Abstract The aim of this cross-sectional study was to investigate the associations between oral health-related quality of life (OHRQoL) and socioeconomic and demographic variables, suicidal ideation, self-perception of oral health, and experiences of dental care in the Brazilian adult LGBTIQ+ population. A sample of 464 participants completed self-administered online questionnaires and provided information for OHRQoL assessment, using the OHIP-14 instrument at three hierarchical levels of explanatory variables: LGBTIQ+ identities; socioeconomic and demographic data and existential suffering; and self-perception of oral health and experience of dental care. The collected data were fitted to hierarchical multiple logistic regression models, in which the associations between each independent variable with the OHIP-14 prevalence outcome were analyzed. The OHIP-14-prevalence index showed that 33.2% of the participants answered ‘frequently’ or ‘always’, and the highest frequencies were obtained for the psychological discomfort (27.8%), psychological disability (18.3%), and physical pain (17.5%) domains. According to the adjusted final model, LGBTIQ+ individuals who were more likely to have their OHRQoL affected were those who were indifferent (OR=3.21; 95% CI: 1.26-8.20), dissatisfied (OR=10.45; 95% CI: 3.86-28.26), or very dissatisfied (OR=53.93; 95% CI: 12.12-239.93) with their oral health status, and also those who had or have difficulty accessing dental treatment (OR=2.06; 95% CI: 1.24-3.41) (p<0.05). It may be concluded that the OHRQoL of the investigated Brazilian LGBTIQ+ population showed associations with individual aspects and with access to dental services. crosssectional cross sectional healthrelated related (OHRQoL variables ideation selfperception self perception LGBTIQ 46 selfadministered administered assessment OHIP14 OHIP 14 OHIP-1 identities suffering models analyzed OHIP14prevalence OHIPprevalence 332 33 2 33.2 ‘frequently frequently ‘always, always ‘always , ‘always’ 27.8%, 278 27.8% 27 8 (27.8%) 18.3%, 183 18.3% 18 3 (18.3%) 17.5% 175 17 5 (17.5% domains model OR=3.21 OR321 OR 21 (OR=3.21 95 CI 1.268.20, 126820 1.26 8.20 1 26 20 1.26-8.20) OR=10.45 OR1045 10 45 (OR=10.45 3.8628.26, 3862826 3.86 28.26 86 28 3.86-28.26) OR=53.93 OR5393 53 93 (OR=53.93 12.12239.93 121223993 12.12 239.93 12 239 12.12-239.93 status OR=2.06 OR206 06 (OR=2.06 1.243.41 124341 1.24 3.41 24 41 1.24-3.41 p<0.05. p005 p p<0.05 . 0 05 (p<0.05) services 4 OHIP1 OHIP- 33. 27.8 (27.8% 18.3 (18.3% 17.5 (17.5 OR=3.2 OR32 (OR=3.2 9 268 1.268.20 12682 126 1.2 820 8.2 1.26-8.20 OR=10.4 OR104 (OR=10.4 8628 3.8628.26 386282 386 3.8 2826 28.2 3.86-28.26 OR=53.9 OR539 (OR=53.9 12239 12.12239.9 12122399 1212 12.1 23993 239.9 23 12.12-239.9 OR=2.0 OR20 (OR=2.0 243 1.243.4 12434 124 341 3.4 1.24-3.4 p00 p<0.0 (p<0.05 27. (27.8 18. (18.3 17. (17. OR=3. OR3 (OR=3. 1.268.2 1268 1. 82 8. 1.26-8.2 OR=10. OR10 (OR=10. 862 3.8628.2 38628 38 3. 282 28. 3.86-28.2 OR=53. OR53 (OR=53. 1223 12.12239. 1212239 121 12. 2399 239. 12.12-239. OR=2. OR2 (OR=2. 1.243. 1243 34 1.24-3. p0 p<0. (p<0.0 (27. (18. (17 OR=3 (OR=3 1.268. 1.26-8. OR=10 OR1 (OR=10 3.8628. 3862 3.86-28. OR=53 OR5 (OR=53 122 12.12239 121223 12.12-239 OR=2 (OR=2 1.243 1.24-3 p<0 (p<0. (27 (18 (1 OR= (OR= 1.268 1.26-8 OR=1 (OR=1 3.8628 3.86-28 OR=5 (OR=5 12.1223 12122 12.12-23 1.24- p< (p<0 (2 ( (OR 1.26- 3.862 3.86-2 12.122 12.12-2 (p< 3.86- 12.12- (p

