title: Development and psychometric validation of a Health Literacy in Dentistry scale (HeLD).
abstract: BACKGROUND
  Oral health literacy is emerging as a new public health challenge and poor oral health literacy is increasingly seen as an important predictor of poor oral health outcomes. Within Indigenous populations, there may be benefits to research in using a culturally acceptable, internally consistent and valid instrument to assess oral health literacy. We translated a general health literacy measure, the Health Literacy Management (HeLM) scale to make a dentally relevant scale; Health Literacy in Dentistry (HeLD).
  
  
  OBJECTIVE
  This study describes the development and assessment of the reliability and validity of the HeLD in an Indigenous Australian population.
  
  
  METHODS
  The 29 item HeLD scale assesses the components of oral health literacy. The reliability and validity of the seven HeLD subscales were evaluated in a convenience sample of 209 Indigenous Australians with mean age 35 years (range 17-81) and of which 139 were female.
  
  
  RESULTS
  The scale was supported by exploratory factor analysis and established seven distinct and internally consistent domains of oral health literacy: Communication, Access, Receptivity, Understanding, Utilisation, Support and Economic Barriers (Cronbach's alpha = 0.91). Discriminative ability was confirmed by HeLD associations with socio-demographic variables and self-reported health ratings in the expected direction. The convergent validity and predictive validity were confirmed by HeLD scores being significantly associated with toothbrush ownership, use of a toothbrush, time since last dental visit and knowledge of the effect of cordial on the teeth.
  
  
  CONCLUSIONS
  The HeLD appears to be an internally valid and reliable instrument and can be used for measuring oral health literacy among rural Indigenous Australian adults.
authors.forename: K
authors.initials: K
authors.lastname: Jones
authors.forename: E
authors.initials: E
authors.lastname: Parker
authors.forename: H
authors.initials: H
authors.lastname: Mills
authors.forename: D
authors.initials: D
authors.lastname: Brennan
authors.forename: L M
authors.initials: LM
authors.lastname: Jamieson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001628:Beverages / Q000009:adverse effects; D003142:Communication; D032882:Comprehension; D003729:Dental Care / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012423:Rural Health; D012944:Social Support; D013021:South Australia; D014099:Toothbrushing / Q000295:instrumentation; D055815:Young Adult