Validation of oral health literacy instrument in Nepali language: a tool to assess oral health literacy of Nepalese population

Abstract Background Oral health literacy is the capacity of processing and understanding basic oral health information. Instruments are available for its measurement in English and other languages. But no validated tool is available in Nepali language that could be used to assess oral health literacy level of Nepalese population. The objective of this study was to translate and validate the Nepalese version of Oral Health Literacy Instrument (OHLI-N) from the original English version. Methods The English version of OHLI along with oral health knowledge test was translated into Nepali language. The translated version was reviewed and pretested on conveniently selected 30 participants. A cross-sectional study was conducted among conveniently selected 160 adult patients of 18 years and above visiting dental OPD of a tertiary care center for testing validity and reliability of OHLI-N. Oral examination was done to record DMFT and CPI scores. Concurrent validity, construct validity and predictive validity of OHLI-N was determined. Internal consistency of OHLI-N was evaluated using Cronbach’s alpha (α). OHLI-N was readministered in 25 patients after 2 weeks to assess test-retest reliability using intra-class correlation coefficient (ICC). Results The mean overall OHLI-N score of the participants was 65.9 ± 17.6. OHLI-N scores were significantly associated with educational level of participants ( p < 0.001). A significant positive correlation (r s =0.72) was observed between OHLI-N and oral health knowledge test. Moderate and statistically significant negative correlation was seen between OHLI-N and oral outcomes including DMFT score (r s = -0.49), number of untreated caries (r s = -0.48), number of teeth with bleeding on probing (r s = -0.71) and number of teeth with periodontal pocket (r s = -0.49). OHLI-N showed high internal consistency (α = 0.92) and test-retest reliability (ICC = 0.99). Conclusion The OHLI-N showed good validity and reliability for assessing the oral health literacy level of adult patients visiting a tertiary care center of Nepal.