Abstract This study aimed to develop and rigorously evaluate the Test of Oral Health Literacy in Adults (TOHLA) for the Iranian population, addressing the limitations of existing oral health literacy (OHL) measurement instruments and contributing to the literature on OHL assessment. The development of the TOHLA involved a qualitative approach, which included a comprehensive literature review and semi-structured interviews with a panel of 15 experts from diverse fields and 22 Iranian adults aged 18 to 64 years. The instrument was designed with 48 items categorized into four domains: cognitive skill, communication skill, media skill, and functional skill. Content validity was established through expert input and content validation indices. Construct validity was supported by factor analysis, and concurrent validity was assessed by comparing TOHLA scores with demographic variables. Internal consistency and test-retest reliability analyses were performed to assess the instrument’s reliability. The psychometric evaluation of the TOHLA demonstrated strong content validity, construct validity, concurrent validity, internal consistency, and test-retest reliability. The instrument exhibited a high level of internal consistency, with a Cronbach’s alpha coefficient of 0.81 for the entire scale. Test-retest reliability was satisfactory, with an intraclass correlation coefficient (ICC) of 0.83. Concurrent validity analysis showed statistically significant associations between OHL scores and demographic variables, supporting the instrument’s overall performance. The TOHLA overcomes the weaknesses observed in existing instruments and offers a comprehensive tool with strong psychometric properties to assess the OHL of the Iranian adult population. Researchers, policymakers, and healthcare providers can utilize the TOHLA to address oral health challenges and enhance overall oral health outcomes among Iranian adults. (TOHLA population (OHL assessment approach semistructured semi structured 1 2 6 years 4 domains skill indices variables testretest test retest s Cronbachs Cronbach 081 0 81 0.8 scale Testretest satisfactory ICC (ICC 083 83 0.83 performance Researchers policymakers 08 8 0.

Resumo O presente estudo, um ensaio teórico, teve como objetivo analisar o papel e o potencial da cavidade bucal junto à pluralidade corpórea das identidades LGBTQIA+. Para tal, guiado por um percurso dialético, dois percursos bucais foram discernidos: um disciplinarizado pelos preceitos de uma hegemonia cristã, machista e cissexista; e o outro sob caráter de superação, questionando a unicidade da cisheteronorma. Por fim, com base nas premissas apresentadas, o território bucal, a partir de então, torna-se um possível caminho para se compreender o percurso histórico-social das identidades LGBTQIA+ - afinal, boca é corpo, e como todas as demais formas da corporeidade, guia-se pelas normatizações socialmente construídas com as quais tecemos nossa existência. estudo teórico LGBTQIA tal dialético discernidos cristã cissexista superação cisheteronorma fim apresentadas então tornase torna históricosocial histórico social afinal corpo corporeidade guiase guia existência

Abstract This study, a theoretical essay, aimed to analyze the role and potential of the oral cavity in the corporeal plurality of LGBTQIA+ identities. Thus, dialectically guided, two oral pathways were evidenced: the first disciplined by the precepts of a Christian, sexist, and cissexist hegemony; the other questioning the unison character of cisheteronormativity. Finally, based on the premises presented, the oral territory, from then on, becomes a possible way to understand the historical-social path of LGBTQIA+ identities - after all, the mouth is body, like all other forms of corporeality, guided by socially constructed norms which we weave our existence. study essay LGBTQIA Thus evidenced Christian sexist hegemony cisheteronormativity Finally presented territory historicalsocial historical social body corporeality existence

Abstract This study, a theoretical essay, aimed to analyze the role and potential of the oral cavity in the corporeal plurality of LGBTQIA+ identities. Thus, dialectically guided, two oral pathways were evidenced: the first disciplined by the precepts of a Christian, sexist, and cissexist hegemony; the other questioning the unison character of cisheteronormativity. Finally, based on the premises presented, the oral territory, from then on, becomes a possible way to understand the historical-social path of LGBTQIA+ identities - after all, the mouth is body, like all other forms of corporeality, guided by socially constructed norms which we weave our existence.

Resumo O presente estudo, um ensaio teórico, teve como objetivo analisar o papel e o potencial da cavidade bucal junto à pluralidade corpórea das identidades LGBTQIA+. Para tal, guiado por um percurso dialético, dois percursos bucais foram discernidos: um disciplinarizado pelos preceitos de uma hegemonia cristã, machista e cissexista; e o outro sob caráter de superação, questionando a unicidade da cisheteronorma. Por fim, com base nas premissas apresentadas, o território bucal, a partir de então, torna-se um possível caminho para se compreender o percurso histórico-social das identidades LGBTQIA+ - afinal, boca é corpo, e como todas as demais formas da corporeidade, guia-se pelas normatizações socialmente construídas com as quais tecemos nossa existência.

ABSTRACT Objective: To map, through a scoping review, the characteristics of scientific dental production directed at LGBTQIA+ people. Material and Methods: Text searches were carried out (September 2022) in three databases: PubMed (MEDLINE), Virtual Health Library (BVS/BIREME), and SciELO (Scientific Electronic Library Online). Data extraction was carried out through the content of the abstracts and full texts. Results: A total of 1,524 studies were found, of which 186 were considered eligible. The results point to the stigmatizing nature of HIV-AIDS among the LGBTQIA+ population, a highlight of the scientific production that is linked to serophobic outcomes. Studies were also found that addressed the precariousness of oral health and inaccessibility to dental services, anatomical specificities, and the risks of contracting and preventing sexually transmitted infections. However, a substantial gap became evident: questions and directions aimed at providing dental care for the LGBTQIA+ population. Conclusion: There is a need to expand the number and scope of research aimed at this population in an attempt to provide evidence for the construction of an effective model of dental care, therefore, integral, collective, and contextualized to the specificities, needs, and demands of the multiple LGBTQIA+ identities. Objective map review LGBTQIA people Methods September 2022 databases MEDLINE, MEDLINE , (MEDLINE) BVS/BIREME, BVSBIREME BVS/BIREME BVS BIREME (BVS/BIREME) Scientific Online. Online . Online) texts Results 1524 1 524 1,52 18 eligible HIVAIDS HIV AIDS outcomes services specificities infections However evident Conclusion therefore integral collective needs identities 202 (MEDLINE (BVS/BIREME 152 52 1,5 20 15 5 1, 2

