Psychometric properties of Health Literacy in Dentistry scale in an elderly Brazilian population

Abstract This study aimed to assess the reliability and validity of Brazilian-Portuguese versions of the Health Literacy in Dentistry (HeLD) scale in a sample of elderly Brazilian participants. HeLD was initially translated into and cross-culturally adapted to the Brazilian Portuguese language. The reliability and validity of HeLD were then assessed in a sample of 535 non-institutionalized older persons who also completed a questionnaire containing sociodemographic and health information. Data were then randomly separated into two sub-datasets, and Confirmatory Factor Analysis was performed through structural equation modelling, with a maximum likelihood estimate to test the fit of the data to the factor structure of the long-and short-form HeLD (HeLD-29 and HeLD-14) versions of the instrument. The models were compared using the Akaike Information Criterion to assess goodness-of-fit and to determine which models were preferred. Internal consistency of HeLD was evaluated using Cronbach´s coefficient α. Both versions of HeLD were observed to demonstrate high internal reliability (Cronbach´s α ≥ 0.87 for all seven subscales), acceptable convergent (estimates of ≥ 0.50 for AVE and ≥ 0.70 for CR) and discriminant validity. However, the goodness-of-fit of the confirmatory factor analysis models demonstrated satisfactory results only for HeLD-14 subsamples (x2/df = 1.8-2.3; CFI = 0.97-0.98; GFI/NFI = 0.98-0.99; RMSEA = 0.05 and SRMR = 0.03). In conclusion, HeLD-14 was shown to be a reliable and valid instrument to measure oral health literacy in elderly Brazilian participants.

Social inequality in dental caries and changes over time among Indigenous and non-Indigenous Australian children.

OBJECTIVE: This paper describes and compares magnitudes of socioeconomic (SES) inequalities in oral health among Indigenous and non-Indigenous children over a 10-year period. METHODS: We analysed annual oral health survey data from NSW, NT and SA. Data were extracted for time period 1 (2000-2002, N=215,317) and time period 2 (2007-2010, N=34,495). Oral health outcomes were untreated decayed deciduous teeth (dt) and cumulative dental caries experience (dmft). Postcode-level Socioeconomic Index for Areas was used to assess SES. Age standardisation and complex survey weights were used. Indices of socioeconomic inequality in health (Slope Index of Inequality, Relative Index of Inequality, Absolute and Relative Concentration Index) were used to quantify inequality in dental caries and its changes over time. RESULTS: Oral health outcomes deteriorated in both Indigenous and non-Indigenous populations over time. Indigenous children experienced higher levels of disease at both times. Untreated dt increased in both populations. The cummulative disease (dmft) increased at higher rate among children in low-SES areas in both populations. Over time, there was an increase in socioecononomic inequalities in dmft in all children and in dt in non-Indigenous children. CONCLUSION: Area-level socioeconomic inequality in child oral health has widened due to deterioration in low-SES children.