Skip to main content
Top
Published in: BMC Oral Health 1/2018

Open Access 01-12-2018 | Research article

Associations of multidimensional health literacy with reported oral health promoting behaviour among Slovak adults: a cross-sectional study

Authors: Eva Cepova, Martina Cicvakova, Peter Kolarcik, Neda Markovska, Andrea Madarasova Geckova

Published in: BMC Oral Health | Issue 1/2018

Login to get access

Abstract

Background

Modification of health literacy (HL) is an important factor for improving and maintaining oral health. The aim of the study is to examine the association of HL with oral health-promoting behaviour (OHPB) and assess possible mediating effects of HL on the impact of socioeconomic status on OHPB.

Methods

A cross-sectional questionnaire survey on the Slovak general adult population (N = 360, mean age 39) was conducted in 2014 and 2015. The association of HL (9 domains of the Health Literacy Questionnaire) and OHPB was analysed using logistic regression models adjusted for gender, age and educational level. Testing the mediating effect of HL domains between education attainment and OHPB was performed using the Sobel test.

Results

Women and respondents with higher education reported better OHPB. Regular tooth-brushing is associated with better HL in five domains: Feeling understood and supported by healthcare provider, Having sufficient information to manage my health, Activelymanaging my health, Social support for health, Appraisal of health information (Odds ratios (ORs) from 1.64 to 2.33, p < 0.05). Using interdental tools is in association with better HL in two domains: Feeling understood and supported by a healthcare provider and Having sufficient information to manage my health (ORs 1.71 to 1.80, p < 0.05). Respondents who visited a dentist for prevention score higher in Social support for health (OR 1.79, p < 0.05). Using a tongue scraper and single brush and reporting gums bleeding is notstatistically significantly associated with HL. Mediation was confirmed between the effect of respondents’ education on using fluoride toothpaste – mediated respondent’s ability to find good health information. Frequency of tooth-brushing and using interdental hygiene aids were both mediated by patient’s sufficient information to manage health.