Aim To analyze associations between sociodemographic factors, self-perception, self-care practices in health with Oral Health Literacy (OHL) levels among users of Primary Health Care (PHC). Methods A cross-sectional and analytical study was performed in Piracicaba (São Paulo), Brazil, in 2018, with a convenience sample of users of PHC that were aged over 18 years. Data were collected with a questionnaire by a trained dentist in two Family Health Units. The outcome variable was OHL, measured by the OHLA-B instrument, which was dichotomized by median into low (≤8 point) and high (>8 point). The independent variables were sociodemographic conditions (age, sex, self-declared skin color, and education), self-perceived oral health and self-care practices in health (tooth brushing frequency, smoking habits, reason for the last visit to the dentist, and source of health information search). Unadjusted and adjusted analyses were performed between OHL and independent variables for multiple logistic regression model (p≤0.05). Results The sample consisted of 450 adults. A total of 54.7% had a low OHL. After adjusting for sex and age, OHL was associated with skin color (OR=0.57; 95%CI=0.37-085), educational level (OR=4.92; 95%CI=3.16-7.79), health information from health professionals (OR=2.40; 95%CI=1.42-4.16) and internet (OR=2.88; 95%CI=1.59-5.32), toothbrushing >1 time a day (OR=3.23; 95%CI=1.27-9.92) and smokers (OR=0.42; 95%CI=0.23-0.73). After adjusting for sex, age and income, OHL was associated with (OR=0.63; 95%CI=0.41-096), educational level (OR=4.06; 95%CI=2.57-6.51) and smokers (OR=0.48; 95%CI=0.26-0.84). Conclusions Low OHL was associated with socioeconomic factors, source of information and smoking. This fact highlights the importance of health professionals to promote OHL. factors selfperception, selfperception self perception, perception self-perception selfcare care (OHL PHC. . (PHC) crosssectional cross sectional São Paulo, Paulo , Paulo) Brazil 2018 1 years Units OHLAB OHLA B instrument ≤8 8 (≤ point >8 (> point. (age selfdeclared declared education, education education) selfperceived perceived tooth frequency habits search. search search) p≤0.05. p005 p p≤0.05 0 05 (p≤0.05) 45 adults 547 54 7 54.7 OR=0.57 OR057 OR 57 (OR=0.57 95%CI=0.37085, 95CI037085 CI 95%CI=0.37 085 95 37 95%CI=0.37-085) OR=4.92 OR492 4 92 (OR=4.92 95%CI=3.167.79, 95CI316779 95%CI=3.16 7.79 3 16 79 95%CI=3.16-7.79) OR=2.40 OR240 2 40 (OR=2.40 95%CI=1.424.16 95CI142416 95%CI=1.42 4.16 42 95%CI=1.42-4.16 OR=2.88 OR288 88 (OR=2.88 95%CI=1.595.32, 95CI159532 95%CI=1.59 5.32 59 5 32 95%CI=1.59-5.32) > OR=3.23 OR323 23 (OR=3.23 95%CI=1.279.92 95CI127992 95%CI=1.27 9.92 27 9 95%CI=1.27-9.92 OR=0.42 OR042 (OR=0.42 95%CI=0.230.73. 95CI023073 95%CI=0.23 0.73 73 95%CI=0.23-0.73) income OR=0.63 OR063 63 (OR=0.63 95%CI=0.41096, 95CI041096 95%CI=0.41 096 41 95%CI=0.41-096) OR=4.06 OR406 06 (OR=4.06 95%CI=2.576.51 95CI257651 95%CI=2.57 6.51 6 51 95%CI=2.57-6.51 OR=0.48 OR048 48 (OR=0.48 95%CI=0.260.84. 95CI026084 95%CI=0.26 0.84 26 84 95%CI=0.26-0.84) (PHC 201 ≤ ( p00 p≤0.0 (p≤0.05 54. OR=0.5 OR05 (OR=0.5 37085 95%CI=0.37085 95CI03708 95CI037 95%CI=0.3 08 95%CI=0.37-085 OR=4.9 OR49 (OR=4.9 167 95%CI=3.167.79 95CI31677 95CI316 95%CI=3.1 779 7.7 95%CI=3.16-7.79 OR=2.4 OR24 (OR=2.4 424 95%CI=1.424.1 95CI14241 95CI142 95%CI=1.4 416 4.1 95%CI=1.42-4.1 OR=2.8 OR28 (OR=2.8 595 95%CI=1.595.32 95CI15953 95CI159 95%CI=1.5 532 5.3 95%CI=1.59-5.32 OR=3.2 OR32 (OR=3.2 279 95%CI=1.279.9 95CI12799 95CI127 95%CI=1.2 992 9.9 95%CI=1.27-9.9 OR=0.4 OR04 (OR=0.4 230 95%CI=0.230.73 95CI02307 95CI023 95%CI=0.2 073 0.7 95%CI=0.23-0.73 OR=0.6 OR06 (OR=0.6 41096 95%CI=0.41096 95CI04109 95CI041 95%CI=0.4 09 95%CI=0.41-096 OR=4.0 OR40 (OR=4.0 576 95%CI=2.576.5 95CI25765 95CI257 95%CI=2.5 651 6.5 95%CI=2.57-6.5 260 95%CI=0.260.84 95CI02608 95CI026 084 0.8 95%CI=0.26-0.84 20 p0 p≤0. (p≤0.0 OR=0. OR0 (OR=0. 3708 95%CI=0.3708 95CI0370 95CI03 95%CI=0. 95%CI=0.37-08 OR=4. OR4 (OR=4. 95%CI=3.167.7 95CI3167 95CI31 95%CI=3. 77 7. 95%CI=3.16-7.7 OR=2. OR2 (OR=2. 95%CI=1.424. 95CI1424 95CI14 95%CI=1. 4. 95%CI=1.42-4. 95%CI=1.595.3 95CI1595 95CI15 53 5. 95%CI=1.59-5.3 OR=3. OR3 (OR=3. 95%CI=1.279. 95CI1279 95CI12 99 9. 95%CI=1.27-9. 95%CI=0.230.7 95CI0230 95CI02 07 0. 95%CI=0.23-0.7 4109 95%CI=0.4109 95CI0410 95CI04 95%CI=0.41-09 95%CI=2.576. 95CI2576 95CI25 95%CI=2. 65 6. 95%CI=2.57-6. 95%CI=0.260.8 95CI0260 95%CI=0.26-0.8 p≤0 (p≤0. OR=0 (OR=0 370 95%CI=0.370 95CI0 95%CI=0 95%CI=0.37-0 OR=4 (OR=4 95%CI=3.167. 95CI3 95%CI=3 95%CI=3.16-7. OR=2 (OR=2 95%CI=1.424 95CI1 95%CI=1 95%CI=1.42-4 95%CI=1.595. 95%CI=1.59-5. OR=3 (OR=3 95%CI=1.279 95%CI=1.27-9 95%CI=0.230. 95%CI=0.23-0. 410 95%CI=0.410 95%CI=0.41-0 95%CI=2.576 95CI2 95%CI=2 95%CI=2.57-6 95%CI=0.260. 95%CI=0.26-0. p≤ (p≤0 OR= (OR= 95CI 95%CI= 95%CI=0.37- 95%CI=3.167 95%CI=3.16-7 95%CI=1.42- 95%CI=1.595 95%CI=1.59-5 95%CI=1.27- 95%CI=0.230 95%CI=0.23-0 95%CI=0.41- 95%CI=2.57- 95%CI=0.260 95%CI=0.26-0 (p≤ (OR 95%CI 95%CI=3.16- 95%CI=1.59- 95%CI=0.23- 95%CI=0.26- (p

