Validation of Health Literacy in Dentistry (HeLD-14) in Peruvian Adults: A Cross-Sectional Study

The Health Literacy in Dentistry (HeLD)-14 instrument was developed as a concise tool for assessing oral health literacy. However, its psychometric properties have not been validated in the Peruvian context. This study aims to adapt and validate the short version of the HeLD-14 instrument for the Peruvian adult population.

A cross-sectional study was conducted on 300 adults aged 18-83 years from three healthcare centers in Lima, Peru. The HeLD-14 was translated, back-translated, and piloted to ensure clarity. Psychometric properties were assessed using exploratory factor analysis, confirmatory factor analysis (CFA), and structural equation modeling (SEM). Internal consistency was measured using Cronbach α and y Omega de McDonald. The test-retest reliability was evaluated in a subsample of 34 participants with a 15-day interval. Data were analyzed using R v4.4.1 and AMOS 24.0.

The HeLD-14 demonstrated strong psychometric properties. The Kaiser-Meyer-Olkin value was 0.804, and Bartlett's test of sphericity was significant (χ ² = 3152; P < 0.001). Cronbach α for internal consistency was 0.913. The test-retest reliability showed a moderate correlation (ρ = 0.666; P < 0.001). CFA results confirmed the multidimensional structure of the instrument, with all factor loadings exceeding 0.40 and P value < 0.001. SEM indicated strong and significant relationships between oral health literacy and its seven dimensions (standardized loadings: 0.33-0.69).

The HeLD-14 instrument is a valid and reliable tool for assessing oral health literacy in Peruvian adults. Its simplicity and robustness make it suitable for application in research and public healthcare interventions. Future studies should explore its application in diverse Peruvian populations and its predictive value for oral health outcomes.