Conclusions

Our results indicate HL to be an important factor related to good oral health, and HL should be considered when planning oral health interventions.
Appendix
Available only for authorised users
Literature
1.
go back to reference Sorensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H. HLS-EU consortium health literacy: health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80.CrossRefPubMedPubMedCentral Sorensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H. HLS-EU consortium health literacy: health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80.CrossRefPubMedPubMedCentral
2.
go back to reference Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(Suppl 2):97–107.CrossRefPubMed Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(Suppl 2):97–107.CrossRefPubMed
3.
go back to reference Kojima A, Ekuni D, Mizutani S, Furuta M, Irie K, Azuma T, Tomofuji T, Iwasaki Y, Morita M. Relationships between self-rated oral health, subjective symptoms, oral health behavior and clinical conditions in Japanese university students: a cross-sectional survey at Okayama University. BMC Oral Health. 2013;13:62.CrossRefPubMedPubMedCentral Kojima A, Ekuni D, Mizutani S, Furuta M, Irie K, Azuma T, Tomofuji T, Iwasaki Y, Morita M. Relationships between self-rated oral health, subjective symptoms, oral health behavior and clinical conditions in Japanese university students: a cross-sectional survey at Okayama University. BMC Oral Health. 2013;13:62.CrossRefPubMedPubMedCentral
4.
go back to reference Nutbeam D. Health promotion glossary. Health Promot Int. 1998;13(Suppl 4):349–64.CrossRef Nutbeam D. Health promotion glossary. Health Promot Int. 1998;13(Suppl 4):349–64.CrossRef
5.
go back to reference Nielsen-Bohlman L, Panzer A, Kindig D. Health literacy: a prescription to end confusion. Washington, DC: National Academic Press; 2004. Nielsen-Bohlman L, Panzer A, Kindig D. Health literacy: a prescription to end confusion. Washington, DC: National Academic Press; 2004.
6.
go back to reference Baker DW, Wolf MS, Feinglass J, Thompson JA, Gazmararian JA, Huang J. Health literacy and mortality among elderly persons. Arch Intern Med. 2007;167(Suppl 14):1503–9.CrossRefPubMed Baker DW, Wolf MS, Feinglass J, Thompson JA, Gazmararian JA, Huang J. Health literacy and mortality among elderly persons. Arch Intern Med. 2007;167(Suppl 14):1503–9.CrossRefPubMed
7.
go back to reference Ratzan S. Health literacy: communication for the public good. Health Promot Internation. 2001;16(Suppl 2):207–14.CrossRef Ratzan S. Health literacy: communication for the public good. Health Promot Internation. 2001;16(Suppl 2):207–14.CrossRef
8.
go back to reference Hongal S, Torwane NA, Goel P, Chandrashekar BR, Jain M, Saxena E. Assessing the oral health literacy: a review. Int J Med Public Health. 2013;3(Suppl 4):219–24. Hongal S, Torwane NA, Goel P, Chandrashekar BR, Jain M, Saxena E. Assessing the oral health literacy: a review. Int J Med Public Health. 2013;3(Suppl 4):219–24.
9.
go back to reference Blizniuk A, Ueno M, Furukawa S, Kawaguchi Y. Evaluation of a Russian version of the oral health literacy instrument (OHLI). BMC Oral Health. 2014;14:141.CrossRefPubMedPubMedCentral Blizniuk A, Ueno M, Furukawa S, Kawaguchi Y. Evaluation of a Russian version of the oral health literacy instrument (OHLI). BMC Oral Health. 2014;14:141.CrossRefPubMedPubMedCentral
10.
go back to reference Osborne RH, Batterham RW, Elsworth GR, Hawkins M, Buchbinder R. The grounded psychometric development and initial validation of the health literacy questionnaire (HLQ). BMC Public Health. 2013;13(Suppl 1):1–17.CrossRef Osborne RH, Batterham RW, Elsworth GR, Hawkins M, Buchbinder R. The grounded psychometric development and initial validation of the health literacy questionnaire (HLQ). BMC Public Health. 2013;13(Suppl 1):1–17.CrossRef
11.
go back to reference Dickson-Swift V, Kenny A, Farmer J, Gussy M, Larkins S. Measuring oral health literacy: a scoping review of existing tools. BMC Oral Health. 2014;14(1):148.CrossRefPubMedPubMedCentral Dickson-Swift V, Kenny A, Farmer J, Gussy M, Larkins S. Measuring oral health literacy: a scoping review of existing tools. BMC Oral Health. 2014;14(1):148.CrossRefPubMedPubMedCentral
12.
go back to reference Friis K, Lasgaard M, Osborne RH, Maindal HT. Gaps in understanding health and engagement with healthcare providers across common long-term conditions: a population survey of health literacy in 29 473 Danish citizens. BMJ Open. 2016;6:1.CrossRef Friis K, Lasgaard M, Osborne RH, Maindal HT. Gaps in understanding health and engagement with healthcare providers across common long-term conditions: a population survey of health literacy in 29 473 Danish citizens. BMJ Open. 2016;6:1.CrossRef
13.
go back to reference Paasche-Orlow MK, Parker RM. Improving the effectiveness of patient education: a Focus on limited health literacy. In: Talmadge E.King, Margaret B.Wheeler, editors. Medical Management of Vulnerable and Underserved Patients: Principles, Practice, and Populations. New York: McGraw Hill. 2007:101–9. Paasche-Orlow MK, Parker RM. Improving the effectiveness of patient education: a Focus on limited health literacy. In: Talmadge E.King, Margaret B.Wheeler, editors. Medical Management of Vulnerable and Underserved Patients: Principles, Practice, and Populations. New York: McGraw Hill. 2007:101–9.
