Development and psychometric validation of the orthodontic health literacy tool.

Introduction: Over the past few years, there has been increasing emphasis on context-specific health literacy. However, no such context-specific psychometric tools are available with regard to oral health literacy. The aim of this study was to develop and validate an Orthodontic Health Literacy Tool (Orth-HLT). Materials and Methods: After development of initial item pool, the items were assessed for content validity. The final tool consisted of 22 items in the four domains of functional, communicative, critical orthodontic health literacy, and orthodontic knowledge. Orth-HLT was administered to a convenience sample of 642 subjects. The data were subjected to exploratory and confirmatory factor analyses using IBM SPSS Version 20.0 software and IBM SPSS Amos 26.0, respectively. Pearson's correlation, independent samples t-test, and one-way analysis of variance were performed. Results: Orth-HLT demonstrated good face and content validity. The domain-specific internal consistency reliability values were optimal. Exploratory factor analysis on the items in all four domains resulted in a single factor solution. Four models were evaluated in the confirmatory factor analysis; the correlated factors model showed best model fit indices. Each domain of Orth-HLT showed moderate to strong positive correlation with Indian Oral Health Literacy Measure in Telugu indicating the convergent validity of the tool. Conclusion: Orth-HLT is the first context-specific oral health literacy tool and demonstrates strong psychometric properties, which could be used to evaluate orthodontic health literacy and articulate orthodontic health education materials in an informed manner.

The Influence of Dissonance Induction and Assessment Reactivity in Improving Adherence to COVID-19 Precautionary Measures: A Cluster Randomised Controlled Trial.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, adherence to suggested precautionary measures has been emphasized as important in preventing and curtailing its spread. However, strict adherence to precautionary measures can be demanding. METHODS: This cluster randomised controlled trial done among 1517 undergraduate dental students tested the effectiveness of 'dissonance induction' (DI) and 'assessment reactivity' (AR) in improving adherence to World Health Organization (WHO) measures as compared to a control group. At baseline, participants in the DI group were tested for their knowledge of precautionary measures, immediately followed by assessment of their adherence to them. This methodology was adapted to systematically reveal the poor adherence of the participants in their self-held cognitions, should there be any. The magnitude of dissonance was measured as the proportion of such dissonant cognitions held by an individual. In the AR group, at baseline, participants were asked about their attitudes alone toward measures. The control group was neither assessed for knowledge and adherence nor for attitudes toward the measures at baseline. Two weeks after the administration of these interventions in the DI and AR groups, the 3 study groups were assessed for adherence. RESULTS: The follow-up adherence scores in the DI group were found to be significantly higher (15.11 ± 4.1) compared to the AR (13.13 ± 2.01) and control (12.87 ± 2.97) groups as analysed by Kruskal-Wallis analysis of variance (H = 243.5; P < .001). Wilcoxon signed-rank test showed that the adherence scores significantly improved in the DI group from baseline to follow-up (z = -8.84; P < .001). Magnitude of dissonance at baseline was found to be a significant predictor of follow-up adherence scores (R2 = 0.255). CONCLUSION: This study found that DI is an easy intervention to bring an immediate and significant change in adherence to precautionary measures.

Vaccination induced complacency in adherence to COVID-19 precautionary measures among oral health care professionals in India and the United States: a retrospective pretest-posttest design.

In the context of the COVID-19 pandemic, vaccination-induced behavioral complacency in adherence to COVID-19 appropriate behavior emerged as a significant concern. This study was conducted among a convenience sample of 540 oral health care professionals in India and the United States. This was a retrospective pretest-post-test design, a choice to eliminate response-shift bias, where the participants responded online on their adherence or otherwise to COVID-19 precautionary measures before and after vaccination. The difference between post-test and retrospective pretest scores was used in assessing the magnitude of complacency demonstrated by the individual as a function of getting vaccinated, and the process was validated using exploratory factor analysis (EFA) with principal axis factoring and confirmatory factor analysis (CFA) on two randomly split subsets of the overall sample. It was observed that there had been a decline in the adherence to all the considered COVID-19 precautionary measures from the time before vaccination to the time of achievement of the fully vaccinated status. EFA performed on the randomly split sub sample of 240 subjects returned a two factor solution with five items in factor 1 and seven items in factor 2. Items in both the factors demonstrated adequate internal consistency in reliability analysis (Cronbach's alpha 0.84 and 0.82, respectively). The two factor solution obtained in EFA demonstrated good model fit in CFA [RMSEA (90%CI) - 0.077 (0.063-0.092); TLI - 0.872; CFI - 0.897; SRMR - 0.056]. These results highlight the vaccination-induced complacency in observing COVID-19 appropriate behavior among oral health professionals in India and the United States.

Is the profession of dentistry losing its yesteryear's glory? An exploratory study from dental students' perspective.

