A cross sectional study examining social desirability bias in caregiver reporting of children’s oral health behaviors

BMC Oral Health

William F Vann Jr¹  A Diane Baker¹  Darren A DeWalt²  Kimon Divaris¹  Jessica Y Lee¹  Lauren A Sanzone¹ 

[1] Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, 228 Brauer Hall, Chapel Hill, NC, USA;Division of General Internal Medicine, School of Medicine, University of North Carolina, 5041 Old Clinic Building, CB#7110 Chapel Hill, NC, USA

关键词: Social desirability bias;    REALD-30;    Oral health behaviors;    Oral health literacy;    Health literacy;    Oral hygiene;    Oral health;    Caregivers children;   

Others  :  1126092
DOI  :  10.1186/1472-6831-13-24

 received in 2013-01-15, accepted in 2013-05-17,  发布年份 2013

【 摘 要 】

Background

Our previous research (Pediatrics 2010:126) found a strong association between caregiver oral health literacy (OHL) and children’s oral health status; however, we found a weak association with oral health behaviors (OHBs). We hypothesize that this may be due to social desirability bias (SDB). Our objectives were to compare caregivers’ responses to traditional OHB items and newer SDB-modulating items, and to examine the association of caregiver literacy with OHBs.

Methods

We performed a cross-sectional study of 102 caregiver-child dyads, collecting data for OHBs using both traditional and new SDB-modulating items. We measured OHL using REALD-30, a validated word recognition test. We relied upon percent agreement and Cohen’s kappa (k) to quantify the concordance in caregivers’ responses and multivariate log-binomial regression to estimate the impact of OHL on OHBs.

Results

Caregivers’ mean REALD-30 score was 20.7 (SD = 6.0), range 1-30. We found an association between OHL and 4 of 8 OHBs examined. A subset of behavior questions compared traditional versus SDB-modulating items: history of bottle-feeding: agreement = 95%, k = 0.83 (95% CL:0.68,0.99); daily tooth brushing: agreement = 78%, k = 0.25 (95% CL:0.04,0.46); fluoridated toothpaste use: agreement = 88%, k = 0.67 (95% CL:0.49,0.85). After controlling for caregivers’ race, marital status and study site, higher literacy scores remained associated with a decreased prevalence of parental report of “decided not brush the child’s teeth because it would be frustrating”.

Conclusions

Agreement between responses was high for 2 of 3 behavior items. Item 3 (tooth brushing frequency) revealed discordance, likely due to SDB. Use of the SDB-modulating items appears to yield a better estimate of OHB.

