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Tan YR, Jawahir S, Doss JG. Oral healthcare seeking behavior of Malaysian adults in urban and rural areas: findings from the National Health and Morbidity Survey 2019. BMC Oral Health 2023; 23:719. [PMID: 37798660 PMCID: PMC10552245 DOI: 10.1186/s12903-023-03470-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 09/28/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The development and implementation of appropriate strategies to enhance oral health in the community can be aided by an understanding of oral healthcare seeking behavior among urban and rural populations. The purpose of this study was to identify the factors associated with oral healthcare seeking behavior of the Malaysians in urban and rural locations who self-reported dental problems. METHODS The National Health and Morbidity Survey 2019, a cross-sectional nationwide household survey that focused on non-institutionalised Malaysians, provided the data for this study on adults in Malaysia who were 18 years of age and older. A two-stage stratified random sampling technique was employed to ensure national representativeness. Data was collected using a multilingual (Malay and English), structured, and validated questionnaire via face-to-face interviews from July to October 2019. The dependent variable was oral healthcare seeking behavior (sought oral healthcare and self-medication). Independent variables were predisposing, enabling and health needs factor based on Andersen's Behavioral Model. Descriptive statistics were used to describe the characteristics and oral healthcare seeking behavior of the respondents. The relationship between the independent and dependent variables were investigated using multivariable logistic regression analysis. RESULTS The analysis comprised a total of 10,134 respondents, representing about 18.2 million Malaysian adults aged 18 and above. The overall prevalence of Malaysian adults who self-reported dental problems was low (5.5%) and was slightly higher in the rural than urban population. Almost half sought treatment from healthcare practitioners, and almost a quarter self-medicated. Ethnicity was associated with seeking healthcare and self-medication among urban dwellers. Among the rural population, income level was associated with seeking healthcare while education level was associated with self-medication. CONCLUSION Disparities in oral healthcare seeking behaviors exist between Malaysians living in urban and rural areas. Future policies should adopt focused strategies that concentrate on oral healthcare accessibility and health literacy of the vulnerable and rural populations to achieve the best oral healthcare for this population group.
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Affiliation(s)
- Yeung R'ong Tan
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, Universiti Malaya, 50603, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Suhana Jawahir
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Jennifer Geraldine Doss
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, Universiti Malaya, 50603, Wilayah Persekutuan Kuala Lumpur, Malaysia.
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Chen HF, Lee HE, Chen IT, Huang YT, Ho PS, Karim SA. Rural-urban disparities in the incidence and treatment intensity of periodontal disease among patients with diabetes. Front Public Health 2023; 11:1241150. [PMID: 37736085 PMCID: PMC10509757 DOI: 10.3389/fpubh.2023.1241150] [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: 06/16/2023] [Accepted: 08/18/2023] [Indexed: 09/23/2023] Open
Abstract
Background Diabetes threatens population health, especially in rural areas. Diabetes and periodontal diseases have a bidirectional relationship. A persistence of rural-urban disparities in diabetes may indicate a rural-urban difference in periodontal disease among patients with diabetes; however, the evidence is lacking. This retrospective study aimed to investigate rural-urban discrepancies in the incidence and treatment intensity of periodontal disease among patients who were newly diagnosed with type 2 diabetes in the year 2010. Methods The present study was a retrospective cohort design, with two study samples: patients with type 2 diabetes and those who were further diagnosed with periodontal disease. The data sources included the 2010 Diabetes Mellitus Health Database at the patient level, the National Geographic Information Standardization Platform and the Department of Statistics, Ministry of Health and Welfare in Taiwan at the township level. Two dependent variables were a time-to-event outcome for periodontal disease among patients with type 2 diabetes and the treatment intensity measured for patients who were further diagnosed with periodontal disease. The key independent variables are two dummy variables, representing rural and suburban areas, with urban areas as the reference group. The Cox and Poisson regression models were applied for analyses. Results Of 68,365 qualified patients, 49% of them had periodontal disease within 10 years after patients were diagnosed with diabetes. Compared to urban patients with diabetes, rural (HR = 0.83, 95% CI: 0.75-0.91) and suburban patients (HR = 0.86, 95% CI: 0.83-0.89) had a lower incidence of periodontal disease. Among 33,612 patients with periodontal disease, rural patients received less treatment intensity of dental care (Rural: RR = 0.87, 95% CI: 0.83, 0.92; suburban: RR = 0.93, 95% CI: 0.92, 0.95) than urban patients. Conclusion Given the underutilization of dental care among rural patients with diabetes, a low incidence of periodontal disease indicates potentially undiagnosed periodontal disease, and low treatment intensity signals potentially unmet dental needs. Our findings provide a potential explanation for the persistence of rural-urban disparities in poor diabetes outcomes. Policy interventions to enhance the likelihood of identifying periodontal disease at the early stage for proper treatment would ease the burden of diabetes care and narrow rural-urban discrepancies in diabetes outcomes.
