O ral H ealth L iteracy A ssessment: development of an oral health literacy instrument for S panish speakers

Objective To develop an oral health literacy instrument for S panish‐speaking adults, evaluate its psychometric properties, and determine its comparability to an E nglish version. Methods The O ral H ealth L iteracy A ssessment in S panish ( OHLA ‐ S ) and E nglish ( OHLA ‐ E ) are designed with a word recognition section and a comprehension section using the multiple‐choice format developed by an expert panel. Validation of OHLA ‐ S and OHLA ‐ E involved comparing the instrument with other health literacy instruments in a sample of 201 S panish‐speaking and 204 E nglish‐speaking subjects. Comparability between S panish and E nglish versions was assessed by testing for differential item functioning ( DIF ) using item response theory. Results We considered three OHLA ‐ S scoring systems. Based on validity and reliability comparisons, 24 items were retained in the OHLA ‐ S instrument. OHLA ‐ S was correlated with another health literacy instrument, S panish T est of F unctional H ealth L iteracy in A dults ( P  < 0.05). Significant correlations were also found between OHLA ‐ S and years of schooling, oral health knowledge, overall health, and an understanding of written health‐care materials ( P  < 0.05). OHLA ‐ S displayed satisfactory reliability with a Cronbach Alpha of 0.70‐0.80. DIF results suggested that OHLA ‐ S and OHLA ‐ E scores were not comparable at a given level of oral health literacy. Conclusions OHLA ‐ S has acceptable reliability and validity. OHLA ‐ S and OHLA ‐ E are two different measurement tools and should not be used to compare oral health literacy between E nglish‐ and S panish‐speaking populations.