{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:05:51Z","timestamp":1789578351391,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Comm Dent Oral Epid"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oral health literacy (OHL) plays a critical role in shaping individuals' engagement with oral health systems and their ability to translate information into effective self\u2010care and service use. While the Health Literacy in Dentistry (HeLD\u201014) scale has demonstrated strong psychometric performance, brief and psychometrically robust instruments explicitly optimized for large\u2010scale surveillance remain limited. This study sought to develop a concise HeLD version that preserves sensitivity to low OHL while remaining operationally feasible for large\u2010scale monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional psychometric study was conducted among 600 adults aged 18\u201365\u2009years from diverse sociodemographic backgrounds. A sequential, theory\u2010informed analytic approach was applied, encompassing Item Response Theory (graded response model), principal axis factoring (PAF) using polychoric correlations, and confirmatory factor analysis (CFA). Items were prioritized based on discrimination and location parameters to enhance sensitivity at the lower end of the latent OHL continuum, while structural coherence and shared variance guided further refinement. The shortened versions were recalibrated using \u03b8 estimation and their classification concordance compared with that of the original HeLD\u201014.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>IRT\u2010based evaluation reduced the item pool from 14 to 8 (HeLD\u20108), retaining items with strong discrimination and threshold locations informative at the lower end of the oral health literacy continuum. Principal axis factoring using polychoric correlations confirmed that all eight retained items exceeded the pre\u2010specified communality threshold, supporting a coherent unidimensional structure; HeLD\u20108 was therefore retained in full as the final candidate instrument. Confirmatory factor analysis in two independent split\u2010half samples supported this unidimensional structure, with acceptable\u2010to\u2010good fit indices. HeLD\u20108 showed strong concordance with the full HeLD\u201014 in identifying individuals with low OHL (sensitivity 92.1%, specificity 93.5%), while reducing respondent burden by more than 40% relative to the parent instrument.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A brief oral health literacy screener, HeLD\u20108, was developed and psychometrically validated to support identification of low OHL within population\u2010based surveillance contexts. By preserving representation across most of the original instrument's conceptual domains while substantially reducing respondent burden, HeLD\u20108 may facilitate integration of OHL assessment into large\u2010scale oral health surveillance systems; further validation in independent and more diverse samples is recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cdoe.70115","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:00:19Z","timestamp":1789578019000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Psychometric Validation of a Brief Oral Health Literacy Instrument for Use in Population\u2010Based Surveillance"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5284-4032","authenticated-orcid":false,"given":"Viswa Chaitanya","family":"Chandu","sequence":"first","affiliation":[{"name":"Department of Public Health Dentistry Government Dental College and Hospital  Vijayawada Andhra Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5518-1935","authenticated-orcid":false,"given":"Manu Raj","family":"Mathur","sequence":"additional","affiliation":[{"name":"Centre for Dental Public Health and Primary Care Queen Mary University of London  London UK"},{"name":"Public Health Foundation of India  Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1480-6438","authenticated-orcid":false,"given":"Yamuna","family":"Marella","sequence":"additional","affiliation":[{"name":"Department of Periodontology Sibar Institute of Dental Sciences  Takkelapadu Andhra Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2069-3652","authenticated-orcid":false,"given":"Vikramsimha","family":"Bommireddy","sequence":"additional","affiliation":[{"name":"Department of Public Health Dentistry Sibar Institute of Dental Sciences  Takkelapadu Andhra Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7134-9779","authenticated-orcid":false,"given":"Pooja","family":"Grandhi","sequence":"additional","affiliation":[{"name":"Department of Public Health Dentistry Government Dental College and Hospital  Vijayawada Andhra Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"issue":"10194","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/S0140-6736(19)31133-X","article-title":"Ending the Neglect of Global Oral Health: Time for Radical Action","volume":"394","author":"Watt R. 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G.","year":"2023","journal-title":"International Dental Journal"},{"issue":"1","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1186\/s12903-025-06472-7","article-title":"Oral Health Literacy From a Person\u2010Centered Focus in the United States: A Narrative Review","volume":"25","author":"Schroeder K. 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A.","year":"2025","journal-title":"Journal of International Society of Preventive and Community Dentistry"},{"issue":"3","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1922\/CDH_4325Ju08","article-title":"Confirmatory Factor Analysis of the Health Literacy in Dentistry Scale (HeLD) in the Australian Population","volume":"35","author":"Chrisopoulos S.","year":"2018","journal-title":"Community Dental Health"},{"issue":"1","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12903-024-04303-9","article-title":"Validation of an Arabic Version of the Short Form of the Health Literacy in Dentistry Scale: A Cross\u2010Sectional Study","volume":"24","author":"Alzeer M. 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