title: Screening for oral health literacy in an urban dental clinic.
abstract: OBJECTIVE
  Studies show that the average person fails to understand and use health care related materials to their full potential. The goal of this study was to evaluate a health literacy instrument based on the Rapid Estimate of Adult Literacy in Medicine (REALM) that incorporates dental and medical terms into one 84-item Rapid Estimate of Adult Literacy in Medicine and Dentistry (REALM-D) measure and determine its association with patient characteristics of a culturally diverse dental clinic population.
  
  
  METHODS
  An 84-item dental/medical health literacy word list and a 48-item health beliefs and attitudes survey was provided to a sample of 200 adult patients seeking treatment for the first time at an oral diagnosis clinic located in a large urban medical center in Los Angeles, California.
  
  
  RESULTS
  Of the total sample, 154 participants read all of list 1 correctly, 141 read list 2 correctly, and only 38 read list 3 correctly. Nonwhite participants had significantly lower REALM-D scores at each level of difficulty as well as the total scale score compared to white participants. Participants who reported English as not their main language had significantly lower REALM-D scores. REALM-D scores also varied significantly by level of education among participants where as level of education increased, oral health literacy increased. At a bivariate level, race, education, and English as a main language remain predictive of health literacy in a regression model. An interaction between education and English as a main language was significant.
  
  
  CONCLUSIONS
  The REALM-D is an effective instrument for use by medical and dental clinicians in detecting differences among people of different backgrounds and for whom English was not their primary language.
authors.affiliation: UCLA School of Dentistry, Box 951688, Room 63-025 CHS, Los Angeles, CA 90095-1668, USA. katchison@conet.ucla.edu
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Atchison
authors.forename: Melanie W
authors.initials: MW
authors.lastname: Gironda
authors.forename: Diana
authors.initials: D
authors.lastname: Messadi
authors.forename: Claudia
authors.initials: C
authors.lastname: Der-Martirosian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018864:Cultural Diversity; D003740:Dental Clinics; D005006:Ethnicity; D005260:Female; D006267:Health Education, Dental; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D007802:Language; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D055815:Young Adult