Validating evidence for the knowledge, management and involvement of dentists in a dental approach to sickle-cell disease.

This study validated the content of an instrument designed to assess the knowledge, involvement (attitudes) and management (practice) of dentists relative to sickle-cell disease (KAPD-SCD). The instrument consisted of five domains composed of a total of thirteen items: I. Dentist's self-assessment relative to sickle-cell disease; II. Dentist's knowledge of the repercussions of sickle-cell disease on the stomatognathic system; III. Dentist's knowledge of the complications of sickle-cell disease in the stomatognathic system; IV. Dentist's knowledge concerning the dental management of sickle-cell disease patients; and V. Dentist's involvement in an approach to sickle-cell disease. Twelve experts assigned scores to each item of the instrument. The criteria were clarity, understanding and appropriateness, leaving open fields for comments. Descriptive and content analyses of the data were made. Each expert analyzed 39 assessment units. The percentages considered for agreement were high (>80%), medium (70%-80%), or low (<70%), and each item was maintained or revised according to the percentage observed. There was high consensus in 74% of the assessment units (the corresponding items were maintained), medium consensus in 24% of them (the corresponding items were revised), and disagreement in 2% of them, namely as regards the "appropriateness" of item 5 ("Are there oral complications in sickle-cell disease?"), which was revised. The final version of the instrument had 16 items for different applications such as in the clinical care program, teaching program, or research program, with different cut-off scores for each application. In conclusion, the level of agreement among experts showed evidence of the content validity of the instrument.

Clarity of publications on HPV in Instagram profiles of official health agencies in Brazil.

The study analyzed the clarity of publications on human papillomavirus (HPV) in the Instagram profiles of official Brazilian health agencies. An infodemiological study analyzed publications on HPV in the 81 Instagram profiles selected from the Health Ministry, States' Health Departments, and dental councils and associations. The following data were collected: classification of content, type of profiles, type of media, how the content was addressed, number of posts, frequency, likes, comments, viewings, and hashtags, and how the HPV vaccine was addressed. The clarity of the educational publications was assessed using the Brazilian version of the Clear Communication Index (BR-CDC-CCI). Data analysis was performed with Spearman's correlation and the Mann-Whitney test (p < 0.05). A total of 504 publications on HPV were found. The average number of likes was 528.3 (SD = 2388.2) and the average BR-CDC-CCI score was 67.1 (SD = 14.1). The quality and clarity of the information was considered adequate (BR-CDC-CCI score ≥ 90) in 6.9% of the publications. A weak positive correlation was found between the number of likes and both the BR-CDC-CCI score (r = 0.195) and number of posts (r = 0.124). Publications from the Health Ministry had a significantly higher BR-CDC-CCI score (72.9) compared to the other profiles analyzed (p = 0.01). Most publications concerned government actions, had low engagement, and written educational information was of low clarity and quality. However, the effort to reach the population was evident, with an increase in publications over the years.

Avaliação de um material educativo sobre higiene bucal e transtorno do espectro autista sob a ótica dos critérios do BR-CDC-CCI / Evaluation of an educational material on oral hygiene and autism spectrum disorder from the perspective of the BR-CDC-CCI criteria

Objetivo: avaliar a clareza e a qualidade das informações de um material educativo sobre higiene bucal voltado para pacientes com Transtorno do Espectro Autista (TEA) sob a ótica de critérios preconizados da versão brasileira do Índice de Comunicação Clara em Saúde (BR-CDC-CCI). Materiais e Métodos: foi realizada uma busca no sítio de busca Google (www.google.com) no dia 4 de março de 2023, utilizando os unitermos "cartilha", "higiene bucal" e "pessoa com deficiência". O critério de inclusão envolveu material educativo direcionado a cuidadores de pessoas com TEA desenvolvido por instituição brasileira. Foram excluídos materiais educativos direcionados para profissionais de saúde ou educação, bem como materiais não disponibilizados online. A primeira página de busca revelou um material educativo em saúde bucal para cuidadores de pessoas com TEA, disponibilizado online. O BR-CDC-CCI foi utilizado de forma independente, por duas cirurgiãs-dentistas, para se avaliar o material a partir dos critérios de "Mensagem principal e chamada para ação", "Linguagem", "Design da informação", "Estado da ciência (conhecimento científico), "Recomendações de comportamento", "Números" e "Riscos". Os escores obtidos pelo consenso das avaliadoras para o material, em uma escala de zero a vinte, foram alcançados em uma reunião. Resultados: o material apresentou 100% de conformidade com os critérios exigidos pelo instrumento como mensagem principal destacada, linguagem simples, design atraente, recomendações comportamentais, evidência científica atual, riscos e abordagem adequada da numeracia, demonstrando clareza e qualidade das informações. Conclusão: o material educativo intitulado "Higiene Bucal Para Pessoas Com TEA", apresentou excelente qualidade de acordo com os critérios utilizados. O mesmo cumpre seu objetivo de ajudar pais e profissionais nos cuidados à higiene bucal das pessoas com TEA.

