Development of the two-stage rapid estimate of adult literacy in dentistry

Community Dent Oral Epidemiol. 2011 Oct;39(5):474-80. doi: 10.1111/j.1600-0528.2011.00619.x. Epub 2011 May 18.

Abstract

Objective: This work proposes a revision of the 30 item Rapid Estimate of Adult Literacy in Dentistry (REALD-30), into a more efficient and easier-to-use two-stage scale.

Methods: Using a sample of 1405 individuals (primarily women) enrolled in a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), the present work utilizes principles of item response theory and multi-stage testing to revise the REALD-30 into a two-stage test of oral health literacy, named Two-Stage REALD or TS-REALD, which maximizes score precision at various levels of participant ability.

Results: Based on the participant's score on the five-item first-stage (i.e., routing test), one of three potential stage-two tests is administered: a four-item Low Literacy test, a six-item Average Literacy test, or a three-item High Literacy test.

Conclusions: The reliability of scores for the TS-REALD is >0.85 for a wide range of ability. The TS-REALD was found to be predictive of perceived impact of oral conditions on well-being, after controlling for educational level, overall health, dental health, and a general health literacy measure. While containing approximately one-third of the items on the original scale, the TS-REALD was found to maintain similar psychometric qualities.

Publication types

  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Adult
  • Calibration
  • Educational Measurement
  • Educational Status
  • Female
  • Health Education, Dental*
  • Health Literacy*
  • Humans
  • Male
  • North Carolina
  • Psychometrics
  • Quality of Life
  • Reproducibility of Results
  • Software
  • Surveys and Questionnaires