INTRODUCTION: The regard for dentistry as a profession has been declining over the recent years in light of the increasing number of dental students graduating per year with negligible improvement in the utilization of oral health care services. In this context, it is important to document the perceptions and apprehensions of the current dental students as these feelings would have an influence on the roles they assume as dentists in future. AIM: With this background, this study attempts to document the willingness of dental students from three South Indian states to re-choose dentistry given an opportunity. MATERIALS AND METHODS: This cross-sectional survey was conducted among house surgeons from 12 dental institutions, 4 each from the southern Indian states of Andhra Pradesh, Telangana, and Tamilnadu. The semi-structured questionnaire used in this study consisted of five primary questions along with details on the participants' gender, type of admission. It aimed at documenting the willingness to re-choose dentistry given an opportunity, and the reasons for their willingness or otherwise. A total of 822 students constituted the final sample. SPSS version 20 software was used to analyse the data. RESULTS: Majority of the study participants were from Tamil Nadu, not reported dentistry as their primary career choice, and demonstrated reluctance in re-choosing dentistry given an opportunity. A significantly higher percentage of dental students from Tamil Nadu reported dentistry as their first professional choice. This observation persisted in the response of students for the question on their willingness to re-choose dentistry. CONCLUSION: The study results demonstrate the declining interest and regard for dentistry among the current dental students with nominal variations between students from the three South Indian states.

Development and psychometric evaluation of COVID-19 Psychological Burden Scale for Indian Health Care Workers.

BACKGROUND: It is beyond doubt that the health care systems across the globe have been experiencing burdens of unprecedented magnitude in the coronavirus disease (COVID-19) era. However, no psychometric tools were validated in India to assess the impact of COVID-19 on the psychological well-being exclusively among health care workers, given their obvious risk for exposure. OBJECTIVES: This study was conducted to develop the first of its kind psychometric tool that measures the psychological burden posed by COVID-19 on Indian health care workers. MATERIALS AND METHODS: One hundred and sixty-nine health care workers attending COVID-19 duties in four different states of India took part in the study. The initial scale designed was tested for face and content validity. Exploratory factor analysis using direct oblimin rotation with Kaiser normalization was employed to determine the factor structure. Differential item functioning (DIF) analysis with ordinal regression based on the type of COVID-19 facility at which the participant is serving, educational background was done for identification of item bias. RESULTS: COVID-19 Psychological Burden Scale for Indian Health Care Workers (CPBS-IHCW), with 17 items loaded on four components, demonstrated good internal consistency reliability (Cronbach's Alpha 0.873). DIF revealed no item bias based on type of facility and educational background. Significant differences in CPBS-IHCW scores were noted between health care workers serving at different COVID-19 facilities and belonging to different educational backgrounds. CONCLUSION: CPBS-IHCW is a 17-item, rapidly administrable scale, demonstrating good internal consistency reliability, and temporal stability, which can be used in the assessment of psychological burden among health care professionals catering to the needs of the COVID-19 affected.

The influence of tobacco consumption on periodontal health: A stratified analysis based on type of tobacco use.

INTRODUCTION: Though the negative influence of tobacco consumption on the periodontal status of an individual is established, the magnitude of this association based on the type of tobacco used is seldom investigated. AIM: The aim of this study is to check the differences in the periodontal status of individuals based on their current tobacco consumption status and type of tobacco consumption. MATERIALS AND METHODS: This study was conducted among subjects attending a teaching dental institution in Andhra Pradesh. Subjects were divided into three groups based on their current tobacco consumption status. The following parameters were recorded after examination by two calibrated investigators: number of sites with bleeding on probing; number of teeth with periodontal pockets; number of teeth with clinical attachment loss of ≥5 mm; number of teeth lost. SPSS version 20 software was used to analyze the data. RESULTS: While current users demonstrated poor periodontal status than the former and nonusers, there was a significant difference in periodontal health between former users and nonusers in all the study parameters except the mean number of teeth lost. Among current users, the mean percentage of sites with bleeding and attachment loss >5 mm were found to be least among smokers compared to tobacco chewers and those who consume both smoke and smokeless forms of tobacco. CONCLUSION: The study confirms the negative influence of tobacco consumption on periodontal health and also establishes the increased destruction of clinical attachment levels among tobacco chewers compared to smokers.

Development and Initial Validation of the COVID-19 Anxiety Scale.

