title: Assessing health literacy and oral health: preliminary results of a multi-site investigation.
abstract: To introduce a multi-site assessment of oral health literacy and to describe preliminary analyses of the relationships between health literacy and selected oral health outcomes within the context of a comprehensive conceptual model.
  
  
  
  Data for this analysis came from the Multi-Site Oral Health Literacy Research Study (MOHLRS), a federally funded investigation of health literacy and oral health. MOHLRS consisted of a broad survey, including several health literacy assessments, and measures of attitudes, knowledge, and other factors. The survey was administered to 922 initial care-seeking adult patients presenting to university-based dental clinics in California and Maryland. For this descriptive analysis, confidence filling out forms, word recognition, and reading comprehension comprised the health literacy assessments. Dental visits, oral health functioning, and dental self-efficacy were the outcomes.
  
  
  
  Overall, up to 21% of participants reported having difficulties with practical health literacy tasks. After controlling for sociodemographic confounders, no health literacy assessment was associated with dental visits or dental caries self-efficacy. However, confidence filling out forms and word recognition were each associated with oral health functioning and periodontal disease self-efficacy.
  
  
  
  Our analysis showed that dental school patients exhibit a range of health literacy abilities. It also revealed that the relationship between health literacy and oral health is not straightforward, depending on patient characteristics and the unique circumstances of the encounter. We anticipate future analyses of MOHLRS data will answer questions about the role that health literacy and various mediating factors play in explaining oral health disparities.
authors.affiliation: Department of Dental Public Health, School of Dentistry, University of Maryland, Baltimore, MD, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Macek
authors.affiliation: Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Atchison
authors.affiliation: Primary Care Coalition of Montgomery County, MD, USA.
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Watson
authors.affiliation: Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.
authors.forename: Jennifer
authors.identifier: 0000-0003-4493-8749
authors.initials: J
authors.lastname: Holtzman
authors.affiliation: Schaefer Center for Public Policy, University of Baltimore, Baltimore, MD, USA.
authors.forename: William
authors.initials: W
authors.lastname: Wells
authors.affiliation: School of Public Health, University of Maryland, College Park, MD, USA.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Braun
authors.affiliation: School of Public Health, University of Maryland, College Park, MD, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Aldoory
authors.affiliation: Section of Oral Medicine & Orofacial Pain, School of Dentistry, University of California, Los Angeles, CA, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Messadi
authors.affiliation: Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Gironda
authors.affiliation: Schaefer Center for Public Policy, University of Baltimore, Baltimore, MD, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Haynes
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Parker
authors.affiliation: Department of Dental Public Health, School of Dentistry, University of Maryland, Baltimore, MD, USA.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Dental Public Health, School of Dentistry, University of Maryland, Baltimore, MD, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Coller
authors.affiliation: Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Richards
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D008396:Maryland; D008875:Middle Aged; D009909:Oral Health; D011795:Surveys and Questionnaires
keywords: adults; attitudes; communication; dental care; health knowledge; health literacy; oral health; practice