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Affiliation(s)
- Hsueh-Fen Chen
- Department of Healthcare Administration and Medical Informatics, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Huey-Er Lee
- Department of Dentistry, Yuan's General Hospital, Kaohsiung, Taiwan
| | - I-Te Chen
- Department of Healthcare Administration and Medical Informatics, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ting Huang
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Shan Ho
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Saleema A. Karim
- Department of Health Administration, College of Health Professions, Virginia Commonwealth University, Richmomd, VA, United States
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Luo H, Moss ME, Basu R, Grant FT. Rural-Urban Differences in Use of Dental Services and Procedures Among Medicare Beneficiaries in 2018. Public Health Rep 2023; 138:788-795. [PMID: 36239470 PMCID: PMC10467503 DOI: 10.1177/00333549221128336] [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] [Indexed: 08/24/2023] Open
Abstract
OBJECTIVE Medicare beneficiaries in rural areas may face challenges in access to dental care. This study assessed rural-urban differences in the use of dental services and dental procedures by Medicare beneficiaries. METHODS We obtained data from the 2018 Medicare Current Beneficiary Survey cost and use files. Outcome variables examined in this study were (1) dental visits (yes/no), whether the Medicare beneficiary had ≥1 dental visit in the past year, and (2) dental procedures-preventive (yes/no), restorative (yes/no), and surgical procedures (yes/no)-whether the beneficiary had the procedure in a dental visit. The independent variable was the beneficiary's residence (rural vs urban). We used multiple logistic regression to analyze data and accounted for the survey design of the Medicare Current Beneficiary Survey. The analytic sample included 7377 respondents aged ≥65 years. RESULTS Approximately 57.0% (95% CI, 54.9%-59.0%) and 46.4% (95% CI, 41.6%-51.2%) of Medicare beneficiaries in urban and rural communities in the United States had a dental visit in 2018, respectively. Rural beneficiaries were significantly less likely than their urban counterparts to have preventive procedures (adjusted odds ratio = 0.51; 95% CI, 0.36-0.72) but significantly more likely to have restorative procedures (adjusted odds ratio = 1.30; 95% CI, 1.05-1.62). CONCLUSION We found significant disparities in use of dental services by Medicare beneficiaries in rural communities. When Medicare beneficiaries in rural areas used dental care, they were less likely than beneficiaries in urban areas to have preventive procedures but more likely to have restorative procedures, suggesting a greater burden of oral health needs among them. Policy research is needed to identify models that can incentivize prevention and improve access to dental care for Medicare beneficiaries in rural communities.