14.
go back to reference Horowitz AM, Kleinman DV. Oral health literacy: a pathway to reducing oral health disparities in Maryland. J Publ Health Dent. 2012;72(Suppl 1):26–30.CrossRef Horowitz AM, Kleinman DV. Oral health literacy: a pathway to reducing oral health disparities in Maryland. J Publ Health Dent. 2012;72(Suppl 1):26–30.CrossRef
17.
go back to reference Masoe AV, Blinkhorn AS, Taylor J, Blinkhorn FA. Preventive management plans recorded by dental therapists and oral health therapists using clinical vignettes for adolescents accessing public oral health services in New South Wales, Australia. Aust Dent J. 2016;61(Suppl 1):21–8.CrossRef Masoe AV, Blinkhorn AS, Taylor J, Blinkhorn FA. Preventive management plans recorded by dental therapists and oral health therapists using clinical vignettes for adolescents accessing public oral health services in New South Wales, Australia. Aust Dent J. 2016;61(Suppl 1):21–8.CrossRef
18.
go back to reference Jin L, Lamster I, Mossey P, Naidoo S,Varenne B, Warnakulasuriya S, Zero D. The Challenge of Oral Disease – A call for global action. In: The Oral Health Atlas. 2nd ed. Brighton: World Dental Federation; 2015. p. 13–15. Jin L, Lamster I, Mossey P, Naidoo S,Varenne B, Warnakulasuriya S, Zero D. The Challenge of Oral Disease – A call for global action. In: The Oral Health Atlas. 2nd ed. Brighton: World Dental Federation; 2015. p. 13–15.
19.
go back to reference Longauerova A, Boledovicova M. Efficiacy of educational preventive programmes in context of dental health of children at early school age. Prevence úrazů, otrav a násilí. 2012; 8(1):75–84. Longauerova A, Boledovicova M. Efficiacy of educational preventive programmes in context of dental health of children at early school age. Prevence úrazů, otrav a násilí. 2012; 8(1):75–84.
20.
go back to reference Horowitz AM. Implications of health literacy for public health: workshop summary:health literacy facilitates public health efforts. Oral Health. Washington, DC: The National Academies Press; 2014. p. 63–6. Horowitz AM. Implications of health literacy for public health: workshop summary:health literacy facilitates public health efforts. Oral Health. Washington, DC: The National Academies Press; 2014. p. 63–6.
22.
go back to reference Kolarcik P, Cepova E, Madarasova Geckova A, Elsworth GR, Batterham RW, Osborne RH. Structural properties and psychometric improvements of the health literacy questionnaire in a Slovak population. Int J Public Health. 2017;62(5):591–604. Kolarcik P, Cepova E, Madarasova Geckova A, Elsworth GR, Batterham RW, Osborne RH. Structural properties and psychometric improvements of the health literacy questionnaire in a Slovak population. Int J Public Health. 2017;62(5):591–604.
23.
go back to reference Bo A, Friis K, Osborne RH, Maindal HT. National indicators of health literacy: ability to understand health information and to engage actively with healthcare providers - a population-based survey among Danish adults. BMC Public Health. 2014;14:1095.CrossRefPubMedPubMedCentral Bo A, Friis K, Osborne RH, Maindal HT. National indicators of health literacy: ability to understand health information and to engage actively with healthcare providers - a population-based survey among Danish adults. BMC Public Health. 2014;14:1095.CrossRefPubMedPubMedCentral
24.
go back to reference National Health Information Center. Zubnolekárska starostlivosť v SR 2013. Štatistické prehľady 6/2014. Bratislava: National Health Information Center; 2014. National Health Information Center. Zubnolekárska starostlivosť v SR 2013. Štatistické prehľady 6/2014. Bratislava: National Health Information Center; 2014.
25.
go back to reference Tseveenjav B, Suominen AL, Vehkalahti MM. Oral health-related behaviours among dentate adults in Finland: findings from the Finnish health 2000 survey. Eur J Oral Sci. 2012;120(1):54–60.CrossRefPubMed Tseveenjav B, Suominen AL, Vehkalahti MM. Oral health-related behaviours among dentate adults in Finland: findings from the Finnish health 2000 survey. Eur J Oral Sci. 2012;120(1):54–60.CrossRefPubMed
26.
go back to reference Sanders A, Spencer A, Stewart J. Clustering of risk behaviours for oral and general health. Community Dent Health. 2005;22(3):133–40.PubMed Sanders A, Spencer A, Stewart J. Clustering of risk behaviours for oral and general health. Community Dent Health. 2005;22(3):133–40.PubMed
27.
go back to reference Prattala R, Karisto A, Berg M. Consistency and variation in unhealthy behavior among Finnish men, 1982-1990. Soc Sci Med. 1994;39(1):115–22.CrossRefPubMed Prattala R, Karisto A, Berg M. Consistency and variation in unhealthy behavior among Finnish men, 1982-1990. Soc Sci Med. 1994;39(1):115–22.CrossRefPubMed
28.
go back to reference Artnik B, Premik M, Zaletel-Kragelj L. Population groups at high risk for poor oral self care: the basis for oral health promotion. Int J Public Health. 2008;53(4):195–203.CrossRefPubMed Artnik B, Premik M, Zaletel-Kragelj L. Population groups at high risk for poor oral self care: the basis for oral health promotion. Int J Public Health. 2008;53(4):195–203.CrossRefPubMed
29.
