{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T18:05:44Z","timestamp":1780682744481,"version":"3.54.1"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to develop and validate the Knowledge Related to Oral Health Literacy Spanish (KROHL- S) instrument to assess oral health knowledge among Spanish-speaking adults in the United States, a population facing significant oral health disparities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted at NYU College of Dentistry. A convenience sample of 175 self-identified Spanish-speaking adults (70% female, mean age 49. 79 years) completed the orally administered KROHL- S questionnaire. Participants, mainly born outside the US (91. 9%), also completed the Comprehensive Measure of Oral Health Knowledge (CMOHK) and a single-item literacy screening tool in Spanish (SILS). Psychometric properties of the KROHL- S, including internal consistency (Cronbach\u2019s alpha), discriminant validity (correlation with CMOHK), and known-group validity (comparison across education levels), were evaluated. Confirmatory factor analysis was used to test the original factor structure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean KROHL- S score was 8.34 (SD\u2009=\u20095.82), indicating a low level of oral health knowledge in the sample. Internal consistency for the overall KROHL- S was good (Cronbach\u2019s alpha\u2009=\u20090.75), and interrater agreement was high. A moderate positive correlation was found between KROHL- S and CMOHK scores (r\u2009=\u20090.49, p\u2009&lt;\u2009.0001). Participants with higher education levels showed significantly greater oral health knowledge on the KROHL- S. Confirmatory factor analysis suggested an average fit to the data (RMSEA\u2009=\u20090.064, CFI\u2009=\u20090.86, TLI\u2009=\u20090.83).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The KROHL- S could be used to assess oral health knowledge among Spanish-speaking adults and incorporates cultural and linguistic aspects, making it suitable for a wider range of individuals. KROHL-S offers a valuable tool for healthcare providers by not only helping identify individuals\u2019 knowledge gaps to guide customized educational interventions but also helping enhance patient-provider communications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0350384","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T17:47:46Z","timestamp":1780681666000},"page":"e0350384","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Breaking barriers: Validation of a Spanish oral health knowledge tool to enhance patient-provider communication"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7113-7499","authenticated-orcid":true,"given":"Silvia","family":"Spivakovsky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce","family":"Figueroa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan Richard","family":"Ruff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"pone.0350384.ref001","unstructured":"United States Census Bureau. 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