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Affiliation(s)
- Huabin Luo
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Mark E. Moss
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, NC, USA
| | - Rashmita Basu
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Ford T. Grant
- Ahoskie Community Service Learning Center, School of Dental Medicine, East Carolina University, Ahoskie, NC, USA
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Hakeem FF, Abdouh I, Hamadallah HH, Alarabi YO, Almuzaini AS, Abdullah MM, Altarjami AA. The Association between Electronic Health Literacy and Oral Health Outcomes among Dental Patients in Saudi Arabia: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:1804. [PMID: 37372921 DOI: 10.3390/healthcare11121804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE This cross-sectional study aimed to investigate the association between electronic health (eHealth) literacy and oral health outcomes, including the number of teeth and brushing frequency. METHODS A total of 478 participants were included in the study and assessed for their eHealth literacy levels. Demographic variables, including age, gender, income, and education, were collected. The participants' number of teeth and brushing frequency were also recorded. Multiple regression analyses were performed to examine the relationship between eHealth literacy and oral health outcomes, adjusting for sociodemographic variables. RESULTS The study sample consisted of both males (66.5%) and females (33.5%), with a mean age of 31.95 years. Among the participants, 16.95% were classified as having inadequate eHealth literacy, 24.06% had problematic eHealth literacy, and the majority (59.00%) demonstrated sufficient eHealth literacy. There was a significant association between eHealth literacy and oral health outcomes. Individuals with problematic eHealth literacy had a higher likelihood of having a greater number of teeth (RR = 1.12, 95% CI: 1.05-1.20, p < 0.001) compared to those with inadequate eHealth literacy. Similarly, individuals with sufficient eHealth literacy showed a higher likelihood of having more teeth (RR = 1.14, 95% CI: 1.07-1.21, p < 0.001) compared to the inadequate eHealth literacy group controlling for age, gender, income, and education. Individuals with problematic eHealth literacy exhibited a tendency towards lower odds of irregular brushing (OR = 0.39, 95% CI: 0.15-1.02, p = 0.054), although this result was marginally significant. In contrast, individuals with sufficient eHealth literacy had significantly lower odds of irregular brushing frequency (OR = 0.24, 95% CI: 0.10-0.62, p = 0.003) compared to the inadequate eHealth literacy group. CONCLUSION The findings suggest a positive association between eHealth literacy and oral health outcomes. Improving eHealth literacy may have implications for promoting better oral health behaviors and outcomes.
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Affiliation(s)
- Faisal F Hakeem
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia
- Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester M13 9PL, UK
| | - Ismail Abdouh
- Department of Oral Basic and Clinical Sciences, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah 42313, Saudi Arabia
| | - Hatem Hazzaa Hamadallah
- College of Dentistryand Hospital, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia
| | - Yunus Osama Alarabi
- College of Dentistryand Hospital, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia
| | | | - Majed Maher Abdullah
- College of Dentistryand Hospital, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia
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Adunola F, Macek MD, Atchison K, Akinkugbe A. Association between oral health knowledge, perceived oral health related quality of life, perceived oral health status and emergency department and/or urgent care visit: Results from the multi-site oral health literacy study. J Public Health Dent 2023; 83:193-199. [PMID: 36938785 PMCID: PMC10258138 DOI: 10.1111/jphd.12567] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 01/04/2023] [Accepted: 01/27/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVES To assess the link between oral health knowledge (OHK), self-perceived oral health, and emergency room (ER)/urgent care utilization for a dental problem. METHODS Data were analyzed from a convenience sample of 790 adult participants who presented to two US dental schools and completed an interviewer-administered survey. Key independent variables were OHK assessed with the Comprehensive Measure of Oral Health Knowledge (CMOHK) instrument, self-perceived oral health status and quality of life determined using the General Oral Health Assessment Index (GOHAI) scores. The dependent variable was ER and/or urgent care utilization for a dental problem. Select sociodemographic variables such as age and gender were adjusted for in logistic regression models using SAS. RESULTS 15.7% of the participants had ever visited an ER and/or urgent care for a dental problem. CMOHK scores were not significantly associated with visits to the ER and/or urgent care. In adjusted analysis, participants with unfavorable GOHAI scores were about three times as likely to have had an ER and/or urgent care visit (OR = 2.60, 95% CI: 1.66-4.09). Similarly, participants who were unsatisfied with their oral health were about twice as likely to have had an ER and/or urgent care visit (OR = 1.91, 95% CI: 1.21-3.00) as compared to those satisfied with their oral health status. CONCLUSION Individuals unsatisfied with their oral health and those with unfavorable perceived oral health related quality of life could benefit from a greater awareness of dental service availability and extended hours including weekend hours at public dental clinics.