go back to reference Guo Y, Logan HL, Dodd VJ, Muller KE, Marks JG, Riley IIIJL. Health literacy: a pathway to better oral health. Am J Public Health. 2014;104(Suppl 7):e85–91.CrossRefPubMedPubMedCentral Guo Y, Logan HL, Dodd VJ, Muller KE, Marks JG, Riley IIIJL. Health literacy: a pathway to better oral health. Am J Public Health. 2014;104(Suppl 7):e85–91.CrossRefPubMedPubMedCentral
30.
go back to reference Soundarya Chowdary M, Sudhir KM, ChandraSekhara RV, KRVS K, Srinivasulu G. Oral health literacy and its impact on oral health status among institutionalised elderly population. J Dent Med Sci. 2015;14(Suppl 8):96–104. Soundarya Chowdary M, Sudhir KM, ChandraSekhara RV, KRVS K, Srinivasulu G. Oral health literacy and its impact on oral health status among institutionalised elderly population. J Dent Med Sci. 2015;14(Suppl 8):96–104.
31.
go back to reference Lee JY, Divaris K, Baker AD, Rozier RG, Lee S-D, Vann Jr WF. Oral health literacy levels among a low-income WIC population. J Publ Health Dent. 2011;71(Suppl 2):152–60.CrossRef Lee JY, Divaris K, Baker AD, Rozier RG, Lee S-D, Vann Jr WF. Oral health literacy levels among a low-income WIC population. J Publ Health Dent. 2011;71(Suppl 2):152–60.CrossRef
32.
go back to reference Devaraj C, Eswar P. Reasons for use and non-use of dental services among people visiting a dental college hospital in India: a descriptive cross-sectional study. Eur J Dent. 2012;6(Suppl 4):422–7.PubMedPubMedCentral Devaraj C, Eswar P. Reasons for use and non-use of dental services among people visiting a dental college hospital in India: a descriptive cross-sectional study. Eur J Dent. 2012;6(Suppl 4):422–7.PubMedPubMedCentral
34.
go back to reference D’Cruz AM, Shankar Aradhya MR. Health literacy among Indian adults seeking dental care. Dent Res J. 2013;10(Suppl 1):20–4. D’Cruz AM, Shankar Aradhya MR. Health literacy among Indian adults seeking dental care. Dent Res J. 2013;10(Suppl 1):20–4.
35.
go back to reference 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;67:94–8.CrossRefPubMed 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;67:94–8.CrossRefPubMed
36.
go back to reference Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, Crouch MA. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993;25:391–5.PubMed Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, Crouch MA. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993;25:391–5.PubMed
37.
go back to reference Parker R, Baker D, Williams M, Nurss J. The test of functional health literacy in adults - a new instrument for measuring patients literacy skills. J Gen Intern Med. 1995;10(10):537–41.CrossRefPubMed Parker R, Baker D, Williams M, Nurss J. The test of functional health literacy in adults - a new instrument for measuring patients literacy skills. J Gen Intern Med. 1995;10(10):537–41.CrossRefPubMed
38.
go back to reference Richman JA, Lee JY, Rozier RG, Gong DA, Pahel BT, Vann WF. Evaluation of a word recognition instrument to test health literacy in dentistry: the REALD-99. J Public Health Dent. 2007;67:99–104.CrossRefPubMed Richman JA, Lee JY, Rozier RG, Gong DA, Pahel BT, Vann WF. Evaluation of a word recognition instrument to test health literacy in dentistry: the REALD-99. J Public Health Dent. 2007;67:99–104.CrossRefPubMed
39.
go back to reference Baur C, Comings J, Evans C, Garcia R, Horowitz A, Ismail A, Kenyon D, Kirsch I, Kleinman D, Rudd R, Strucker J, Taylor G, White K. The invisible barrier: literacy and its relationship with oral health. J Public Health Dent. 2005;65:174–82.CrossRef Baur C, Comings J, Evans C, Garcia R, Horowitz A, Ismail A, Kenyon D, Kirsch I, Kleinman D, Rudd R, Strucker J, Taylor G, White K. The invisible barrier: literacy and its relationship with oral health. J Public Health Dent. 2005;65:174–82.CrossRef
40.
go back to reference Jones K, Parker E, Mills H, Brennan D, Jamieson LM. Development and psychometric validation of a health literacy in dentistry scale (HeLD). Community Dent Health. 2014;31(1):37–43.PubMed Jones K, Parker E, Mills H, Brennan D, Jamieson LM. Development and psychometric validation of a health literacy in dentistry scale (HeLD). Community Dent Health. 2014;31(1):37–43.PubMed
41.
go back to reference Batterham RW, Buchbinder R, Beauchamp A, Dodson S, Elsworth GR, Osborne RH. The OPtimising HEalth LIterAcy (Ophelia) process: study protocol for using health literacy profiling and community engagement to create and implement health reform. BMC Public Health. 2014;14:694.CrossRefPubMedPubMedCentral Batterham RW, Buchbinder R, Beauchamp A, Dodson S, Elsworth GR, Osborne RH. The OPtimising HEalth LIterAcy (Ophelia) process: study protocol for using health literacy profiling and community engagement to create and implement health reform. BMC Public Health. 2014;14:694.CrossRefPubMedPubMedCentral
Metadata
Title
Associations of multidimensional health literacy with reported oral health promoting behaviour among Slovak adults: a cross-sectional study
Authors
Eva Cepova
Martina Cicvakova
Peter Kolarcik
Neda Markovska
Andrea Madarasova Geckova
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2018
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-018-0506-6

Other articles of this Issue 1/2018

BMC Oral Health 1/2018 Go to the issue