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

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  • Divaris, Kimon
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
  • Lee, Jessica Y.
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
  • Baker, Diane
    • Affiliation: School of Dentistry, Department of Pediatric Dentistry
  • Vann, William
    • Affiliation: School of Dentistry, Department of Pediatric Dentistry
Abstract
  • 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.
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Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Kimon Divaris et al.; licensee BioMed Central Ltd.
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Journal title
  • Health and Quality of Life Outcomes
Journal volume
  • 9
Journal issue
  • 1
Page start
  • 108
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1477-7525
Bibliographic citation
  • Health and Quality of Life Outcomes. 2011 Dec 01;9(1):108
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • November 6, 2015

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