Document Type

Thesis

Date of Degree

Fall 2015

Degree Name

MS (Master of Science)

Degree In

Dental Public Health

First Advisor

Michelle R. McQuistan

Abstract

Objectives: To determine oral health literacy levels among Hispanic adults living in Iowa, and assess the relationship between oral health literacy and dental utilization.

Methods: This cross-sectional study included a convenience sample of self-identifying Hispanic/Latino adults. Participants were recruited via mass email, word of mouth, and from faith-based organizations that provided church services in Spanish. Participants were recruited from urban and rural communities in Central and Eastern Iowa. Participants were asked to complete a questionnaire, in either English or Spanish, that contained questions pertaining to: oral health literacy, dental utilization, acculturation, language proficiency, demographic information, country of origin, number of years living in the United States, and preferences pertaining to the characteristics of their dental providers (e.g. importance of dentist to be able to speak Spanish). Oral health literacy was assessed using the Comprehensive Measure of Oral Health Knowledge (Macek and colleagues). Oral health knowledge levels were categorized as low (0-14) or high (15-23). Dental utilization was defined as visiting a dental provider within the past 12 months or more than 12 months ago. Bivariate analyses were conducted using the Chi-square test with oral health knowledge and dental utilization being the two main outcome variables. Multiple logistic regression models were created to identify the variables related to low oral health knowledge irregular dental utilization. Statistical significance was set as p<0.05. IRB approval was obtained prior to conducting the study.

Results: Three hundred thirty-eight participants completed the questionnaire. Sixty-seven percent of participants (n=228) completed the questionnaire in Spanish. The mean oral health knowledge score was 14 (low knowledge =51% vs. high knowledge = 49%). Thirty-five percent reported visiting the dentist <12 months ago. Bivariate analyses revealed that the following respondents were more likely to have low oral health knowledge (p<0.05): being older (i.e. 55-71 years of age), male, self-reporting low health literacy, having less than a high-school education, earning ≤$25,000, not having dental insurance, having low acculturation, being born outside of the United States, preferring a dental provider who speaks Spanish, perceiving one’s oral health to be fair/poor/or not knowing the status of one’s oral health, seeking dental care someplace other than a private dental office, and being more likely to seek care for a problem related visit rather than routine care. Having low oral health knowledge was statistically significantly associated visiting a dentist >12 months ago. Many other variables were also associated (p<;0.05) with infrequent dental utilization: low health literacy, being male, having <12th grade degree or a high school diploma, earning ≤$25,000, not having dental insurance, having low acculturation, reporting fewer years living in the United States, preferring a dental provider who speaks Spanish, perceiving one’s oral health to be fair/poor/or not knowing the status of one’s oral health, and seeking dental care someplace other than a private dental office. Final logistic regression analyses indicated that having less than a 12th grade education, lack of dental insurance, and a preference for receiving care from a Spanish speaking dental provider were associated with low oral health literacy. Furthermore, final logistic regression results predicting irregular dental utilization demonstrated that the following variables were statistically significant: being male, earning ≤$25,000 per year, not having dental insurance and having a history of tooth decay.

Conclusion: Dental utilization and oral health knowledge appear to be associated. Patients with low oral health literacy may be less likely to utilize dental care, thus decreasing the opportunity to increase dental knowledge. Dental teams should recognize which patients are more likely to have low oral health literacy and provide dental education in patients’ preferred language.

Public Abstract

The objectives of this study were to determine the oral health knowledge levels of Hispanic adults living in Iowa and whether oral health knowledge is associated with the use of dental care. A survey was conducted with 338 participants who were recruited via mass email, word of mouth, and from faith-based organizations that provided church services in Spanish. Oral health knowledge was assessed using the Comprehensive Measure of Oral Health Knowledge (Macek and colleagues) and was categorized as low (0-14) or high (15-23). Dental care was defined as visiting a dental provider ≤12 months or >12 months ago. Fifty-one percent of participants had low oral health knowledge. Thirty-five percent of participants reported visiting the dentist >12 months ago. Participants with low oral health literacy were more likely to have less than a 12th grade education, lack dental insurance, and prefer to receive care from a Spanish speaking dental provider. Participants who visited the dentist >12 months ago were more likely to be male, earn <$25,000 per year, lack dental insurance, and have a history of tooth decay. Additionally, participants with low oral health knowledge were more likely to visit the dentist > 12 months ago. Patients with low oral health literacy may be less likely to utilize dental care, thus decreasing the opportunity to increase dental knowledge. Dental teams should recognize which patients are more likely to have low oral health literacy and provide dental education in patients’ preferred language.

Keywords

publicabstract, dental public health, dentistry, health literacy, hispanic, oral health literacy, patient education

Pages

xi, 184 pages

Bibliography

Includes bibliographical references (pages 178-184).

Copyright

Copyright 2015 Daisy Patino

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