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Flynn P, Ingleshwar A, Chen X, Feuerstahler L, Reibel Y, John MT. Validation of the HeLD-14 functional oral health literacy instrument in a general population. PeerJ 2023; 11:e16106. [PMID: 37842062 PMCID: PMC10573372 DOI: 10.7717/peerj.16106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/25/2023] [Indexed: 10/17/2023] Open
Abstract
Background Oral health literacy (OHL) is recognized as an important determinant of oral outcomes. Measuring OHL with a valid and reliable instrument that accurately captures the functional nature of this construct across cultures is needed. The short version of the Health Literacy in Dentistry scale (HeLD-14) shows promise as an appropriate instrument due to its inclusion of comprehensive domains hypothesized to comprise OHL. While studies validating the instrument in several languages have occurred, the number of dimensions in the various analyses range from one to seven. Validation of the HeLD-14 in a general English-speaking population is also lacking. The purpose of this study was to explore and confirm the dimensionality of the HeLD-14 in a general US English-speaking population. Methods The psychometric properties of HeLD-14 were evaluated in a sample of 631 participants attending the Minnesota State Fair. Construct validity was assessed using exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA) on the data set split into two groups. Internal consistency reliability was assessed using the Cronbach's alpha coefficient. Concurrent validity was established between the HeLD-14 and the Oral Health Inventory Profile (OHIP-5) using Pearson's correlation. Results EFA found, and CFA reinforced, a unidimensional structure of the HeLD-14. Cronbach's alpha was acceptable at 0.92. Fit assessment also supported a unidimensional structure, comparative fit index = 0.992, Tucker-Lewis index = 0.991, root mean square error of approximation = 0.065, and standardized root mean square residual = 0.074. Concurrent validity analyses showed that the HeLD-14 correlated with the OHIP-5. Conclusions The HeLD-14 is a unidimensional reliable and valid instrument for measuring the oral health literacy in the general US English-speaking adult population.
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Affiliation(s)
- Priscilla Flynn
- Primary Dental Care, School of Dentistry, University of Minnesota, Minneapolis, MN, United States of America
| | - Aparna Ingleshwar
- Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, United States of America
| | - Xing Chen
- Department of Psychology, Fordham University, Bronx, NY, United States of America
| | - Leah Feuerstahler
- Department of Psychology, Fordham University, Bronx, NY, United States of America
| | - Yvette Reibel
- Primary Dental Care, School of Dentistry, University of Minnesota, Minneapolis, MN, United States of America
| | - Mike T. John
- Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, United States of America
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Świątek AH, Szcześniak M, Wojtkowiak K, Stempień M, Chmiel M. Polish version of the Aesthetic Experience Questionnaire: validation and psychometric characteristics. Front Psychol 2023; 14:1214928. [PMID: 37720630 PMCID: PMC10501565 DOI: 10.3389/fpsyg.2023.1214928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/03/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction The purpose of the article is to present the results of works on the Polish version of the Aesthetic Experience Questionnaire (AEQ). The AEQ is a 22-item tool for assessing aesthetic experience in the following dimensions: emotional, cultural, perceptual, understanding, and two dimensions about flow (proximal conditions and flow experience). Methods In the course of works on the Polish version of the AEQ, 3 independent studies with the participation of more than 800 people were carried out. In addition to the AEQ measurement, the tools included: the Emotion Regulation Strategies for Artistic Creative Activities Scale, the Brief Music in Mood Regulation, the Aesthetic Competence Scale, the Aesthetic Processing Preference Scale, the Need for Cognition Scale, the Center for Epidemiologic Studies - Depression Scale, the Material Values Scale and the Multidimensional Existential Meaning Scale. Results The results obtained in the three studies through Confirmatory Factor Analysis indicated the compliance of the factor structure of the Polish version of the AEQ with the original and its good psychometric characteristics. It was also shown that the overall result and individual components of the aesthetic experience correlate positively with emotion regulation through artistic creative activities and mood regulation through music, aesthetic competences (music, literature, plastic arts, film), cognitive curiosity and some dimensions of aesthetic processing preferences. The studies also proved a very weak positive relationship between aesthetic experience and meaning of life. The assumption about a negative correlation between aesthetic experience and depression or materialism was not confirmed. Discussion The Polish version of the AEQ is a credible psychometric measurement and encourages scientists to design research on the psychology of art and aesthetics in the Polish cultural conditions.
