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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2011

Open Access 01-12-2011 | Research

The relationship of oral health literacy with oral health-related quality of life in a multi-racial sample of low-income female caregivers

Authors: Kimon Divaris, Jessica Y Lee, A Diane Baker, William F Vann Jr

Published in: Health and Quality of Life Outcomes | Issue 1/2011

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Abstract

Background

To investigate the association between oral health literacy (OHL) and oral health-related quality of life (OHRQoL) and explore the racial differences therein among a low-income community-based group of female WIC participants.

Methods

Participants (N = 1,405) enrolled in the Carolina Oral Health Literacy (COHL) study completed the short form of the Oral Health Impact Profile Index (OHIP-14, a measure of OHRQoL) and REALD-30 (a word recognition literacy test). Socio-demographic and self-reported dental attendance data were collected via structured interviews. Severity (cumulative OHIP-14 score) and extent of impact (number of items reported fairly/very often) scores were calculated as measures of OHRQoL. OHL was assessed by the cumulative REALD-30 score. The association of OHL with OHRQoL was examined using descriptive and visual methods, and was quantified using Spearman's rho and zero-inflated negative binomial modeling.

Results

The study group included a substantial number of African Americans (AA = 41%) and American Indians (AI = 20%). The sample majority had a high school education or less and a mean age of 26.6 years. One-third of the participants reported at least one oral health impact. The OHIP-14 mean severity and extent scores were 10.6 [95% confidence limits (CL) = 10.0, 11.2] and 1.35 (95% CL = 1.21, 1.50), respectively. OHL scores were distributed normally with mean (standard deviation, SD) REALD-30 of 15.8 (5.3). OHL was weakly associated with OHRQoL: prevalence rho = -0.14 (95% CL = -0.20, -0.08); extent rho = -0.14 (95% CL = -0.19, -0.09); severity rho = -0.10 (95% CL = -0.16, -0.05). "Low" OHL (defined as < 13 REALD-30 score) was associated with worse OHRQoL, with increases in the prevalence of OHIP-14 impacts ranging from 11% for severity to 34% for extent. The inverse association of OHL with OHIP-14 impacts persisted in multivariate analysis: Problem Rate Ratio (PRR) = 0.91 (95% CL = 0.86, 0.98) for one SD change in OHL. Stratification by race revealed effect-measure modification: Whites--PRR = 1.01 (95% CL = 0.91, 1.11); AA--PRR = 0.86 (95% CL = 0.77, 0.96).