Abstract: The aim of this study was to investigate associations of health literacy (HL), general self-efficacy (GSE), and sociodemographic variables with non-adherence to dental treatment among Brazilian young adults. This is a cross-sectional study based on a cohort study of 248 young adults aged 19 to 25 years followed up in an earlier study. The participants completed the perceived general self-efficacy scale (GSE), a questionnaire on socioeconomic and demographic variables and were examined for oral conditions. HL was measured using the Brazilian version of the health literacy questionnaire (HLQ-Br), which provides nine individual scores based on an average of the items within each of the nine scales. Dental treatment adherence was evaluated as the decision of young adults to seek a dentist to finish the recommended restorative treatment for dental caries. The effects of HL domains on the adherence to dental treatment were analyzed by logistic regression and the effect was adjusted for sex, age, family income, paternal and maternal education, type of housing, and self-efficacy. The results of the adjusted analysis showed associations among young adults who did not adhere to dental treatment with lower self-efficacy levels, living in non-owner-occupied homes, and lower HL levels in almost all of the HL domains (p < 0.05). Only the HLQ6 domain “Ability to actively engage with healthcare providers” was not associated with the outcome (p>0.05). Adherence to dental treatment in primary care among young adults was associated with their general self-efficacy levels, socioeconomic characteristics, and individual's lower HL aspects. Abstract HL, , (HL) selfefficacy self efficacy GSE, GSE (GSE) nonadherence non crosssectional cross sectional 24 1 2 conditions HLQBr, HLQBr HLQ Br (HLQ-Br) scales caries sex age income education housing selfefficacy. efficacy. nonowneroccupied owner occupied homes p 0.05. 005 0.05 . 0 05 0.05) Ability providers p>0.05. p005 p>0.05 (p>0.05) characteristics individuals s aspects (HL (GSE (HLQ-Br 00 0.0 p00 p>0.0 (p>0.05 0. p0 p>0. (p>0.0 p>0 (p>0. p> (p>0 (p>