Objective: to evaluate the clarity and quality of information in one educational material on oral hygiene aimed at patients with Autism Spectrum Disorder (ASD) according to the criteria recommended by the Brazilian version of the Clear Communication in Health Index (BR-CDC-CCI). Materials and Methods: a electronic search was carried out on the Google search site (www.google.com) on March 4th, 2023, using the keywords "cartilha", "higiene bucal" and "pessoa com deficiência". The inclusion criterion involved educational material directed to caregivers of people with ASD developed by a Brazilian institution. Educational materials directed to health or education professionals were excluded, as well as materials not available online. The first search page revealed one oral health educational material for caregivers of people with ASD, available online. The BR-CDC-CCI was used independently by two dentists to assess the material using the criteria of "Main message and call to action", "Language", "Information design", "State of the science (scientific knowledge)", "Behavior recommendations", "Numbers", and "Risks". The scores obtained by the consensus of the evaluators for the material, on a scale of zero to twenty, were reached in a meeting. Results: the material showed 100% compliance with the criteria required by the instrument as highlighted main message, simple language, attractive design, behavioral recommendations, current scientific evidence, risks and appropriate approach to numeracy, demonstrating clarity and quality of information. Conclusion: the educational material entitled "Oral Hygiene for People with Autism" proved to be excellent material and could fulfill its goal of helping parents and professionals in the oral hygiene of people with ASD.

Clarity of publications on HPV in Instagram profiles of official health agencies in Brazil

Abstract The study analyzed the clarity of publications on human papillomavirus (HPV) in the Instagram profiles of official Brazilian health agencies. An infodemiological study analyzed publications on HPV in the 81 Instagram profiles selected from the Health Ministry, States' Health Departments, and dental councils and associations. The following data were collected: classification of content, type of profiles, type of media, how the content was addressed, number of posts, frequency, likes, comments, viewings, and hashtags, and how the HPV vaccine was addressed. The clarity of the educational publications was assessed using the Brazilian version of the Clear Communication Index (BR-CDC-CCI). Data analysis was performed with Spearman's correlation and the Mann-Whitney test (p < 0.05). A total of 504 publications on HPV were found. The average number of likes was 528.3 (SD = 2388.2) and the average BR-CDC-CCI score was 67.1 (SD = 14.1). The quality and clarity of the information was considered adequate (BR-CDC-CCI score ≥ 90) in 6.9% of the publications. A weak positive correlation was found between the number of likes and both the BR-CDC-CCI score (r = 0.195) and number of posts (r = 0.124). Publications from the Health Ministry had a significantly higher BR-CDC-CCI score (72.9) compared to the other profiles analyzed (p = 0.01). Most publications concerned government actions, had low engagement, and written educational information was of low clarity and quality. However, the effort to reach the population was evident, with an increase in publications over the years.

Some Psychometric Properties of the Brazilian CDC Clear Communication Index.

The Centers for Disease Control and Prevention (CDC) Clear Communication Index (CCI) was cross-culturally adapted to Brazilian Portuguese (BR). It was necessary to analyze the reliability and validity of the BR-CDC-CCI for its use in Brazil. This study aimed to evaluate the psychometric properties of the instrument in its Brazilian version. Four specialists in health education used the BR-CDC-CCI to evaluate a population-level health education material. Primary health care professionals (n = 105) evaluated the same health material using the BRCDC-CCI, and 30 professionals performed the retest 15 to 20 days after the first assessment. Cohen Kappa and area under the receiver operating characteristic (ROC) curve analyses were developed. Inter-rater agreement ranged from moderate to almost perfect, with 90% of the items almost perfect. The percentage of agreement ranged from 8.6% to 98.1%. For the analyzed questions, the area on the ROC curve was 0.9412 (confidence interval [CI] 95%; [0.8259, 1.000]). The BR-CDC-CCI had sufficient validity and reliability for its use in the evaluation of educational/informational materials in health in the Brazilian context. In view of the good results from this psychometric assessment, we anticipated the BR-CDC-CCI could contribute to improvements in Brazilian professionals' skills in developing health communication materials, thereby improving the quality of education and, possibly health outcomes. [HLRP: Health Literacy Research and Practice. 2022;6(2):e84-e87.].

Cross-cultural adaptation of the Clear Communication Index to Brazilian Portuguese.

