Development, judgment of the validity and reliability of an instrument of assessment of Oral Health Literacy among diabetics

MARTINS, Andréa Maria Eleutério de Barros Lima; AMORIM, Mônica Maria Teixeira; CARVALHO, Bianca Oliveira de; PINTO, Rodrigo Alves; FRÓES, Danielle Tayrine Celestina; SANTOS, Aline Soares Figueiredo

doi:10.1590/1981-86372020000393588

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Original • Rev Gaúch. Odontol. 68 • 2020 • https://doi.org/10.1590/1981-86372020000393588 copy

Development, judgment of the validity and reliability of an instrument of assessment of Oral Health Literacy among diabetics

Desenvolvimento, julgamento da validade e confiabilidade de um instrumento de avaliação da Alfabetização em Saúde Bucal entre diabéticos

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

The study purposed to perform content validation and verification of the reliability of an instrument in the form of a questionnaire, called “ Oral Health Literacy for Diabetics “. It was designed to investigate whether there was access, understanding, appraise and practice of information related to oral health among diabetics.

Methods

This is a methodological research that was carried out through the application of the Oral Health Literacy for Diabetics between 109 diabetic patients, since at least 60 participants should be considered in studies using test/retest. The research complied with the ethical principles of research. The content validation was performed by dentists, acknowledging the relevance and the ability to measure the levels of literacy of each item of the Oral Health Literacy for Diabetics. The reliability/reproducibility was estimated by the test/retest in an interval of seven to fifteen days by Kappa, using the SPSS^®.

Results

The results showed that the content of the Oral Health Literacy for Diabetics presented relevance and ability to measure the levels of literacy in oral health among diabetics. The results of the Kappa ranged from -0.09 to 1. Only 16 of the 150 questions did not have satisfactory levels of agreement, i.e., Kappa smaller or equal to 0.60. We chose to synthesize the Oral Health Literacy for Diabetics initially with 150 questions, for a version with 30 questions.

Conclusion

It is concluded that the Oral Health Literacy for Diabetics was considered valid with respect to the content and that a general form its reliability was satisfactory. It is recommended to use the Oral Health Literacy for Diabetics in academia and in health services aiming to improve the quality of life of diabetic patients.

Indexing terms
Data accuracy; Diabetes mellitus; Oral health; Reproducibility of results

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[1] Correspondence to: AMEB Lima. E-mail: martins.andreamebl@gmail.com.

1. Have you received any information about oral health?						1
2. When was the last time you received oral health information?						0,755
3. How often do you receive information about oral health?						0,823
4. Did you understand the information you have already received about oral health?						0,717
5. Can you appraise whether the information you have already received about oral health is true or false?						0,827
6. Can you rank in more or less important the information you have already received about oral health?						0,805
7. Can you identify the information quality you have already received about quality oral health?						0,726
8. Can you appraise the advantages and disadvantages of different dental treatments considering the information you have already received about oral health?						0,730
9. Do you put into practice in your daily life the information you have received about Oral Health?						0,798
10. Do you maintain a proper behavior, considering the information you have received on Oral Health?						0,714
From which health professional(s) have you received information about oral health?
	Yes/No	Last time	Understanding	Appraisal	Practice
Doctor	0,901	0,780	0,470	1	0,669
Nurse/Crew	0,955	0,821	-0,176	0,615	0,528
Dentist/Dental Team	0,957	0,828	0,805	0,772	0,773
Community Health Agent	0,901	0,899	-0,090	0,555	0,647
Other? Who?	0,970	0,823	0,727	0,823	0,666
What issues were considered when you received information about oral health?
	Yes/No	Last Time	Understanding	Appraisal	Practice
Caries	0,980	0,689	0,823	0,753	0,787
Dental Canal treatment	0,960	0,626	0,786	0,834	0,771
Gingival problems / Gingival bleeding	0,970	0,771	0,774	0,797	0,772
Bone loss around teeth / Dental mobility	0,980	0,746	0,416	0,538	0,508
Dental trauma	0,950	0,746	0,863	1	0,400
Bruxism / clenching	0,960	0,576	0,750	0,777	0,708
Oral cancer	0,950	0,722	0,777	0,882	0,760
Dental prosthesis	0,960	0,782	0,742	0,739	0,623
Dental implants	0,970	0,768	0,739	0,733	0,884
Orthodontic treatment	0,930	0,832	0,502	0,729	0,785
Other?	0,980	1	1	1	0,499
Have you read information about oral health in printed or electronic materials?
	Yes/No	Last Time	Understanding	Appraisal	Practice
Dental recipes	0,930	0,627	0,850	0,907	0,945
Package leaflets for medicinal products / Oral Rinse and / or Toothpaste Labels	0,930	0,723	0,521	0,488	0,672
Pre-and / or post-dental care guidelines	0,910	0,762	0,793	0,878	0,757
Poster	0,960	0,798	0,681	0,777	0,683
Reviews	0,920	0,829	0,865	0,625	0,766
Newspapers	0,970	0,869	0,624	0,625	0,857
Flyer / Folder / Booklet	0,924	0,853	0,485	0,504	0,808
Internet	0,960	0,750	0,646	0,778	0,729
Other?	0,980
Have you ever watched and/or heard about oral health information in print or electronic materials?
	Yes/No	Last Time	Understanding	Appraisal	Practice
Educational video	0,910	0,660	0,710	0,710	0,799
Television	0,901	0,755	0,820	0,813	0,903
Radio	0,950	0,781	1	1	0,877
Internet	0,960	1	1	1	0,400
Lecture	0,950	0,818	0,817	0,798	0,810
Movie / cinema	0,940	0,684	0,744	0,912	0,823
Other, which?	0,980	1	1	1	1