Resumo Introdução A Autopercepção da Saúde Bucal (ASB) é uma importante variável subjetiva associada à procura por serviços odontológicos e determinada por diversos fatores. Objetivo O objetivo deste trabalho foi investigar associações entre a ASB, o Letramento em Saúde Bucal (LSB) e covariáveis, em usuários da Atenção Básica. Método A amostra foi composta por 366 adultos e idosos, moradores em territórios adscritos a uma unidade de equipe de Saúde da Família (eSF) do município de Piracicaba, que procuraram por tratamento odontológico no ano de 2019 e que aceitaram participar da pesquisa. Aplicou-se o instrumento Health Literacy in Dentistry (HeLD-14) para avaliação do LSB, bem como um questionário para investigar características sociodemográficas e da ASB. Ademais, exames intrabucais foram realizados. Realizaram-se análises de regressões logísticas simples e múltipla, para se avaliar o nível de associação entre a variável ASB e as variáveis preditoras. Resultados Pacientes com menor escore de LSB, pior Autopercepção da Saúde Geral e com mais de um dente perdido tiveram, respectivamente, 2,73 (IC95%: 1,62-4,61), 14,24 (IC95%: 7,41-27,38) e 2,93 (IC95%: 1,76-4,89) vezes mais chance de apresentar pior ASB (p<0,05). Conclusão A ASB é um constructo associado a diversas variáveis não clínicas, incluindo o LSB.

Abstract Background The Self-Rated Oral Health (SROH) is an important subjective variable associated with the demand for dental services and determined by several factors. Objective The objective of this work was to investigate associations between SROH, Oral Health Literacy (OHL) and covariates in Primary Care users. Method The sample consisted of 366 adults and elderly living in territories assigned to a Family Health team unit in the municipality of Piracicaba who sought dental treatment in 2019 and who agreed to participate in the research. The Health Literacy in Dentistry instrument (HeLD-14) was applied to assess OHL, as well as a questionnaire to investigate sociodemographic and SROH characteristics. In addition, clinical dental examinations were performed. Simple and multiple logistic regression analyzes were performed to assess the level of association between the SROH variable and the predictor variables. Results Patients with lower OHL score, worse Self-Rated Health and with more than one missing tooth had, respectively, 2.73 (95% CI: 1.62-4.61), 14.24 (95% CI: 7.41-27.38) and 2.93 (95% CI: 1.76-4.89) times more likely to have worse SROH (p <0.05). Conclusion The SROH is a construct associated with several non-clinical variables, including OHL.

Resumo Esta pesquisa traz em seu escopo a análise do potencial estigmatizador do conteúdo de estudos direcionados à população LGBTQIA+ indexados na plataforma PubMed. Por meio de uma ampla e sistemática pesquisa bibliográfica foram identificados e incluídos, respectivamente, 821 e 334 (40,68%) artigos, dos quais foram extraídos 1838 descritores. Da análise dos dados coletados foram identificados as maiores prevalências dos descritores “men having sex with man” (192 repetições) e “HIV” (98 repetições). Sendo assim, o percurso analítico das informações levantadas refletiu que a população LGBTQIA+ é essencialmente designada como “homens que fazem sexo com outros homens e soropositivos”. Este estudo traz, portanto, a presença de características estigmatizantes nos estudos direcionados à população LGBTQIA+. Contudo, cabe destacar que o resultado encontrado é subsídio para o fortalecimento de uma perspectiva crítica de um fazer científico mais humanizado e direcionado às especificidades e necessidades da população LGBTQIA+.

Abstract This study analyzes the stigmatizing potential of studies on the LGBTQIA+ population indexed on the PubMED database. By a broad and systematic bibliographic search, 821 publications were found and 334 (40.68%) were included in this study. From these, 1838 keywords were extracted. Data analysis showed that the keywords “men who have sex with man” (192 repetitions) and “HIV” (98 repetitions) had the highest prevalence. Thus, according to the analysis, the LGBTQIA+ population is essentially described as “men who have sex with other men” and “HIV positive.” This study unveils the presence of stigmatizing characteristics in studies on the LGBTQIA+ population. However, such findings can help strengthen the critical perspective of a more humanized scientific practice, actually concerned with the specificities and needs of the LGBTQIA+ population.

RESUMO Objetivo: Traduzir e adaptar a eHealth Literacy Scale para a realidade cultural do Brasil e avaliar suas propriedades psicométricas da versão em português brasileiro. Métodos: O instrumento foi traduzido e adaptado ao português brasileiro e, em seguida, aplicado em uma amostra de 502 indivíduos entre 18 e 80 anos residentes em áreas circunvizinhas a seis Unidades de Saúde da Família de um município do interior do estado de São Paulo, Brasil. Os dados foram avaliados mediante análises fatorial exploratória e confirmatória, Teoria de Resposta ao Item e confiabilidade do instrumento (alfa de Cronbach e ômega de McDonald). Resultados: O instrumento eHealth Literacy Scale - versão brasileira (eHEALS-Br) apresentou excelente consistência interna (α = 0,95 e ω = 0,95), apenas uma dimensão e variância explicada de 81,79%. Conclusões: A versão brasileira do instrumento mostrou excelentes propriedades psicométricas para aferição dos níveis de letramento digital em saúde em adultos do nosso país.