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Affiliation(s)
- Folasayo Adunola
- Health Resources and Services Administration, Rockville, Maryland, USA
| | - Mark D Macek
- Department of Dental Public Health, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Kathryn Atchison
- Section of Public and Population Health, University of California - Los Angeles School of Dentistry, Los Angeles, California, USA
| | - Aderonke Akinkugbe
- Division of Environmental Epidemiology, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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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.
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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
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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.
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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
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Gao B, Shamrock AG, Gulbrandsen TR, O’Reilly OC, Duchman KR, Westermann RW, Wolf BR. Can Patients Read, Understand, and Act on Online Resources for Anterior Cruciate Ligament Surgery? Orthop J Sports Med 2022; 10:23259671221089977. [PMID: 35928178 PMCID: PMC9344126 DOI: 10.1177/23259671221089977] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/11/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Patients undergoing elective procedures often utilize online educational
materials to familiarize themselves with the surgical procedure and expected
postoperative recovery. While the Internet is easily accessible and
ubiquitous today, the ability of patients to read, understand, and act on
these materials is unknown. Purpose: To evaluate online resources about anterior cruciate ligament (ACL) surgery
utilizing measures of readability, understandability, and actionability. Study Design: Cross-sectional study; Level of evidence, 4. Methods: Using the term “ACL surgery,” 2 independent searches were performed utilizing
a public search engine (Google.com). Patient education
materials were identified from the top 50 results. Audiovisual materials,
news articles, materials intended for advertising or medical professionals,
and materials unrelated to ACL surgery were excluded. Readability was
quantified using the Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple
Measure of Gobbledygook, Coleman-Liau Index, Automated Readability Index,
and Gunning Fog Index. The Patient Education Materials Assessment Tool for
Printable Materials (PEMAT-P) was utilized to assess the actionability and
understandability of materials. For each online source, the relationship
between its Google search rank (from first to last) and its readability,
understandability, and actionability was calculated utilizing the Spearman
rank correlation coefficient (ρS). Results: Overall, we identified 68 unique websites, of which 39 met inclusion
criteria. The mean Flesch-Kincaid Grade Level was 10.08 ± 2.34, with no
website scoring at or below the 6th-grade level. Mean understandability and
actionability scores were 59.18 ± 10.86 (range, 33.64-79.17) and 34.41 ±
22.31 (range, 0.00-81.67), respectively. Only 5 (12.82%) and 1 (2.56%)
resource scored above the 70% adequate PEMAT-P threshold mark for
understandability and actionability, respectively. Readability (lowest
P value = .103), understandability (ρS =
–0.13; P = .441), and actionability (ρS = 0.28;
P = .096) scores were not associated with Google
rank. Conclusion: Patient education materials on ACL surgery scored poorly with respect to
readability, understandability, and actionability. No online resource scored
at the recommended reading level of the American Medical Association or
National Institutes of Health. Only 5 resources scored above the proven
threshold for understandability, and only 1 resource scored above it for
actionability.
