Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Ann Behav Med. 2021 Oct 27;55(11):1144-1155. doi: 10.1093/abm/kaab006.
Health literacy (HL) is the "ability to find, understand, evaluate and put information to use to improve decision making and, ultimately, improve health and quality of life." Parents with limited HL are less likely to follow recommended parental oral health behaviors.
We tested a theoretical framework designed to clarify mechanisms through which HL may influence parental oral health behavior. The framework proposed that HL: (a) has a direct effect on parental oral health knowledge, beliefs (i.e. self-efficacy; perceived susceptibility, severity, benefits, barriers), and behavior; (b) influences beliefs indirectly through knowledge; and (c) influences behavior indirectly through knowledge and beliefs.
We analyzed cross-sectional data from a randomized controlled trial designed to reduce dental decay in American Indian children (N = 521). Parents completed survey questions assessing sociodemographic characteristics, HL, and parental oral health knowledge, beliefs, and behavior. Path analysis was used to test the framework.
HL exerted significant direct effects on knowledge and beliefs but not behavior. HL had significant indirect effects on all beliefs through knowledge. Significant indirect effects of HL on behavior occurred through self-efficacy (estimate: 0.99, 95% CI: 0.42, 1.83, p = .005), perceived barriers (estimate: 0.73, 95% CI: 0.29, 1.43, p = .010), knowledge to self-efficacy (estimate: 0.57, 95% CI: .31, 0.98, p = .001), and knowledge to perceived barriers (estimate: 0.24, 95% CI: 0.09, 0.47, p = .012).
HL exerted an indirect effect on parental oral health behavior, with knowledge, self-efficacy, and perceived barriers being the primary constructs linking HL to behavior.
健康素养（HL）是“查找、理解、评估和利用信息以改善决策，最终改善健康和生活质量的能力”。健康素养有限的父母不太可能遵循推荐的父母口腔健康行为。
我们测试了一个理论框架，旨在阐明 HL 可能影响父母口腔健康行为的机制。该框架提出 HL：（a）对父母的口腔健康知识、信念（即自我效能感；感知易感性、严重性、益处、障碍）和行为有直接影响；（b）通过知识间接影响信念；（c）通过知识和信念间接影响行为。
我们分析了一项旨在减少美国印第安儿童龋齿的随机对照试验的横断面数据（N=521）。父母完成了调查问题，评估了社会人口特征、HL 和父母的口腔健康知识、信念和行为。路径分析用于检验该框架。
HL 对知识和信念有显著的直接影响，但对行为没有显著影响。HL 通过知识对所有信念都有显著的间接影响。HL 通过自我效能感（估计值：0.99，95%CI：0.42，1.83，p=0.005）、感知障碍（估计值：0.73，95%CI：0.29，1.43，p=0.010）、知识到自我效能感（估计值：0.57，95%CI：0.31，0.98，p=0.001）和知识到感知障碍（估计值：0.24，95%CI：0.09，0.47，p=0.012）对行为产生了显著的间接影响。
HL 对父母的口腔健康行为有间接影响，知识、自我效能感和感知障碍是 HL 与行为联系的主要结构。