ABSTRACT Objective: To translate and adapt the eHealth Literacy Scale for the cultural reality of Brazil and to evaluate the psychometric properties of its Brazilian Portuguese version. Methods: The instrument was translated and adapted to Brazilian Portuguese and applied to a sample of 502 individuals from 18 to 80 years old who lived in the surrounding areas of six Family Health Units of a city in the countryside of the state of São Paulo, Brazil. The data was evaluated using exploratory and confirmatory factor analysis, item response theory, and instrument reliability measures (Cronbach’s alpha and McDonald’s omega). Results: The eHealth Literacy Scale - Brazilian version (eHEALS-Br) presented an excellent internal consistency (α = 0.95 e ω = 0.95), with only one dimension and an explained variation of 81.79%. Conclusions: The Brazilian version of the instrument showed excellent psychometric properties to measure the levels of digital health literacy in adults from the country.

RESUMEN Objetivo: Traducir y adaptar la eHealth Literacy Scale a realidad cultural Brasileña y evaluar sus propiedades psicométricas de la versión en portugués brasileño. Métodos: El instrumento fue traducido y adaptado al portugués brasileño y, en seguida, aplicado en una muestra de 502 individuos entre 18 y 80 años residentes en áreas cercas a seis Unidades de Salud de la Familia de un municipio del interior del estado de São Paulo, Brasil. Los datos fueron evaluados mediante análisis factorial exploratoria y confirmatoria, Teoría de Respuesta al Ítem y confiabilidad del instrumento (alfa de Cronbach y omega de McDonald). Resultados: El instrumento eHealth Literacy Scale - versión brasileña (eHEALS-Br) presentó excelente consistencia interna (α = 0,95 y ω = 0,95), apenas una dimensión y variancia explicada de 81,79%. Conclusiones: La versión brasileña del instrumento mostró excelentes propiedades psicométricas para contraste de los niveles de alfabetización digital en salud en adultos del nuestro país.

Abstract This study aimed to investigate the association between Oral Health Literacy (OHL) and dental outcomes. A sample of 920 adults above 18 years of age living in areas covered by 10 Family Health Units (FHUs) in a large city in São Paulo state, Brazil, was included. OHL was assessed using the short-form Health Literacy in Dentistry Scale (HeLD-14). Data on sociodemographic factors, oral health, and general health were obtained through a structured questionnaire. The investigated outcomes “tooth loss” and “reason for the last dental appointment” were evaluated using self-reported data. Simple logistic regression models were used to analyze the associations between each independent factor and outcomes. Factors that presented a significance level of ≤0.20 in the bivariate analysis were included in the hierarchical multiple logistic regression models. Participants with an education level up to high school, low OHL, and poor/fair self-rated oral health had 1.35 (95%CI, 1.01-1.80), 1.48 (95%CI, 1.12-1.95), and 1.46 (95%CI, 1.11-1.92) times more probability to report missing teeth, respectively. Adults from families with lower monthly income, low OHL, and poor/fair self-rated oral health had 1.70 (95%CI, 1.29-2.26), 1.89 (95%CI, 1.42-2.51), and 1.73 (95%CI, 1.30-2.30) times more chance, respectively, to have gone to the last dental appointment due to pain or caries. Adults with low OHL levels are more likely to have missing teeth and have gone to the last dental visit for pain, reinforcing the importance of OHL as an important determinant for promoting oral health.

Resumo Introdução A Autopercepção da Saúde Bucal (ASB) é uma importante variável subjetiva associada à procura por serviços odontológicos e determinada por diversos fatores. Objetivo O objetivo deste trabalho foi investigar associações entre a ASB, o Letramento em Saúde Bucal (LSB) e covariáveis, em usuários da Atenção Básica. Método A amostra foi composta por 366 adultos e idosos, moradores em territórios adscritos a uma unidade de equipe de Saúde da Família (eSF) do município de Piracicaba, que procuraram por tratamento odontológico no ano de 2019 e que aceitaram participar da pesquisa. Aplicou-se o instrumento Health Literacy in Dentistry (HeLD-14) para avaliação do LSB, bem como um questionário para investigar características sociodemográficas e da ASB. Ademais, exames intrabucais foram realizados. Realizaram-se análises de regressões logísticas simples e múltipla, para se avaliar o nível de associação entre a variável ASB e as variáveis preditoras. Resultados Pacientes com menor escore de LSB, pior Autopercepção da Saúde Geral e com mais de um dente perdido tiveram, respectivamente, 2,73 (IC95%: 1,62-4,61), 14,24 (IC95%: 7,41-27,38) e 2,93 (IC95%: 1,76-4,89) vezes mais chance de apresentar pior ASB (p<0,05). Conclusão A ASB é um constructo associado a diversas variáveis não clínicas, incluindo o LSB.

