Firmino Ramon Targino, Fraiz Fabian Calixto, Montes Gisele Ristow, Paiva Saul Martins, Granville-Garcia Ana Flávia, Ferreira Fernanda Morais
Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil.
Community Dent Oral Epidemiol. 2018 Dec;46(6):624-630. doi: 10.1111/cdoe.12415. Epub 2018 Aug 24.
To investigate whether oral health literacy (OHL) impacts missing data obtained through self-reporting in oral health epidemiological research.
A cross-sectional study was conducted with parents (n = 344) of 4- to 5-year-old children randomly selected from public schools within the city of Curitiba, Brazil. Parental OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Parents answered a set of questionnaires comprising 88 items concerning sociodemographic and economic data, children's access to dental services, oral hygiene behaviour, diet and mealtime behaviour. The total number of unanswered items (TUI) and the number of unanswered items in each type of question (open-ended, dichotomous, multiple choice with up to 4 options and with 5-9 options) for each participant was compared across different levels of OHL (chi-squared, Mann-Whitney, Kruskal-Wallis and Spearman's correlation test). Multiple Poisson regression was used to estimate rate ratios (RR) of TUI between OHL scores and their respective 95% confidence interval (95% CI).
Approximately one-third of studied parents (37%) exhibited low OHL (BREALD-30 ≤ 21). The prevalence of missing data in at least one item was 85.5%. Low OHL was associated with failing to respond open-ended items (P = 0.003) and multiple-choice items with up to 4 (P = 0.003) and between 5 and 9 options (P = 0.030). There was a negative correlation between OHL scores and TUI (r = -0.195; P < 0.001), as well as with the number of unanswered items in all types of questions (P < 0.01), except dichotomous questions. Parents with lower OHL were more likely to show higher values of TUI (RR 0.95: 0.93-0.98), when adjusted by income and education.
Participants with lower OHL were significantly more likely to fail to complete research questionnaires. The impact of OHL on missing data was greater with more complex types of items.
调查口腔健康素养（OHL）是否会影响口腔健康流行病学研究中通过自我报告获得的缺失数据。
对从巴西库里蒂巴市公立学校随机抽取的4至5岁儿童的家长（n = 344）进行了一项横断面研究。使用巴西版的牙科成人识字率快速评估（BREALD - 30）来测量家长的OHL。家长回答了一组包含88个项目的问卷，内容涉及社会人口统计学和经济数据、儿童获得牙科服务的情况、口腔卫生行为、饮食和用餐行为。比较了不同OHL水平下（卡方检验、曼 - 惠特尼检验、克鲁斯卡尔 - 沃利斯检验和斯皮尔曼相关性检验）每个参与者未回答项目的总数（TUI）以及每种类型问题（开放式、二分法、最多4个选项的多项选择题和5 - 9个选项的多项选择题）中未回答项目的数量。使用多元泊松回归来估计OHL得分与TUI之间的率比（RR）及其各自的95%置信区间（95%CI）。
约三分之一的受试家长（37%）表现出低OHL（BREALD - 30≤21）。至少有一项数据缺失的发生率为85.5%。低OHL与未回答开放式项目（P = 0.003）以及最多4个选项（P = 0.003）和5至9个选项的多项选择题（P = 0.030）有关。OHL得分与TUI之间存在负相关（r = -0.195；P < 0.001），并且与除二分法问题外的所有类型问题中未回答项目的数量也存在负相关（P < 0.01）。在根据收入和教育程度进行调整后，OHL较低的家长更有可能表现出较高的TUI值（RR 0.95：0.93 - 0.98）。
OHL较低的参与者更有可能无法完成研究问卷。OHL对缺失数据的影响在更复杂类型的项目中更大。