BACKGROUND: Safeguarding the psychological well-being of the public is also an integral component of fighting COVID-19. However, there is limited availability of psychometric measures to document COVID-19-related anxiety among the general public. OBJECTIVES: This study was aimed at developing a validated scale to measure COVID-19-related anxiety. METHODS: Three hundred and seven subjects from different gender, educational categories participated in the study. Exploratory factor analysis for the determination of factor structure, Pearson's correlation test, and Kruskal-Wallis ANOVA were employed in data analysis using SPSS version 20 software. RESULTS: COVID-19 Anxiety Scale (CAS) demonstrated a two-component structure identified as: "fear of social interaction;" "illness anxiety." The final scale with seven items demonstrated good internal consistency reliability (Cronbach's Alpha 0.736). CAS exhibited good construct validity showing moderately negative correlation (Pearson's r = -0.417) with the self-rated mental health and resulted in higher scores among individuals with lower educational qualification (Kruskal-Wallis ANOVA χ2 [2, 303] = 38.01; P = 0.001). CONCLUSION: CAS is a rapidly administrable, valid, and reliable tool that can be used to measure COVID-19-related anxiety among the Indian population.

Measuring the Impact of COVID-19 on Mental Health: A Scoping Review of the Existing Scales.

BACKGROUND: The coronavirus disease (COVID-19) pandemic, associated with the economic consequences of non-pharmaceutical interventions such as lockdown, has led to mental health consequences among people worldwide. Protecting the mental well-being of populations is an imperative component of fighting the COVID-19 pandemic. This scoping review attempts to present an overview of the existing tools to measure COVID-19-related mental health problems. METHODS: Literature search was conducted in the PubMed electronic database using developed key search terms. Reference lists of the identified eligible articles were reviewed to locate relevant articles missed from the electronic database search. Fifteen scales measuring COVID-19-associated mental health problems, validated among diverse populations across the world, were included in this review. RESULTS: The majority of these scales were validated among middle-aged adults in Turkey. Only a few validated scales encompass the negative socioeconomic consequences of COVID-19. None of the available scales focused on the aspects of suicidal ideation or behavioral responses/coping strategies, neither were they inclusive of participants from diverse age, geographic, and COVID-19 exposure groups. CONCLUSION: This scoping review highlights the need for future research to develop and validate comprehensive psychometric tools to assess COVID-19-associated mental health problems. Also, in view of the vulnerable nature of healthcare professionals for developing mental health concerns in the course of providing services for COVID-19-affected individuals, future psychometric research needs to concentrate on the development of measures specific for these professionals.

Utilization of health services in Tenali Mandal, Andhra Pradesh- A cross-sectional study.

INTRODUCTION: India has a plurality of health care with different systems of medicine delivered by government and local bodies in hospitals and clinics. Public hospitals provide 60% of all hospitalizations, while the private sector provides 75% of all routine care. Utilization is the actual attendance by the members of the public at health care facilities, which measures the number of visits per year or the number of people with at least one visit during the previous year, serves as an important tool and acts as a guiding path in understanding disease profile and also helps resource allocation. MATERIALS AND METHODS: A cross-sectional study was done using the National Pathfinder survey (stratified cluster random sampling) to know the health care utilization, profile, and pattern in Tenali Mandal, Guntur, Andhra Pradesh. RESULTS: The study sample comprised of 1,500 subjects who were equally divided among 5 age groups. Out of 1,500 participants, 52.8% were females and 47.2% were males. In total, 71.7% of the study participants have utilized health services, with majority of them (44.5%) had availed services within the last 6 months with prime reason of fevers (15.8%), while the main barrier for not seeking care was distance (17.03%), almost an equal proportion of the population sought care for their problems through home remedies and over-the-counter. CONCLUSION: There is an utmost need to minimize barriers of utilizing by making them aware of the health problems, so that they develop a positive attitude toward health care utilization. Therefore, knowledge of utilization of health services and associated factors is important in planning and delivery of interventions by the primary care physicians to improve health services coverage.

Dental Service Utilization: Patterns and Barriers among Rural Elderly in Guntur District, Andhra Pradesh.

INTRODUCTION: The biological process of ageing is outside human control and has its own dynamics. It is a known fact that elderly people have more treatment needs compared to the younger population and at the same time elderly people are facing a multitude of barriers in utilization of health care as well as oral health care. AIM: To identify the utilization patterns of oral health care and barriers for utilization among rural population. MATERIALS AND METHODS: A cross-sectional study was done on 621 rural elderly subjects to identify the utilization of oral health care services and the barriers for utilization. Using stratified cluster sampling study area was stratified into 13 rural clusters, fifty houses were randomly selected from each stratum. All the elderly subjects, as defined by the age criteria were considered for study. The data were analysed using SPSS 20 v and Chi-square tests were used to analyse the data. RESULTS: Only 31.9% of participants reported visiting a dentist in the past while 36.7% reported experiencing a dental problem at some point in their life. There were no significant differences in utilization of dental services based on gender, socio-economic status, age groups and religion. However, significant differences were found in utilization of dental services based on the response of participants to past experience of dental problems. CONCLUSION: The present study results conclude that fear was one of the most commonly reported barriers for utilisation of dental services and there is a need for oral health education and promotion among elderly population.