Abstract Background The Self-Rated Oral Health (SROH) is an important subjective variable associated with the demand for dental services and determined by several factors. Objective The objective of this work was to investigate associations between SROH, Oral Health Literacy (OHL) and covariates in Primary Care users. Method The sample consisted of 366 adults and elderly living in territories assigned to a Family Health team unit in the municipality of Piracicaba who sought dental treatment in 2019 and who agreed to participate in the research. The Health Literacy in Dentistry instrument (HeLD-14) was applied to assess OHL, as well as a questionnaire to investigate sociodemographic and SROH characteristics. In addition, clinical dental examinations were performed. Simple and multiple logistic regression analyzes were performed to assess the level of association between the SROH variable and the predictor variables. Results Patients with lower OHL score, worse Self-Rated Health and with more than one missing tooth had, respectively, 2.73 (95% CI: 1.62-4.61), 14.24 (95% CI: 7.41-27.38) and 2.93 (95% CI: 1.76-4.89) times more likely to have worse SROH (p <0.05). Conclusion The SROH is a construct associated with several non-clinical variables, including OHL.

Resumo Esta pesquisa traz em seu escopo a análise do potencial estigmatizador do conteúdo de estudos direcionados à população LGBTQIA+ indexados na plataforma PubMed. Por meio de uma ampla e sistemática pesquisa bibliográfica foram identificados e incluídos, respectivamente, 821 e 334 (40,68%) artigos, dos quais foram extraídos 1838 descritores. Da análise dos dados coletados foram identificados as maiores prevalências dos descritores “men having sex with man” (192 repetições) e “HIV” (98 repetições). Sendo assim, o percurso analítico das informações levantadas refletiu que a população LGBTQIA+ é essencialmente designada como “homens que fazem sexo com outros homens e soropositivos”. Este estudo traz, portanto, a presença de características estigmatizantes nos estudos direcionados à população LGBTQIA+. Contudo, cabe destacar que o resultado encontrado é subsídio para o fortalecimento de uma perspectiva crítica de um fazer científico mais humanizado e direcionado às especificidades e necessidades da população LGBTQIA+.

Abstract This study analyzes the stigmatizing potential of studies on the LGBTQIA+ population indexed on the PubMED database. By a broad and systematic bibliographic search, 821 publications were found and 334 (40.68%) were included in this study. From these, 1838 keywords were extracted. Data analysis showed that the keywords “men who have sex with man” (192 repetitions) and “HIV” (98 repetitions) had the highest prevalence. Thus, according to the analysis, the LGBTQIA+ population is essentially described as “men who have sex with other men” and “HIV positive.” This study unveils the presence of stigmatizing characteristics in studies on the LGBTQIA+ population. However, such findings can help strengthen the critical perspective of a more humanized scientific practice, actually concerned with the specificities and needs of the LGBTQIA+ population.

Resumo Objetivo: Validar o instrumento de avaliação do letramento em saúde Health Literacy Questionnaire para o português brasileiro. Métodos: Para a adaptação transcultural e validação das propriedades psicométricas da versão brasileira do Health Literacy Questionnaire (HLQ-Br), foi utilizado o protocolo estabelecido pelos autores do instrumento original. O HLQ-Br foi respondido por 794 adultos de três regiões do Brasil. A Análise Fatorial Confirmatória foi realizada por meio do Diagonally Weighted Least Squares e a confiabilidade foi verificada pelos indicadores alfa de Cronbach e confiabilidade composta. Resultados: A avaliação cognitiva do HLQ-Br mostrou que os itens do instrumento foram facilmente compreendidos pelos participantes. A análise confirmatória apresentou índices de ajuste satisfatórios: χ2WLSMV (866 GL) = 1698,53, p<0,0001; CFI = 0,978; TLI = 0,976 e RMSEA = 0,035 [0,032; 0,037, IC de 90%]. O alfa de Cronbach e confiabilidade composta foram >0,76 em oito das nove escalas do instrumento. Conclusão: O HLQ-Br apresentou equivalência com a versão original e propriedades psicométricas satisfatórias. Pode ser aplicado para avaliar o letramento em saúde da população brasileira na prática clínica, ensino e pesquisa. O uso do HLQ-Br nas práticas de saúde pode auxiliar a incorporar o letramento em saúde nas práticas de saúde no Brasil.

Abstract Objective: To validate the health literacy assessment instrument Health Literacy Questionnaire to Brazilian Portuguese. Methods: We used the protocol established by the original authors of the instrument for transcultural adaptation and validation of the psychometric properties of the Brazilian version of the Health Literacy Questionnaire (HLQ-Br). The HLQ-Br was answered by 794 adults from three regions of Brazil. Confirmatory Factor Analysis was performed by means of the Diagonally Weighted Least Squares and reliability was verified by Cronbach’s Alpha and Composite Reliability indicators. Results: Cognitive evaluation of the HLQ-Br showed that the items of the instrument were easily understood by the participants. The confirmatory analysis presented satisfactory fit indices: χ2WLSMV (866 df) = 1698.53, p <0.0001; CFI = 0.978; TLI = 0.976, and RMSEA = 0.035 [0.032; 0.037, 90%CI]. Cronbach’s Alpha and Composite Reliability > 0.76 on eight of the nine scales of the instrument. Conclusion: The HLQ-Br presented equivalence to the original version and satisfactory psychometric properties. It can be applied in the evaluation of Brazilian population HL in clinical practice, teaching and research. The use of HLQ-Br in health practices can aid in the incorporation of health literacy into health care practices in Brazil.

