title: Caregivers' oral health literacy and their young children's oral health-related quality-of-life.
abstract: OBJECTIVE
  To investigate the association of caregivers' oral health literacy (OHL) with their children's oral health related-quality of life (C-OHRQoL) and explore literacy as a modifier in the association between children's oral health status (COHS) and C-OHRQoL.
  
  
  METHODS
  This study relied upon data from structured interviews with 203 caregivers of children aged 3-5 from the Carolina Oral Health Literacy (COHL) Project. Data were collected for OHL using REALD-30, caregiver-reported COHS using the NHANES-item and C-OHRQoL using the Early Childhood Oral Health Impact Scale (ECOHIS). This study also measured oral health behaviors (OHBs) and socio-demographic characteristics and calculated overall/stratified summary estimates for OHL and C-OHRQoL. Spearman's rho and 95% confidence intervals (CI) were computed as measures of correlation of OHL and COHS with C-OHRQoL. To determine whether OHL modified the association between COHS and C-OHRQoL, this study compared literacy-specific summary and regression estimates.
  
  
  RESULTS
  Reported COHS was: excellent-50%, very good-28%, good-14%, fair-6%, poor-2%. The aggregate C-OHRQoL mean score was 2.0 (95% CI: 1.4, 2.6), and the mean OHL score 15.9 (95% CI: 15.2, 16.7). There was an inverse relationship between COHS and C-OHRQoL: ρ = -0.32 (95% CI: -0.45, -0.18). There was no important association between OHL and C-OHRQoL; however, deleterious OHBs were associated with worse C-OHRQoL. Literacy-specific linear and Poisson regression estimates of the association between COHS and C-OHRQoL departed from homogeneity (Wald χ(2) p < 0.2).
  
  
  CONCLUSIONS
  In this community-based sample of caregiver/child dyads, a strong correlation was found between OHS and C-OHRQoL. The association's magnitude and gradient were less pronounced among caregivers with low literacy.
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry, University of North Carolina-Chapel Hill, USA. divarisk@dentistry.unc.edu
authors.forename: Kimon
authors.initials: K
authors.lastname: Divaris
authors.forename: Jessica Yuna
authors.initials: JY
authors.lastname: Lee
authors.forename: Arnett Diane
authors.initials: AD
authors.lastname: Baker
authors.forename: William Felix
authors.initials: WF
authors.lastname: Vann
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D001294:Attitude to Health; D001628:Beverages; D001903:Bottle Feeding; D017028:Caregivers / Q000523:psychology; D002675:Child, Preschool; D015331:Cohort Studies; D019422:Dietary Sucrose / Q000008:administration & dosage; D004522:Educational Status; D005247:Feeding Behavior; D005638:Fruit; D015438:Health Behavior; D057220:Health Literacy; D006304:Health Status; D006801:Humans; D007198:Indians, North American; D008875:Middle Aged; D009657:North Carolina; D009909:Oral Health; D011788:Quality of Life; D044465:White People; D055815:Young Adult
chemical_list: D019422:Dietary Sucrose