title: Evaluation of a word recognition instrument to test health literacy in dentistry: the REALD-99.
abstract: OBJECTIVE
  This study aims to evaluate a dental health literacy word recognition instrument.
  
  
  METHODS
  Based on a reading recognition test used in medicine, the Rapid Estimate of Adult Literacy in Medicine (REALM), we developed the Rapid Estimate of Adult Literacy in Dentistry (REALD-99). Parents of pediatric dental patients were recruited from local dental clinics and asked to read aloud words in both REALM and REALD-99. REALD-99 scores had a possible range of 0 (low literacy) to 99 (high literacy); REALM scores ranged from 0 to 66. Outcome measures included parents' perceived oral health for themselves and of their children, and oral health-related quality of life of the parent as measured by the short-form Oral Health Impact Profile (OHIP-14). To determine the validity, we tested bivariate correlations between REALM and REALD-99, REALM and perceived dental outcomes, and REALD-99 and perceived dental outcomes. We used ordinary least squares regression and logit models to further examine the relationship between REALD-99 and dental outcomes. We determined internal reliability using Cronbach's alpha.
  
  
  RESULTS
  One hundred two parents of children were interviewed. The average REALD-99 and REALM-66 scores were high (84 and 62, respectively). REALD-99 was positively correlated with REALM (PCC = 0.80). REALM was not related to dental outcomes. REALD-99 was associated with parents' OHIP-14 score in multivariate analysis. REALD-99 had good reliability (Cronbach's alpha = 0.86).
  
  
  CONCLUSIONS
  REALD-99 has promise for measuring dental health literacy because it demonstrated good reliability and is quick and easy to administer. Additional studies are needed to examine the validity of REALD-99 using objective clinical oral health measures and more proximal outcomes such as behavior and compliance to specific health instructions.
authors.affiliation: Department of Pediatric Dentistry CB 7450, University of North Carolina, Chapel Hill, NC 27599-7450, USA.
authors.forename: Julia A
authors.initials: JA
authors.lastname: Richman
authors.forename: Jessica Y
authors.initials: JY
authors.lastname: Lee
authors.forename: R Gary
authors.initials: RG
authors.lastname: Rozier
authors.forename: Debra A
authors.initials: DA
authors.lastname: Gong
authors.forename: Bhavna T
authors.initials: BT
authors.lastname: Pahel
authors.forename: William F
authors.initials: WF
authors.lastname: Vann
mesh_terms: D000328:Adult; D003813:Dentistry; D004521:Educational Measurement / Q000379:methods*; D004522:Educational Status; D005260:Female; D006267:Health Education, Dental; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016018:Least-Squares Analysis; D016015:Logistic Models; D008297:Male; D010290:Parents; D010865:Pilot Projects; D011788:Quality of Life; D015203:Reproducibility of Results; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D014825:Vocabulary