Affiliation(s)
- Jagan Kumar Baskaradoss
- Division of Dental Public Health, Department of Developmental and Preventive Sciences, Faculty of Dentistry, Kuwait University, P.O.Box: 24923, -13110, Safat, Kuwait.
| |
Collapse
|
16
|
Stein L, Bergdahl M, Pettersen KS, Bergdahl J. Effects of the Conceptual Model of Health Literacy as a Risk: A Randomised Controlled Trial in a Clinical Dental Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081630. [PMID: 30071702 PMCID: PMC6121536 DOI: 10.3390/ijerph15081630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/20/2018] [Accepted: 07/31/2018] [Indexed: 12/24/2022]
Abstract
Numerous conceptual models of health literacy have been proposed in the literature, but very few have been empirically validated in clinical contexts. The aim of this study was to test the effects of the conceptual model of health literacy as a risk in a clinical dental context. A convenience sample of 133 Norwegian-speaking adults was recruited. Participants were randomly allocated to an intervention group (n = 64, 54% women, mean age = 50 years) and a control group (n = 69, 49% women, mean age = 46 years). Clinical measurements were conducted pre-intervention and six months post-intervention. In the intervention group, communication regarding patients’ oral health was tailored to their health literacy levels using recommended communication techniques, whereas the control group received brief information not tailored to health literacy levels. The ANCOVA showed significant between-group effects, finding reduced post-intervention mean gingival (p < 0.000) and mean plaque (p < 0.000) indices in the intervention group when controlling for baseline index scores. The adjusted Cohen’s d indicated large effect sizes between the intervention group and the control group for both the mean gingival index (−0.98) and the mean plaque index (−1.33). In conclusion, the conceptual model of health literacy as a risk had a large effect on important clinical outcomes, such as gingival status and oral hygiene. The model may be regarded as a suitable supplement to patient education in populations.
Collapse
Affiliation(s)
- Linda Stein
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT-The Arctic University of Norway, 9019 Tromsø, Norway.
| | - Maud Bergdahl
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT-The Arctic University of Norway, 9019 Tromsø, Norway.
| | - Kjell Sverre Pettersen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, 0130 Oslo, Norway.
| | - Jan Bergdahl
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT-The Arctic University of Norway, 9019 Tromsø, Norway.
- Department of Psychology, Umeå University, 901 87 Umeå, Sweden.
| |
Collapse
|
17
|
Tiwari T, Jamieson L, Broughton J, Lawrence HP, Batliner TS, Arantes R, Albino J. Reducing Indigenous Oral Health Inequalities: A Review from 5 Nations. J Dent Res 2018; 97:869-877. [PMID: 29554440 DOI: 10.1177/0022034518763605] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Indigenous populations around the world experience a disproportionate burden in terms of oral diseases and conditions. These inequalities are likely due to a complex web of social determinants that includes poverty, historical consequences of colonialism, social exclusion, government policies of assimilation, cultural annihilation, and racism in all its forms (societal, institutional). Despite documented oral health disparities, prevention interventions have been scarce in Indigenous communities. This review describes oral health interventions and their outcomes conducted for Indigenous populations of the United States, Canada, Brazil, Australia, and New Zealand. The review includes research published since 2006 that are available in English in electronic databases, including MEDLINE. A total of 13 studies were included from the United States, Canada, Brazil, and Australia. The studies reviewed provide a wide range of initiatives, including interventions for prevention and treatment of dental disease, as well as interventions that improve oral health knowledge, behaviors, and other psychosocial factors. Overall, 6 studies resulted in improved oral health in the study participants, including improvements in periodontal health, caries reduction, and oral health literacy. Preferred intervention methodologies included community-based research approaches, culturally tailored strategies, and use of community workers to deliver the initiative. Although these studies were conducted with discrete Indigenous populations, investigators reported similar challenges in research implementation. Recommendations for future work in reducing oral health disparities include addressing social determinants of health in various Indigenous populations, training future generations of dental providers in cultural competency, and making Indigenous communities true partners in research.
Collapse
Affiliation(s)
- T Tiwari
- 1 University of Colorado Anschutz Medical Campus, School of Dental Medicine, Aurora, CO, USA
| | - L Jamieson
- 2 Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, South Australia, Australia
| | - J Broughton
- 3 Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - H P Lawrence
- 4 School of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - T S Batliner
- 5 University of Colorado Anschutz Medical Campus, School of Public Health, Aurora, CO, USA
| | - R Arantes
- 6 Fundação Oswaldo Cruz-Fiocruz Mato Grosso do Sul, Brazil
| | - J Albino
- 5 University of Colorado Anschutz Medical Campus, School of Public Health, Aurora, CO, USA
| |
Collapse
|