Resumen Objetivo: Validar el instrumento de evaluación del nivel de conocimientos en salud Health Literacy Questionnaire al portugués brasileño. Métodos: Para la adaptación transcultural y validación de las propiedades psicométricas de la versión brasileña del Health Literacy Questionnaire (HLQ-Br), se utilizó el protocolo establecido por los autores del instrumento original. El HLQ-Br fue respondido por 794 adultos de tres regiones de Brasil. El análisis factorial confirmatorio fue realizado mediante el Diagonally Weighted Least Squares y la fiabilidad fue verificada por el indicador alfa de Cronbach y fiabilidad compuesta. Resultados: La evaluación cognitiva del HLQ-Br demostró que los ítems del instrumento fueron fácilmente comprendidos por los participantes. El análisis confirmatorio presentó índices de ajustes satisfactorios: χ2WLSMV (866 GL) = 1698,53, p<0,0001; CFI = 0,978; TLI = 0,976 y RMSEA = 0,035 [0,032; 0,037, IC de 90%]. El alfa de Cronbach y la fiabilidad compuesta fueron >0,76 en ocho de las nueve escalas del instrumento. Conclusión: El HLQ-Br presentó equivalencia con la versión original y propiedades psicométricas satisfactorias. Puede aplicarse para evaluar el nivel de conocimientos en salud de la población brasileña en la práctica clínica, educación e investigación. El uso del HLQ-Br en las prácticas de salud puede ayudar a incorporar la instrucción en salud en las prácticas sanitarias en Brasil.

Objetivo: investigar as propriedades psicométricas da versão adaptada ao português do Brasil do questionário de letramento em saúde European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) em adultos brasileiros. Método: o instrumento foi traduzido e pré-testado em uma amostra de 50 indivíduos. Em seguida, ele foi aplicado em uma amostra com 783 indivíduos adultos. Os dados passaram por um processo adequado de testagem das propriedades, com a combinação de técnicas da Análise Fatorial Exploratória, Análise Fatorial Confirmatória e Teoria de Resposta ao Item. Para a avaliação da confiabilidade, foram utilizados os indicadores de alfa de Cronbach e o Ômega de McDonald. Foi aplicada a validação cruzada com análise integral dos dados. Resultados: a maioria dos participantes era do sexo feminino (68,1%), com idade média de 38,6 (dp=14,5) anos e 33,5% estudaram até o ensino fundamental. Os resultados indicaram um modelo unidimensional com variância explicada de 71,23%, níveis de cargas fatoriais, comunalidades e discriminação do item adequados, bem como estabilidade e a replicabilidade do instrumento para outras populações. Conclusão: a versão brasileira do HLS-EU-Q6 indicou que o instrumento está adequado para aplicação de forma indiscriminada na população a que se destina para aferir os níveis de letramento em saúde.

Objective: to investigate the psychometric properties of the Brazilian Portuguese version of the health literacy questionnaire European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) in Brazilian adults. Method: the instrument was translated and pre-tested in a sample of 50 individuals. Subsequently, it was applied to a sample of 783 adult individuals. The data went through an appropriate process of testing the properties, with the combination of techniques of Exploratory Factor Analysis, Confirmatory Factor Analysis and Item Response Theory. For the assessment of reliability, the Cronbach's alpha and McDonald's Omega indicators were used. Cross-validation with full data analysis was applied. Results: the majority of the participants was female (68.1%), with a mean age of 38.6 (sd=14.5) years old and 33.5% studied up to elementary school. The results indicated a unidimensional model with an explained variance of 71.23%, adequate factor load levels, commonality and item discrimination, as well as stability and replicability of the instrument to other populations. Conclusion: the Brazilian version of HLS-EU-Q6 indicated that the instrument is suitable for indiscriminate application in the population to which it is intended to assess health literacy levels.

Objetivo: investigar las propiedades psicométricas de la versión en portugués brasileño del cuestionario de alfabetización en salud European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) en adultos brasileños. Método: el instrumento fue traducido y probado primero en una muestra de 50 individuos. Luego, se aplicó a una muestra de 783 individuos adultos. Los datos pasaron por un proceso adecuado de prueba de las propiedades, con la combinación de técnicas de Análisis Factorial Exploratorio, Análisis Factorial Confirmatorio y Teoría de Respuesta al Ítem. Para evaluar la confiabilidad se utilizaron los indicadores alfa de Cronbach y Omega de McDonald's. Se aplicó validación cruzada con análisis de datos completo. Resultados: la mayoría de los participantes era de sexo femenino (68,1%), con una edad media de 38,6 (dt = 14,5) años y el 33,5% cursó hasta la educación primaria. Los resultados indicaron un modelo unidimensional con una varianza explicada de 71,23%, niveles adecuados de carga factorial, comunalidades y discriminación de ítems, así como estabilidad y replicabilidad del instrumento a otras poblaciones. Conclusión: la versión brasileña de HLS-EU-Q6 indicó que el instrumento es apto para su aplicación indiscriminada en la población a la que se destina para evaluar los niveles de alfabetización en salud.