title: Brazilian immigrants' oral health literacy and participation in oral health care in Canada.
abstract: BACKGROUND
  Inadequate functional health literacy is a common problem in immigrant populations. The aim of this study was to investigate the association between oral (dental) health literacy (OHL) and participation in oral health care among Brazilian immigrants in Toronto, Ontario, Canada.
  
  
  METHODS
  The study used a cross-sectional design and a convenience sample of 101 Brazilian immigrants selected through the snowball sampling technique. Data were analyzed using descriptive statistics and logistic regression modeling.
  
  
  RESULTS
  Most of the sample had adequate OHL (83.1 %). Inadequate/marginal OHL was associated with not visiting a dentist in the preceding year (OR = 3.61; p = 0.04), not having a dentist as the primary source of dental information (OR = 5.55; p < 0.01), and not participating in shared dental treatment decision making (OR = 1.06; p = 0.05; OHL as a continuous variable) in multivariate logistic regressions controlling for covariates. A low average annual family income was associated with two indicators of poor participation in oral health care (i.e., not having visited a dentist in the previous year, and not having a dentist as regular source of dental information).
  
  
  CONCLUSIONS
  Limited OHL was linked to lower participation in the oral health care system and with barriers to using dental services among a sample of Brazilian immigrants. More effective knowledge transfer will be required to help specific groups of immigrants to better navigate the Canadian dental care system.
authors.affiliation: Oswaldo Cruz Foundation- FIOCRUZ, Young Talent Scientist Fellowship CAPES, Ceará, Brazil. paolagcal@gmail.com.|Department of Biological and Diagnostic Sciences, Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada. paolagcal@gmail.com.
authors.forename: Paola
authors.initials: P
authors.lastname: Calvasina
authors.affiliation: Department of Biological and Diagnostic Sciences, Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.
authors.forename: Herenia P
authors.initials: HP
authors.lastname: Lawrence
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
authors.forename: Laurie
authors.initials: L
authors.lastname: Hoffman-Goetz
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Cameron D
authors.initials: CD
authors.lastname: Norman
mesh_terms: D001938:Brazil; D002170:Canada; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D009909:Oral Health