Conclusions

Although the inverse association between OHL and OHRQoL across the entire sample was weak, subjects in the "low" OHL group reported significantly more OHRQoL impacts versus those with higher literacy. Our findings indicate that the association between OHL and OHRQoL may be modified by race.
Appendix
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Literature
1.
Lee IC, Shieh TY, Yang YH, Tsai CC, Wang KH: Individuals' perception of oral health and its impact on the health-related quality of life. J Oral Rehabil 2007, 34: 79–87. 10.1111/j.1365-2842.2006.01694.xPubMedCrossRef
2.
3.
Gift HC, Atchison KA: Oral health, health, and health-related quality of life. Med Care 1995,33(11 Suppl):NS57–77.PubMed
4.
Locker D: Measuring oral health: a conceptual framework. Community Dent Health 1988, 5: 3–18.PubMed
5.
Wilson IB, Cleary PD: Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA 1995, 273: 59–65. 10.1001/jama.1995.03520250075037PubMedCrossRef
6.
Brennan DS, Spencer AJ: Mapping oral health related quality of life to generic health state values. BMC Health Serv Res 2006, 6: 96. 10.1186/1472-6963-6-96PubMedCentralPubMedCrossRef
7.
8.
Montero J, Bravo M, Vicente MP, Galindo MP, López JF, Albaladejo A: Dimensional structure of the oral health-related quality of life in healthy Spanish workers. Health Qual Life Outcomes 2010, 8: 24. 10.1186/1477-7525-8-24PubMedCentralPubMedCrossRef
9.
John MT: Exploring dimensions of oral health-related quality of life using experts' opinions. Qual Life Res 2007, 16: 697–704. 10.1007/s11136-006-9150-8PubMedCrossRef
10.
Sanders AE, Slade GD, Lim S, Reisine ST: Impact of oral disease on quality of life in the US and Australian populations. Community Dent Oral Epidemiol 2009, 37: 171–81. 10.1111/j.1600-0528.2008.00457.xPubMedCentralPubMedCrossRef
11.
Slade GD, Nuttall N, Sanders AE, Steele JG, Allen PF, Lahti S: Impacts of oral disorders in the United Kingdom and Australia. Br Dent J 2005, 198: 489–493. 10.1038/sj.bdj.4812252PubMedCrossRef
12.
Protheroe J, Wallace LS, Rowlands G, DeVoe JE: Health literacy: setting an international collaborative research agenda. BMC Fam Pract 2009, 10: 51. 10.1186/1471-2296-10-51PubMedCentralPubMedCrossRef
13.
Nutbeam D: The evolving concept of health literacy. Soc Sci Med 2008, 67: 2072–2078. 10.1016/j.socscimed.2008.09.050PubMedCrossRef
14.
Dewalt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP: Literacy and health outcomes: a systematic review of the literature. J Gen Intern Med 2004, 19: 1228–1239. 10.1111/j.1525-1497.2004.40153.xPubMedCentralPubMedCrossRef
15.
Andrus MR, Roth MT: Health literacy: a review. Pharmacotherapy 2002, 22: 282–302. 10.1592/phco.22.5.282.33191PubMedCrossRef
16.
17.
Wallace LS, Rogers ES, Weiss BD: Relationship between health literacy and health-related quality of life among Tennesseans. Tenn Med 2008, 101: 35–39.PubMed
18.
19.
Patrick DL, Lee RS, Nucci M, Grembowski D, Jolles CZ, Milgrom P: Reducing oral health disparities: a focus on social and cultural determinants. BMC Oral Health 2006,6(Suppl 1):S4. 10.1186/1472-6831-6-S1-S4PubMedCentralPubMedCrossRef
20.
National Institute of Dental and Craniofacial Research, National Institute of Health, U.S. Public Health Service, Department of Health and Human Services: The invisible barrier: literacy and its relationship with oral health. A report of a workgroup sponsored by the National Institute of Dental and Craniofacial Research, National Institute of Health, U.S. Public Health Service, Department of Health and Human Services. J Public Health Dent 2005, 65: 174–182.CrossRef
21.
Horowitz AM, Kleinman DV: Oral health literacy: the new imperative to better oral health. Dent Clin North Am 2008, 52: 333–344. 10.1016/j.cden.2007.12.001PubMedCrossRef
22.
Jones M, Lee JY, Rozier RG: Oral health literacy among adult patients seeking dental care. J Am Dent Assoc 2007, 138: 1199–1208.PubMedCrossRef
23.
Lee JY, Rozier RG, Lee SY, Bender D, Ruiz RE: Development of a word recognition instrument to test health literacy in dentistry: the REALD-30 -- a brief communication. J Public Health Dent 2007, 67: 94–98. 10.1111/j.1752-7325.2007.00021.xPubMedCrossRef
24.
Lee JY, Divaris K, Baker D, Rozier RG, Vann WF Jr: The Relationship of Oral Health Literacy with Oral Health Status and Dental Neglect. Am J Public Health 2011, e1-e7.
25.
Sabbahi DA, Lawrence HP, Limeback H, Rootman I: Development and evaluation of an oral health literacy instrument for adults. Community Dent Oral Epidemiol 2009, 37: 451–462. 10.1111/j.1600-0528.2009.00490.xPubMedCrossRef
26.
Parker EJ, Jamieson LM: Associations between Indigenous Australian oral health literacy and self-reported oral health outcomes. BMC Oral Health 2010, 10: 3. 10.1186/1472-6831-10-3PubMedCentralPubMedCrossRef
27.
Divaris K, Lee JY, Baker AD, Vann WF Jr: Caregivers' oral health literacy and their young children's oral health related quality of life. Acta Odont Scand, in press.
28.
Gong DA, Lee JY, Rozier RG, Pahel BT, Richman JA, Vann WF Jr: Development and testing of the Test of Functional Health Literacy in Dentistry (TOFHLiD). J Public Health Dent 2007, 67: 105–112. 10.1111/j.1752-7325.2007.00023.xPubMedCrossRef