1. Have you received any information about oral health?		1	0 No 1 Yes
2. When was the last time you received oral health information?		2	0 Never received information 1More than 2 years ago 2In the last two years 3In the last year	4 In the last 6 months 5In the last month 99No answer/ did not know
3. How often do you receive information about oral health?		3	0 Never received information 1Interval bigger than 2 years 2from 2 to 2 years 3Once each year	4 Once in the last 6 months 5Once in the last month 99No answer/ did not know
4. Did you understand the information you have already received about oral health?		4	0 Never received information 1Did not understand 2Understood poorly 3Understood partially	4 Understood almost everything 5Understood everything 99No answer/ did not know
5. Can you appraise whether the information you have already received about oral health is true or false?		5	0 Never received information 1Unable 2Able with major difficulty 3Able with some difficulty	4 Able with minor difficulty 5Easily able 99No answer/ did not know
6. Can you rank in more or less important the information you have already received about oral health?		6	0 Never received information 1Unable 2Able with major difficulty 3Able with some difficulty	4 Able with minor difficulty 5Easily able 99No answer/ did not know
7. Can you identify the information quality you have already received about quality oral health?		7	0 Never received information 1Unable 2Able with major difficulty 3Able with some difficulty	4 Able with minor difficulty 5Easily able 99No answer/ did not know
8. Can you appraise the advantages and disadvantages of different dental treatments considering the information you have already received about oral health?		8	0 Never received information 1Unable 2Able with major difficulty 3Able with some difficulty	4 Able with minor difficulty 5Easily able 99No answer/Did not know
9. Do you put into practice in your daily life the information you have received about Oral Health?		9	0 Never received information 1Never 2Seldom 3Sometimes	4 Frequently 5Always 99No answer/ did not know
10. Do you maintain a proper behavior, considering the information you have received on Oral Health?		10	0 Never received information 1Never 2Seldom 3Sometimes	4 Frequently 5Always 99No answer/ did not know
11. From which health professional(s) have you received information about oral health?	12. When was the last time you received information about oral health from this\these professional(s)?	13. Did you understand the information you received about oral health from the(se) professional(s)?	14. Can you appraise the quality of the information you received about oral health from the(se) professional(s)?	15. Do you put into practice the information you received about oral health from the(se) professional(s)?
0 Doctor 0 Nurse/Crew 0 Dental Surgeon(s)/Team 0 Community Health Agent 0 Other? Who? _______________________	0 Never received information 1Interval bigger than 2 years 2In the last 2 years 3In the last year 4In the last 6 months 5In the last month 98 Not applicable 99No answer/ did not know	0 Never received information 1Did not understand 2Understood poorly 3Understood partially 4Understood almost everything 5Understood everything 98 Not applicable 99No answer/Did not know	0 Never received information 1Unable 2Able with major difficulty 3Able with some difficulty 4Able with minor difficulty 5Easily able 98 Not applicable 99No answer/Did not know	0 Never received information 1Never 2Seldom 3Sometimes 4Frequently 5Always 98 Not applicable 99No answer/Did not know
16. What issues were considered when you received information about oral health?	17. When was the last time you received information about oral health from this\these issues?	18. Did you understand the information you received about oral health from the(se) issues?	19. Can you appraise the quality of the information you received about oral health from the(se) issues?	20. Do you put into practice the information you received about oral health from the(se) issues?
