title: Oral health conceptual knowledge and its relationships with oral health outcomes: Findings from a Multi-site Health Literacy Study.
abstract: In 2010, a health literacy instrument designed to measure oral health conceptual knowledge was introduced. This developmental work was limited in that it included a relatively small and homogeneous study population and few oral health measures against which to test concurrent validity. The purpose of the present investigation is to expand upon the earlier work by utilizing a larger study sample and additional outcome variables.
  
  
  
  Data for this report came from the Multi-site Oral Health Literacy Research Study (MOHLRS), a large, cross-sectional survey conducted at two university-based dental clinics in the United States. MOHLRS included multiple assessments administered during face-to-face interviews. Conceptual knowledge was measured with the Comprehensive Measure of Oral Health Knowledge (CMOHK). Questions about self-efficacy, utilization, and dental beliefs and attitudes were also asked. Covariates included recruitment site, age, gender, race/ethnicity, education level, and languages spoken.
  
  
  
  Overall, 18% of 909 adult participants exhibited "low" conceptual knowledge. CMOHK scores were significantly associated with three health literacy instruments, the REALM, Short-test of functional health literacy in adults (TOFHLA), and confidence filling out forms. In both bivariate and multivariable analyses, CMOHK scores were also significantly associated with dental beliefs and attitudes and self-efficacy to prevent both dental caries and periodontal disease. CMOHK scores were not associated with utilization, measured either as having a dental visit or a dental cleaning in the last year.
  
  
  
  The present investigation provides additional support for the CMOHK's validity. Researchers are encouraged to incorporate oral health conceptual knowledge into their theoretical frameworks, especially as it relates to beliefs and self-efficacy.
authors.affiliation: University of Maryland School of Dentistry, Baltimore, MD, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Macek
authors.affiliation: University of California, Los Angeles, School of Dentistry, Los Angeles, CA, USA.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Atchison
authors.affiliation: University of Maryland School of Dentistry, Baltimore, MD, USA.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Chen
authors.affiliation: Schaefer Center for Public Policy, University of Baltimore, Baltimore, MD, USA.
authors.forename: William
authors.initials: W
authors.lastname: Wells
authors.affiliation: Schaefer Center for Public Policy, University of Baltimore, Baltimore, MD, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Haynes
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Parker
authors.affiliation: NYU-Langone Medical Center, Brooklyn, NY, USA.
authors.forename: Shurouk
authors.initials: S
authors.lastname: Azzo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009909:Oral Health / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: adult; dental care; health literacy; health services accessibility; oral health