Culture and Health Literacy in a Dental Clinic

描述（由申请人提供）：本研究旨在研究在复杂的医疗保健系统框架内文化和教育或知识对患者牙齿健康素养的影响。健康素养是卫生保健提供者在对患者进行一般评估时应该进行的社会审查中的四个信息领域之一。识字率低与健康状况较差、遵守复杂药物治疗方案的比例低、住院率高、过度使用紧急服务以及预防性保健服务使用不足有关。文化与卫生知识的普及有着联系，因为价值观和语言障碍影响着对卫生信息的理解和处理。教育系统的广义概念包括持续的成人教育和经验。卫生系统因素包括获得牙科保健的障碍以及保健就诊和服务的数量和类型。提出了三个具体目标：1）修订成人医学素养快速评估（REALM），纳入牙科术语（REALM-D），并确定其与知识，健康价值观和不同文化患者的患者特征之间的关联; 2）检查牙科健康素养水平的紧急/紧急就诊与预防/综合就诊数量的差异;以及3）在控制文化背景（年龄、性别、种族/民族、首选语言）后，检查具有不同牙科健康素养水平的患者在要求和接受的健康促进教育服务的范围中的差异。这项可行性研究的目标是双管齐下的：修改和扩大牙科健康素养的措施，并制定一个过程，前瞻性地利用电子病历（EPR）跟踪患者与牙科保健系统的互动和口腔健康服务的收购。

DESCRIPTION (provided by applicant): This research is designed to examine the influence on a patient's dental health literacy of culture and education or knowledge within the framework of a complex health care system. Health literacy is one of four information domains in a social review that health care providers should conduct in their general assessment of a patient. Low literacy is associated with poorer health status, low rates of compliance with complicated medication regimens, high hospitalization rates, overuse of emergency services, and under-use of preventive health services. Culture is linked to health literacy by the values and language barriers that shape the perception and processing of health information. A broad conceptualization of the education system includes ongoing adult education and experiences. Health system factors include barriers to access dental care and number and type of health care visits and services. Three specific aims are proposed: 1) Revise the Rapid Estimate of Adult Literacy in Medicine (REALM) to incorporate dental terminology (REALM-D) and determine its association with knowledge, health values, and patient characteristics among culturally diverse patients; 2) Examine differences in numbers of urgent / emergency visits versus preventive/comprehensive visits by dental health literacy levels; and 3) Examine differences in the range of health promotion education services requested and received among patients with varied dental health literacy levels after controlling for cultural background (age, sex, race/ethnicity, preferred language). The goal of this feasibility study is two-pronged: to modify and expand a measure of dental health literacy, and to develop a process for prospectively utilizing an electronic patient record (EPR) to track patient interaction with the dental health care system and acquisition of oral health services.