0 Caries 0 Dental Canal treatment 0 Gingival problems / Gingival bleeding 0 Bone loss around teeth / Dental mobility 0 Oral Hygiene 0 Dental trauma 0 Bruxism / clenching 0 Oral cancer 0 Dental prosthesis 0 Dental implants 0 Orthodontic treatment 0 Other, which? _______________________	0 Never received information 1Interval bigger than 2 years 2In the last 2 years 3In the last year 4In the last 6 months 5In the last month 98 Not applicable 99No answer/Did not know	0 Never received information 1Did not understand 2Understood poorly 3Understood partially 4Understood almost everything 5Understood everything 98 Not applicable 99No answer/Did not know	0 Never received information 1Unable 2Able with major difficulty 3Able with some difficulty 4Able with minor difficulty 5Easily able 98 Not applicable 99No answer/Did not know	0 Never received information 1Never 2Seldom 3Sometimes 4Frequently 5Always 98 Not applicable 99No answer/Did not know
21. Have you read information about oral health in printed or electronic materials?	22. When was the last time you read information about oral health in print or electronic materials?	23. Did you understand the information about oral health you read from those printed or electronic materials?	24. Can you appraise the quality of oral health information from those printed or electronic materials?	25. Do you put oral health information from printed or electronic materials into practice?
0 Dental recipes 0 Package leaflets for medicinal products / Oral Rinse and / or Toothpaste Labels 0 Pre-and / or post-dental care guidelines 0 Poster 0 Reviews 0 Newspapers 0 Billboard 0 Flyer / Folder / Booklet 0 Internet 0 Other, which? ______________________	0 Never received information 1Interval bigger than 2 years 2In the last 2 years 3In the last year 4In the last 6 months 5In the last month 98 Not applicable 99No answer/Did not know	0 Never received information 1Did not understand 2Understood poorly 3Understood partially 4Understood almost everything 5Understood everything 98 Not applicable 99No answer/Did not know	0 Never received information 1Unable 2Able with major difficulty 3Able with some difficulty 4Able with minor difficulty 5Easily able 98 Not applicable 99No answer/Did not know	0 Never received information 1Never 2Seldom 3Sometimes 4Frequently 5Always 98 Not applicable 99No answer/Did not know
26. Have you ever watched and/or heard about oral health information in print or electronic materials?	27. What was the last time you watched and/or heard oral health information in print or electronic materials?	28. Did you understand the information you watched and/or heard about oral health from those printed or electronic materials?	29. Can you appraise the quality of the information about oral health you watched and/or heard from those printed or electronic materials?	30. Do you put oral health information you watched and/or heard from printed or electronic materials into practice?
0 Educational video 0 Television 0 Radio 0 Internet 0 Lecture 0 Movie / cinema 0 Other, which? _______________________	0 Never received information 1Interval bigger than 2 years 2In the last 2 years 3In the last year 4In the last 6 months 5In the last month 98 Not applicable 99No answer/Did not know	0 Never received information 1Did not understand 2Understood poorly 3Understood partially 4Understood almost everything 5Understood everything 98 Not applicable 99No answer/Did not know	0 Never received information 1Unable 2Able with major difficulty 3Able with some difficulty 4Able with minor difficulty 5Easily able 98 Not applicable 99No answer/Did not know	0 Never received information 1Never 2Seldom 3Sometimes 4Frequently 5Always 98 Not applicable 99No answer/Did not know