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Affiliation(s)
| | - Małgorzata Szcześniak
- Faculty of Social Sciences, Institute of Psychology, University of Szczecin, Szczecin, Poland
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Tavousi M, Mohammadi S, Sadighi J, Zarei F, Kermani RM, Rostami R, Montazeri A. Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021. PLoS One 2022; 17:e0271524. [PMID: 35839272 PMCID: PMC9286266 DOI: 10.1371/journal.pone.0271524] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 07/04/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND It has been about 30 years since the first health literacy instrument was developed. This study aimed to review all existing instruments to summarize the current knowledge on the development of existing measurement instruments and their possible translation and validation in other languages different from the original languages. METHODS The review was conducted using PubMed, Web of Science, Scopus, and Google Scholar on all published papers on health literacy instrument development and psychometric properties in English biomedical journals from 1993 to the end of 2021. RESULTS The findings were summarized and synthesized on several headings, including general instruments, condition specific health literacy instruments (disease & content), population- specific instruments, and electronic health. Overall, 4848 citations were retrieved. After removing duplicates (n = 2336) and non-related papers (n = 2175), 361 studies (162 papers introducing an instrument and 199 papers reporting translation and psychometric properties of an original instrument) were selected for the final review. The original instruments included 39 general health literacy instruments, 90 condition specific (disease or content) health literacy instruments, 22 population- specific instruments, and 11 electronic health literacy instruments. Almost all papers reported reliability and validity, and the findings indicated that most existing health literacy instruments benefit from some relatively good psychometric properties. CONCLUSION This review highlighted that there were more than enough instruments for measuring health literacy. In addition, we found that a number of instruments did not report psychometric properties sufficiently. However, evidence suggest that well developed instruments and those reported adequate measures of validation could be helpful if appropriately selected based on objectives of a given study. Perhaps an authorized institution such as World Health Organization should take responsibility and provide a clear guideline for measuring health literacy as appropriate.
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Affiliation(s)
- Mahmoud Tavousi
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Samira Mohammadi
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Jila Sadighi
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Fatemeh Zarei
- Faculty of Medical Sciences, Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Ramin Mozafari Kermani
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Rahele Rostami
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Ali Montazeri
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
- Faculty of Humanity Sciences, University of Science and Culture, Tehran, Iran
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Almeida ER, Sistani MMN, Bendo CB, Pordeus IDA, Firmino RT, Paiva SM, Ferreira FM. Validation of the Brazilian Oral Health Literacy-Adults Questionnaire. Health Lit Res Pract 2022; 6:e224-e231. [PMID: 36099034 PMCID: PMC9469776 DOI: 10.3928/24748307-20220822-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Objective: Methods: Key Results: Conclusions: Plain Language Summary:
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Affiliation(s)
- Eliete Rodrigues Almeida
- Address correspondence to Eliete Rodrigues Almeida, PhD, Department of Pediatric Dentistry, School of Dentistry, Federal University of Minas Gerais. Rua Professor Moacir Gomes de Freitas, 688. Belo Horizonte, MG, Brazil, 31270-901;
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Urstad KH, Andersen MH, Larsen MH, Borge CR, Helseth S, Wahl AK. Definitions and measurement of health literacy in health and medicine research: a systematic review. BMJ Open 2022; 12:e056294. [PMID: 35165112 PMCID: PMC8845180 DOI: 10.1136/bmjopen-2021-056294] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The way health literacy is understood (conceptualised) should be closely linked to how it is measured (operationalised). This study aimed to gain insights into how health literacy is defined and measured in current health literacy research and to examine the relationship between health literacy definitions and instruments. DESIGN Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. DATA SOURCES The MEDLINE, PsycINFO, ERIC and CINAHL databases were searched for articles published during two randomly selected months (March and October) in 2019. ELIGIBILITY CRITERIA We included articles with a quantitative design that measured health literacy, were peer-reviewed and original, were published in the English language and included a study population older than 16 years. DATA EXTRACTION AND SYNTHESIS Six researchers screened the articles for eligibility and extracted the data independently. All health literacy definitions and instruments were considered in relation to category 1 (describing basic reading and writing skills, disease-specific knowledge and practical skills) and category 2 (social health literacy competence and the ability to interpret and critically assess health information). The categories were inspired by Nutbeam's descriptions of the different health literacy levels. RESULTS 120 articles were included in the review: 60 within public health and 60 within clinical health. The majority of the articles (n=77) used instruments from category 1. In total, 79 of the studies provided a health literacy definition; of these, 71 were in category 2 and 8 were in category 1. In almost half of the studies (n=38), health literacy was defined in a broad perspective (category 2) but measured with a more narrow focus (category 1). CONCLUSION Due to the high degree of inconsistency between health literacy definitions and instruments in current health literacy research, there is a risk of missing important information about health literacy considered be important to the initial understanding of the concept recognised in the studies. PROSPERO REGISTRATION NUMBER CRD42020179699.