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Affiliation(s)
- Burke Gao
- Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Alan G. Shamrock
- Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Trevor R. Gulbrandsen
- Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Olivia C. O’Reilly
- Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Kyle R. Duchman
- Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Robert W. Westermann
- Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Brian R. Wolf
- Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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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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MIALHE FL, SANTOS BL, BADO FMR, OLIVEIRA JÚNIOR AJD, SOARES GH. Association between oral health literacy and dental outcomes among users of primary healthcare services. Braz Oral Res 2022; 36:e004. [DOI: 10.1590/1807-3107bor-2022.vol36.0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/02/2021] [Indexed: 11/21/2022] Open
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Luo H, Wu Q, Bell RA, Wright W, Quandt SA, Basu R, Moss ME. Rural-Urban Differences in Dental Service Utilization and Dental Service Procedures Received Among US Adults: Results From the 2016 Medical Expenditure Panel Survey. J Rural Health 2020; 37:655-666. [PMID: 32697007 DOI: 10.1111/jrh.12500] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE To assess rural-urban differences in dental service use and procedures and to explore the interaction effects of individual- and county-level factors on having dental service use and procedures. METHODS Data were from the 2016 Medical Expenditure Panel Survey (MEPS). We assessed rural-urban differences in 3 outcome variables: number of dental visits (1, 2, or 3+ visits), preventive care procedures (Yes/No), and treatment procedures (Yes/No). The study sample included 8,199 adults ≥ 18 years of age who reported at least 1 dental visit in the past year. Sampling weights embedded in MEPS were incorporated into all the analyses. FINDINGS A significant interaction between residential location and race/ethnicity (P = .030) suggested limited access to dental visits for minority groups, especially for blacks in the more rural areas. Adults from a more rural area were less likely to have received a preventive procedure (AOR = 0.55, 95% CI: 0.35-0.87) than those from an urban area. Adults of racial/ethnic minority groups, with lower SES, and without dental insurance were less likely to have received a preventive procedure (all P < .01) but were more likely to have received a treatment procedure (all P < .05). CONCLUSIONS The study showed rural adults were less likely to have received preventive dental procedures than their urban counterparts. Racial/ethnic minority groups living in a more rural area had even more limited access to dental services. Innovative service delivery models that integrate telehealth and community-based case management may contribute to addressing these gaps in rural communities.
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Affiliation(s)
- Huabin Luo
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Qiang Wu
- Department of Biostatistics, College of Allied Health, East Carolina University, Greenville, North Carolina
| | - Ronny A Bell
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Wanda Wright
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina
| | - Sara A Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Rashmita Basu
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Mark E Moss
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina
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Timková S, Klamárová T, Kovaľová E, Novák B, Kolarčik P, Madarasová Gecková A. Health Literacy Associations with Periodontal Disease among Slovak Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062152. [PMID: 32213865 PMCID: PMC7143350 DOI: 10.3390/ijerph17062152] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/12/2020] [Accepted: 03/20/2020] [Indexed: 11/25/2022]
Abstract
Periodontal disease is inflammation of the gums and without good oral hygiene, it can progress to periodontitis. Oral hygiene might be related to a patient’s health literacy (HL), defined as ability to gain access, understand, and use information to promote and maintain good health. The aim of our study is to examine the associations of HL with indicators of periodontal disease. A cross-sectional study on 1117 adults (36.2% males; mean age = 36.4, SD = 14.2) attending dental hygiene treatment was conducted. Data on demographics, socioeconomic status, and nine domains of HL (Health Literacy Questionnaire, HLQ) were collected by questionnaire, and Community Periodontal Index of Treatment Needs (CPITN) was established by the dental hygienist. Data were analysed using t-tests and logistic regression. Respondents with periodontal disease (N = 152) had statistically significantly lower levels of HL in seven out of nine HLQ domains compared to intact patients (N = 818) (t from 3.03 to 4.75, p < 0.01). Association of higher HL in seven domains with lower chance of diagnosed periodontal disease remain significant even after adjustment for age, gender and educational attainment (adjusted ORs 0.55–0.67, p < 0.05). Our findings confirm that an individual’s lower HL is significantly associated with higher chance of periodontal disease incidence, specifically among Slovak adults attending oral hygiene clinics. HL might be a promising factor in the improvement of oral health in this population, worthy of consideration in intervention and preventive activities.
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Affiliation(s)
- Silvia Timková
- 1st Department of Stomatology, Faculty of Medicine, P.J. Šafarik University, 04011 Košice, Slovakia;
| | - Tatiana Klamárová
- Department of Dental Hygiene, Faculty of Health Care, University of Prešov, 08001 Prešov, Slovakia; (T.K.); (E.K.)
| | - Eva Kovaľová
- Department of Dental Hygiene, Faculty of Health Care, University of Prešov, 08001 Prešov, Slovakia; (T.K.); (E.K.)
