Development and Validation of an Instrument to Assess Oral Health Literacy among Adults-seeking Dental Care in Pune, India

Abstract

Context: Oral health literacy (OHL) has emerged as an important dimension of oral health care with the potential to have multiple applications in a health-care setting. Most of the tools that measure were developed out of India. Aim: Since OHL is a contextually sensitive construct, this study developed and validated a tool to measure OHL among adults in India. Material and Methods: A questionnaire covering all three domains of OHL was framed in two languages using the “dual development approach.” After content validation, the 20-item questionnaire was subjected to test-retest, pretest, and pilot test. It was then administered to 200 adults in a dental college and five private clinics. Socio-demographics, Decayed, Missing, Filled Permanent Teeth (DMFT) and Oral Hygiene Index– Simplified (OHI-S) were recorded to establish the construct and predictor validity of the tool. Results: The results showed that the overall reliability of the questionnaire was high, with Cronbach’s alpha of 0.81. The mean OHL score was 15.4, with a minimum score of 2 and a maximum of 20. A statistically significant correlation was found between socioeconomic status and OHL as an indicator of convergent validity (r = 0.62). The discriminant validity of the questionnaire was assessed by comparing OHL levels with education levels using the Kruskal–Wallis test, and statistically significant results were derived. Significant associations (P < 0.001) between DMFT and OHL; and OHI-S and OHL were found with an adjusted odds ratio of 3.01 and 4.78, respectively, establishing its predictive validity. Conclusions: Hence the validity and reliability of this tool were established through this research, opening avenues for further research.