OBJECTIVE: To perform a cross-cultural adaptation of the Clear Communication Index instrument from the Centers for Disease Control and Prevention (CDC-CCI) from English to Brazilian Portuguese. METHODS: This study comprised initial discussion about the conceptual equivalence of the instrument by a committee formed by experts on health education. We performed translations, synthesis of translations, back-translations, revision by the committee, and linguistic revision. Semantic equivalence was obtained by analyzing the referential and general meaning of each item by the committee, resulting in a pre-final version of the instrument. Subsequently, thirty professionals with health sciences degrees performed a pre-test. These professionals used the pre-final version of the instrument to assess a health education material. A questionnaire was applied to evaluate the acceptability of the instrument, the understanding of each of the 20 items, as well as the individual and professional variables. We analyzed the scores attributed to the health education material, the variables related to healthcare professionals, the proportions of the acceptability of the instrument, and the comprehension of each item. RESULTS: After we obtained the conceptual equivalence of the instrument, the committee of experts, the instrument's main author, and the linguist produced the pre-final version using two translations, a synthesis of the translations, and two back-translations. A general equivalence was maintained in 15 of the 20 items (75%), four of the items were slightly altered (20%), and one item was very altered (5%). Nineteen items presented referential equivalence or near equivalence (95%). We then carried out with the pre-test, in which the professionals used the pre-final version. Two items in the domains of "risks" and "main message" were unclear and needed to be revised. CONCLUSION: The process of cross-cultural adaptation of the Clear Communication Index provided an adapted version to the Brazilian Portuguese language.

Adaptação transcultural e validação do instrumento Clear Communication Index (CDC-CCI) para a língua portuguesa do Brasil / Cross-cultural adaptation and validation of the Clear Communication Index (CDC-CCI) instrument for Brazilian Portuguese

Materiais educativos e informativos em saúde, para promoverem saúde, devem ser compreendidos pelo público final. Para qualificar a elaboração e avaliação de materiais de comunicação em saúde foi criado o instrumento Clear Communication Index do Centers for Disease Control and Prevention (CDC-CCI). Constitui-se de 20 questões de múltipla escolha as quais pontuam presença ou ausência de critérios para a clareza da comunicação, distribuídos em sete domínios: "Mensagem Principal e Chamada para Ação", "Linguagem", "Design da Informação", "Estado da Ciência", "Recomendações de comportamento", "Números" e "Risco". Objetivou-se adaptar transculturalmente e validar o CDC-CCI para a língua portuguesa do Brasil. Na adaptação transcultural, avaliou-se as equivalências semântica (composta por equivalências de significados referencial e geral) e conceitual por meio de traduções, síntese das traduções, retrotraduções e pré-testes. Para significado referencial, a equivalência foi julgada em escala analógica visual de 0 a 100%, considerando-se "não equivalência" (<80%), "quase equivalência" (80-89%) e "máxima equivalência" (90-100%). O significado geral foi considerado como "Inalterado" (IA), "Pouco Alterado" (PA), "Muito alterado" (MA) ou "Completamente Alterado" (CA). Em seguida, buscou-se a equivalência conceitual pelo pré-teste aplicando-se a versão pré-final em material educativo, por 30 profissionais de nível superior de atenção primária em saúde pública, alcançando-se a versão adaptada. O instrumento adaptado foi aplicado, por outros 105 profissionais de saúde pública, em mesmo material educativo, com vistas à análise das propriedades psicométricas. 30% desses 105 profissionais fizeram reteste de 15 a 20 dias depois para testar a estabilidade temporal pelas concordâncias Kappa Cohen intra-examinadores. Simultaneamente, um comitê de especialistas avaliou o mesmo material educativo constituindo-se o padrão-ouro. As respostas positivas dos avaliadores foram confrontadas às do padrão-ouro e descritas na área sob a curva ROC (IC95) e em testes de sensibilidade. Dados demográficos e profissionais foram coletados por questionário. As informações foram registradas por dupla digitação e analisadas no Programa STATA. Na primeira fase, a idade média de profissionais foi de 36,8 anos, 87% eram mulheres (87%) e 77% eram dentistas e enfermeiros. Na segunda fase, a idade média foi de 35,6 anos, 77% mulheres e 71% dentistas e enfermeiros. Houve manutenção da equivalência geral em 15 dos 20 itens (75%), três itens mantiveram-se pouco alterados (15%) e um deles apresentou-se muito alterado (10%). Dezenove itens apresentaram equivalência referencial máxima ou quase equivalência (95%). O item muito alterado, após submissão ao comitê, foi considerado, por consenso, adaptado. A reprodutibilidade em dezoito questões (90,0%) teve valor de Kappa foi igual a 1 (concordância quase perfeita), em uma questão (5,0%) o Kappa foi de 0,839 (concordância substancial) e uma questão (5,0%), 0,570 (concordância moderada). A área sob a curva ROC para as dezenove questões consideradas aplicáveis pelo padrão-ouro, foi de 0,9412 (CI 95% - 0,8259-1,000). Nas quatro simulações feitas, nas quais incluiu-se questão considerada não aplicável pelo padrão-ouro, os valores de área sob a curva foram superiores ou igual a 0,6275. O CDC-CCI apresentou em sua versão brasileira (BR-CDC-CCI) equivalência com versão original além de validade e confiabilidade para uso no contexto brasileiro.