| | - Bohuslav Novák
- Department of Stomatology and Maxilofacial Surgery, Faculty of Medicine, Comenius University, 81250 Bratislava, Slovakia;
| | - Peter Kolarčik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Šafárik University, 04011 Košice, Slovakia;
- Olomouc University Social Health Institute—OUSHI, Palacký University, 77111 Olomouc, Czech Republic
- Correspondence: ; Tel.: +421-55-234-3264
| | - Andrea Madarasová Gecková
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Šafárik University, 04011 Košice, Slovakia;
- Olomouc University Social Health Institute—OUSHI, Palacký University, 77111 Olomouc, Czech Republic
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13
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Das D, Menon I, Gupta R, Arora V, Ashraf A, Ahsan I. Oral health literacy: A practical strategy towards better oral health status among adult population of Ghaziabad district. J Family Med Prim Care 2020; 9:764-770. [PMID: 32318417 PMCID: PMC7113944 DOI: 10.4103/jfmpc.jfmpc_1049_19] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 01/24/2020] [Accepted: 01/31/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND AIMS Despite tremendous considerable effort by health professionals to promote oral health to create beautiful smiles, gap between oral health knowledge and practice undoubtedly still remains. Thus the aim of this study was to assess the Oral health literacy level and its impact on socioeconomic and oral health status among adult population in Ghaziabad district. METHODS A total of 600 study subjects aged 18-64 years from all 4 blocks of Ghaziabad visiting various outreach programmes using a multistage random sampling technique were included in the study. A specially designed questionnaire assessed the demographic variables. Oral health literacy level (OHL) was assessed with help of a bilingually adapted Hindi OHL tool. Clinical examination was recorded using WHO (World Health Organization) Oral Health Assessment Form 2013. RESULTS The mean age of the study subjects was 43.9 ± 14.36 years. Majority 300 (50%) study subjects had inadequate oral health literacy level followed by Marginal oral health literacy level which was seen among 180 (30%) subjects and 120 (20%) subjects had adequate oral health literacy level. Oral health literacy level was slightly higher among females as compared to male subjects although the results were not statistically significant. A statistically significant difference was found between oral health literacy and oral health status as well as socioeconomic status. (P value ≤ 0.05). CONCLUSION A significant association between OHL and oral health status was found stating Oral health literacy as an efficient role in influencing oral health outcome of any individual.
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Affiliation(s)
- Dipshikha Das
- Department of Public Health Dentistry, I.T.S Centre for Dental Studies and Research, Delhi- Meerut Road, Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Ipseeta Menon
- Department of Public Health Dentistry, I.T.S Centre for Dental Studies and Research, Delhi- Meerut Road, Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Ritu Gupta
- Department of Public Health Dentistry, I.T.S Centre for Dental Studies and Research, Delhi- Meerut Road, Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Vikram Arora
- Department of Public Health Dentistry, I.T.S Centre for Dental Studies and Research, Delhi- Meerut Road, Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Asifa Ashraf
- Department of Public Health Dentistry, I.T.S Centre for Dental Studies and Research, Delhi- Meerut Road, Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Iram Ahsan
- Department of Public Health Dentistry, I.T.S Centre for Dental Studies and Research, Delhi- Meerut Road, Murad Nagar, Ghaziabad, Uttar Pradesh, India
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Abstract
Setting the stage for good oral health early in life is critical to long-term oral and overall health. This exploratory study aimed to characterize and compare maternal and newborn oral microbiota among mother-infant pairs. Oral samples were collected from 34 pregnant African American women and their infants at 1 to 3 months of age. Extracted 16SrRNA genes were matched to the Human Oral Microbiome Database. Alpha and beta diversity differed significantly between overall maternal and infant microbiomes. Maternal or infant alpha diversity, however, was not differentiated by maternal gingival status. Several demographic and behavioral variables were associated with, but not predictive of, maternal oral microbiome alpha diversity. There was no association, however, among birth mode, feeding mode, and the infant oral microbiome. Megasphaera micronuciformis was the only periodontal pathogen detected among the infants. Notably, maternal gingival status was not associated with the presence/absence of most periodontal pathogens. This study provides an initial description of the maternal and infant oral microbiomes, laying the groundwork for future studies. The perinatal period presents an important opportunity where perinatal nurses and providers can provide oral assessment, education, and referral to quality dental care.
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