29.
Richman JA, Lee JY, Rozier RG, Gong DA, Pahel BT, Vann WF Jr: Evaluation of a word recognition instrument to test health literacy in dentistry: the REALD-99. J Public Health Dent 2007, 67: 99–104. 10.1111/j.1752-7325.2007.00022.xPubMedCrossRef
30.
Lee JY, Divaris K, Baker D, Rozier RG, Lee SY, Vann WF Jr: Oral health literacy levels among a low-income WIC population. J Public Health Dent 2011, 71: 152–160. 10.1111/j.1752-7325.2011.00244.xPubMedCrossRef
31.
Kalton G: Models in the practice of survey sampling. International Statistical Review 1983, 51: 175–188. 10.2307/1402747CrossRef
32.
Slade GD: Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol 1997, 25: 284–290. 10.1111/j.1600-0528.1997.tb00941.xPubMedCrossRef
33.
Locker D, Allen F: What do measures of 'oral health-related quality of life' measure? Community Dent Oral Epidemiol 2007, 35: 401–411. 10.1111/j.1600-0528.2007.00418.xPubMedCrossRef
34.
Vann WF Jr, Lee JY, Baker D, Divaris K: Oral health literacy among female caregivers: impact on oral health outcomes in early childhood. J Dent Res 2010, 89: 1395–1400. 10.1177/0022034510379601PubMedCentralPubMedCrossRef
35.
Fan J, Gijbels I: Local Polynomial Modelling and its Applications. London: Chapman & Hall; 1996:14–22.
36.
Cleveland WS: Robust locally weighted regression and smoothing scatterplots. Journal of the American Statistical Association 1979, 74: 829–836. 10.2307/2286407CrossRef
37.
Lee AH, Wang K, Scott JA, Yau KK, McLachlan GJ: Multi-level zero-inflated poisson regression modelling of correlated count data with excess zeros. Stat Methods Med Res 2006, 15: 47–61. 10.1191/0962280206sm429oaPubMedCrossRef
38.
Lewsey JD, Thomson WM: The utility of the zero-inflated poisson and zero-inflated negative binomial models: a case study of cross-sectional and longitudinal DMF data examining the effect of socio-economic status. Community Dent Oral Epidemiol 2004, 32: 183–189. 10.1111/j.1600-0528.2004.00155.xPubMedCrossRef
39.
Vuong QH: Likelihood Ratio Tests for Model Selection and Non-Nested Hypotheses. Econometrica 1989, 57: 307–333. 10.2307/1912557CrossRef
40.
John MT, Slade GD, Szentpétery A, Setz JM: Oral health-related quality of life in patients treated with fixed, removable, and complete dentures 1 month and 6 to 12 months after treatment. Int J Prosthodont 2004, 17: 503–511.PubMed
41.
42.
Greenland S, Rothman KJ: Introduction to stratified analysis. In Modern epidemiology. Edited by: Rothman KJ, Greenland S, Lash TL. New York: Lippincott, Williams and Wilkins; 2008:258–282.
43.
Sanders AE, Slade GD, John MT, Steele JG, Suominen-Taipale AL, Lahti S, Nuttall NM, Allen PF: A cross-national comparison of income gradients in oral health quality of life in four welfare states: application of the Korpi and Palme typology. J Epidemiol Community Health 2009, 63: 569–574. 10.1136/jech.2008.083238PubMedCentralPubMedCrossRef
44.
Sanders AE, Slade GD, Turrell G, John Spencer A, Marcenes W: The shape of the socioeconomic-oral health gradient: implications for theoretical explanations. Community Dent Oral Epidemiol 2006, 34: 310–319. 10.1111/j.1600-0528.2006.00286.xPubMedCrossRef
45.
Miller E, Lee JY, DeWalt DA, Vann WF Jr: Impact of caregiver literacy on children's oral health outcomes. Pediatrics 2010, 126: 107–114. 10.1542/peds.2009-2887PubMedCentralPubMedCrossRef
46.
Simon MA, Dong X, Nonzee N, Bennett CL: Heeding our words: complexities of research among low-literacy populations. J Clin Oncol 2009, 27: 1938–1940. 10.1200/JCO.2008.20.8231PubMedCrossRef
47.
Macek MD, Haynes D, Wells W, Bauer-Leffler S, Cotten PA, Parker RM: Measuring conceptual health knowledge in the context of oral health literacy: preliminary results. J Public Health Dent 2010, 70: 197–204. 10.1111/j.1752-7325.2010.00165.xPubMedCentralPubMedCrossRef
48.
Hyde S, Satariano WA, Weintraub JA: Welfare dental intervention improves employment and quality of life. J Dent Res 2006, 85: 79–84. 10.1177/154405910608500114PubMedCentralPubMedCrossRef
49.
Gilbert GH: Racial and socioeconomic disparities in health from population-based research to practice-based research: the example of oral health. J Dent Educ 2005, 69: 1003–1014.PubMed
50.
Manly JJ: Deconstructing race and ethnicity: implications for measurement of health outcomes. Med Care 2006,44(11 Suppl 3):S10–6.PubMedCrossRef
51.
Lawrence HP, Thomson WM, Broadbent JM, Poulton R: Oral health-related quality of life in a birth cohort of 32-year olds. Community Dent Oral Epidemiol 2008, 36: 305–316. 10.1111/j.1600-0528.2007.00395.xPubMedCentralPubMedCrossRef
52.
Stucky BD, Lee JY, Lee SY, Rozier RG: Development of the Two-Stage Rapid Estimate of Adult Literacy in Dentistry. Community Dent Oral Epidemiol 2011, in press.
Metadata
Title
The relationship of oral health literacy with oral health-related quality of life in a multi-racial sample of low-income female caregivers
Authors
Kimon Divaris
Jessica Y Lee
A Diane Baker
William F Vann Jr
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2011
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-9-108

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