【 授权许可】

   
2013 Sanzone et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]National Institute of Dental and Craniofacial Research, National Institute of Health, U.S. Public Health Service, Department of Health and Human Services: The invisible barrier: literacy and its relationship with oral health. A report of a workgroup sponsored by the national institute of dental and craniofacial research, national institute of health, U.S. Public health service, department of health and human services. J Public Health Dent 2005, 65(3):174-182.
• [2]Doak C, Doak L, Root J: Teaching patients with low literacy skills. 2nd edition. Philadelphia: JB Lippincott; 1996.
• [3]Seligman HK, Wallace AS, DeWalt DA: Developing low-literacy patient educational materials to facilitate behavior change. Am J Health Behav 2007, 31(Suppl):S69-S78.
• [4]DeWalt DA, Hink A: Health literacy and child health outcomes: a systematic review of the literature. Pediatrics 2009, 124(Suppl 3):S265-S274.
• [5]Sanders LM, Thompson VT, Wilkinson JD: Caregiver health literacy and the use of child health services. Pediatrics 2007, 119(1):e86-e92.
• [6]Zarcadoolas C, Pleasant A, Greer DS: Understanding health literacy: an expanded model. Health Promot Int 2005, 20(2):195-203.
• [7]Davis TC, Frederickson DD, Potter L, Brouillette R, Bocchini AC, Williams MV, Parker RM: Patient understanding and use of oral contraceptive pills in a southern public health family planning clinic. South Med J 2006, 99(7):713-718.
• [8]DeWalt DA, Dilling MH, Rosenthal MS, Pignone MP: Low parental literacy is associated with worse asthma care measures in children. Ambul Pediatr 2007, 7(1):25-31.
• [9]Kripalani S, Henderson LE, Chiu EY, Robertson R, Kolm P, Jacobson TA: Predictors of medication self-management skill in a low-literacy population. J Gen Intern Med 2006, 21(8):852-856.
• [10]Lee JY, Divaris K, Baker AD, Rozier RG, Lee SY, Vann WF Jr: Oral health literacy levels among a low-income WIC population. J Public Health Dent 2011, 71(2):152-160.
• [11]Miller E, Lee JY, DeWalt DA, Vann WF Jr: Impact of caregiver literacy on children’s oral health outcomes. Pediatrics 2010, 126(1):107-114.
• [12]Vann WF Jr, Lee JY, Baker D, Divaris K: Oral health literacy among female caregivers: Impact on oral health outcomes in early childhood. J Dent Res 2010, 89(12):1395-1400.
• [13]Bender BG, Bartlett SJ, Rand CS, Turner C, Wamboldt FS, Zhang L: Impact of interview mode on accuracy of child and parent report of adherence with asthma-controller medication. Pediatrics 2007, 120(3):e471-e477.
• [14]Phillips DI, Clancy KJ: Some effects of ‘social desirability’ in survey studies. Amer J Sociol 1972, 77(5):921-940.
• [15]King MF, Bruner GC: Social desirability bias: a neglected aspect of validity testing. Psychol Market 2000, 17(2):79-103.
• [16]Nederhof AJ: Methods of coping with social desirability bias: a review. Eur J Soc Psychol 1985, 15(3):263-280.
• [17]Douglass JM, Tinanoff N, Tang JM, Altman DS: Dental caries patterns and oral health behaviors in Arizona infants and toddlers. Community Dent Oral 2001, 29(1):14-22.
• [18]Shick EA, Lee JY, Rozier RG: Determinants of dental referral practices among WIC nutritionists in North Carolina. J Public Health Dent 2005, 65(4):196-202.
• [19]NIDCR Data Resource Center: Oral health questions included in National Oral Health Surveys (September 9, 2009). Available at: http://drc.hhs.gov/surveyq/index.htm webcite
• [20]Lee JY, Rozier RG, Lee SD, Bender D, Ruiz RE: Development of a word recognition instrument to test health literacy in dentistry: the REALD-30 – a brief communication. J Public Health Dent 2007, 67(2):94-98.
• [21]D’Agostino RB, Belanger A, D’Agostino RB Jr: A suggestion for using powerful and informative tests of normality. Am Statistician 1990, 44(4):316-321.
• [22]Maldonado G, Greenland S: Simulation study of confounder-selection strategies. Am J Epidemiol 1993, 138(11):923-936.
• [23]Cohen J: A coefficient of agreement for nominal scales. Educ Psych Measurement 1960, 20(1):37-46.
• [24]Sim J, Wright C: The kappa statistic in reliability studies: Use, interpretation, and sample size requirements. Phys Therapy 2005, 85(3):257-268.
• [25]Aho J, Koushik A, Diakite SL, Loua KM, Nguyen VK, Rashed S: Biological validation of self-reported condom use among sex workers in Guinea. AIDS Behav 2010, 14(6):1287-1293.
• [26]Hebert JR, Clemow L, Pbert L, Ockene IS, Ockene JK: Social desirability bias in dietary self-report may compromise the validity of dietary intake measures. Int J Epidemiol 1995, 24(2):389-398.
• [27]Klesges LM, Baranowski T, Beech B, Cullen K, Murray DM, Rochon J, Pratt C: Social desirability bias in self-reported dietary, physical activity and weight concerns measures in 8- to 10-year old African-American girls: results from the Girls Health Enrichment Multisite Studies (GEMS). Prev Med 2004, 38(Suppl):S78-S87.
• [28]Macalino GE, Celentano DD, Latkin C, Strathdee SA, Vlahov D: Risk behaviors by audio computer-assisted self-interviews among HIV-seropositive and HIV-seronegative injection drug users. AIDS Educ Prev 2002, 14(5):367-378.
• [29]Miller TM, Abdel-Maksoud MF, Crane LA, Marcus AC, Byers TE: Effects of social approval bias on self-reported fruit and vegetable consumption: a randomized controlled trial. Nutr J 2008, 27:7-18.
• [30]Sjöstrom O, Holst D: Validity of a questionnaire survey: response patterns in different subgroups and the effect of social desirability. Acta Odontol Scand 2002, 60(3):136-140.
• [31]Heaivilin N, Gerbert B, Page JE, Gibbs JL: Public health surveillance of dental pain via Twitter. J Dent Res 2011, 90(9):1047-1051.
• [32]Al-Sane M, Bourisly N, Almulla T, Andersson L: Laypeoples’ preferred sources of health information on the emergency management of tooth avulsion. Dent Traumatol 2011, 27(6):432-437.
• [33]Davis TC, Crouch MA, Long SW, Jackson RH, Bates P, George RB, Bairnsfather LE: Rapid assessment of literacy levels of adult primary care patients. Fam Med 1991, 23(6):433-435.
• [34]Richman JA, Lee JY, Rozier RG, Gong D, Pahel BT, Vann WF Jr: Evaluation of a word recognition instrument to test health literacy in dentistry: the REALD-99. J Pub Health Dent 2007, 67(2):99-104.
• [35]Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, Crouch MA: Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med 1993, 25(6):391-395.