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Affiliation(s)
- Kristin Hjorthaug Urstad
- Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway
- Faculty of Health Sciences, VID Specialized University, Oslo, Akershus, Norway
| | - Marit Helen Andersen
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
- Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Marie Hamilton Larsen
- Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
- Lovisenberg Diaconal University College, Oslo, Akershus, Norway
| | - Christine Råheim Borge
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
- Lovisenberg Diakonale Hospital, Oslo, Norway
| | - Sølvi Helseth
- Faculty of Health Scienes, Oslo Metropolitan University, Oslo, Norway
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Astrid Klopstad Wahl
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
- Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
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Pattanaik S, John MT, Kohli N, Davison ML, Chung S, Self K, Naik A, Flynn PM. Item and scale properties of the Oral Health Literacy Adults Questionnaire assessed by item response theory. J Public Health Dent 2020; 81:214-223. [PMID: 33305385 DOI: 10.1111/jphd.12434] [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: 04/14/2020] [Revised: 10/21/2020] [Accepted: 11/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES a) To evaluate the item and scale properties of the Oral Health Literacy Adults Questionnaire (OHL-AQ) in an adult general population. b) To determine precision or accuracy of the respondents' estimated scores along the Oral Health Literacy (OHL) spectrum using item response theory (IRT) modeling. METHODS Survey data were collected from a convenience sample of 405 adult attendees of the 2014 Minnesota State Fair. We used the two-parameter logistic (2PL) model for the item response theory (IRT) analyses of OHL-AQ data and calibrated items to estimate model-based item difficulty and discrimination parameters. Item and scale properties were also assessed by plotting and interpreting item characteristic curves (ICCs), test characteristic curve (TCC), and test information function (TIF). RESULTS Based on interpretation of model coefficients, statistical testing, and model fit criteria, we deemed the 2PL model superior and selected this model to examine item and scale properties. Scale reliability was shown to be good through the test information function (TIF). TIF from our analysis showed that higher levels of OHL were measured less precisely than lower levels of OHL. CONCLUSION We demonstrated OHL-AQ as a whole has promising psychometric properties. However, for equiprecise measurement across the scale range, the scale needs more items for measuring higher levels of OHL.
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Affiliation(s)
- Swaha Pattanaik
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Mike T John
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Nidhi Kohli
- Department of Educational Psychology, College of Human Development, University of Minnesota, Minneapolis, MN, USA
| | - Mark L Davison
- Department of Educational Psychology, College of Human Development, University of Minnesota, Minneapolis, MN, USA
| | - Seungwon Chung
- Department of Educational Psychology, College of Human Development, University of Minnesota, Minneapolis, MN, USA
| | - Karl Self
- Department of Primary Dental Care, University of Minnesota School of Dentistry, Minneapolis, MN, USA
| | - Amruta Naik
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Priscilla M Flynn
- Department of Primary Dental Care, University of Minnesota School of Dentistry, Minneapolis, MN, USA
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