Development of a Word Recognition Instrument to Test Health Literacy in Dentistry: the REALD-30--a Brief Communication

Objective: This study aims to develop and pilot test a dental word recognition instrument.

Methods: The development of our instrument was based on the Rapid Estimate of Adult Literacy in Medicine (REALM), an efficient word recognition instrument used to assess health literacy in the medical arena. Our instrument, Rapid Estimate of Adult Literacy in Dentistry (REALD-30), consisted of 30 common dental words with various degrees of difficulty. It was administered to 202 English-speaking adults recruited from outpatient medical clinics. We examined the instrument's internal reliability using Cronbach's alpha and its validity by correlating the REALD-30 score to two dental outcomes (perceived dental health status and oral health-related quality of life) and medical health literacy.

Results: REALD-30 scores were significantly correlated with REALM scores. REALD-30 was significantly related to perceived dental health status in the bivariate analysis. It also was significantly related to oral health-related quality of life in a multivariate analysis. In contrast, medical health literacy was not related to either of the dental outcome measures.

Conclusions: The new REALD-30 instrument displays good reliability but only partial validity. Results suggest that dental health literacy may be distinct from medical health literacy and may have an independent effect on dental health outcomes.