Educational and informational materials in health, to promote health, must be understood by the final public. In order to qualify the elaboration and evaluation of health communication materials, the Clear Communication Index instrument of the Centers for Disease Control and Prevention (CDC-CCI) was created. It consists of 20 multiple-choice questions that mark presence or absence of criteria for clarity of communication, distributed in seven domains: "Main Message and Call to Action", "Language", "Information Design", "State of Information" Science "," Behavioral Recommendations "," Numbers "and" Risk ". The objective was to adapt cross-culturally and validate the CDC-CCI for the Portuguese language of Brazil. In the cross-cultural adaptation, the semantic equivalences (composed of equivalences of referential and general meanings) and conceptual equivalences were evaluated through translations, synthesis of translations, back-translations and pre-tests. For referential meaning, equivalence was judged on a visual analog scale from 0 to 100%, considering "non-equivalence" (<80%), "almost equivalence" (80-89%) and "maximum equivalence" (90-100 %). The general meaning was considered to be "Unchanged" (UC), "Little Changed" (LC), "Very Changed" (VC) or "Completely Changed" (CC). Then, conceptual equivalence was sought through the pre-test by applying the pre-final version in educational material, by 30 professionals with a higher level of primary care in public health, reaching the adapted version. The adapted instrument was applied, by 105 other public health professionals, in the same educational material, with a view to the analysis of psychometric properties. 30% of these 105 professionals retested 15 to 20 days later to test the temporal stability using Kappa Cohen intra-examiner concordances. At the same time, a committee of experts evaluated the same educational material, constituting the gold standard. The positive responses of the evaluators were compared to those of the gold standard and described in the area under the ROC curve (IC95) and in sensitivity tests. Demographic and professional data were collected by questionnaire. The information was recorded by double entry and analyzed in the STATA Program. In the first phase, the average age of professionals was 36.8 years, 87% were women (87%) and 77% were dentists and nurses. In the second phase, the average age was 35.6 years, 77% women and 71% dentists and nurses. General equivalence was maintained in 15 of the 20 items (75%), three items remained little changed (15%) and one of them was very changed (10%). Nineteen items showed maximum referential equivalence or almost equivalence (95%). The highly altered item, after submission to the committee, was considered, by consensus, adapted. The reproducibility in eighteen questions (90.0%) had a Kappa value equal to 1 (almost perfect agreement), in one question (5.0%) the Kappa was 0.839 (substantial agreement) and one question (5.0 %), 0.570 (moderate agreement). The area under the ROC curve for the nineteen questions considered applicable by the gold standard, was 0.9412 (CI 95% - 0.8259-1,000). In the four simulations performed, which included a question considered not applicable by the gold standard, the area values under the curve were greater than or equal to 0.6275. The CDC-CCI presented in its Brazilian version (BR-CDC-CCI) equivalence with the original version in addition to validity and reliability for use in the Brazilian context.

Cross-cultural adaptation of the Clear Communication Index to Brazilian Portuguese

ABSTRACT OBJECTIVE To perform a cross-cultural adaptation of the Clear Communication Index instrument from the Centers for Disease Control and Prevention (CDC-CCI) from English to Brazilian Portuguese. METHODS This study comprised initial discussion about the conceptual equivalence of the instrument by a committee formed by experts on health education. We performed translations, synthesis of translations, back-translations, revision by the committee, and linguistic revision. Semantic equivalence was obtained by analyzing the referential and general meaning of each item by the committee, resulting in a pre-final version of the instrument. Subsequently, thirty professionals with health sciences degrees performed a pre-test. These professionals used the pre-final version of the instrument to assess a health education material. A questionnaire was applied to evaluate the acceptability of the instrument, the understanding of each of the 20 items, as well as the individual and professional variables. We analyzed the scores attributed to the health education material, the variables related to healthcare professionals, the proportions of the acceptability of the instrument, and the comprehension of each item. RESULTS After we obtained the conceptual equivalence of the instrument, the committee of experts, the instrument's main author, and the linguist produced the pre-final version using two translations, a synthesis of the translations, and two back-translations. A general equivalence was maintained in 15 of the 20 items (75%), four of the items were slightly altered (20%), and one item was very altered (5%). Nineteen items presented referential equivalence or near equivalence (95%). We then carried out with the pre-test, in which the professionals used the pre-final version. Two items in the domains of "risks" and "main message" were unclear and needed to be revised. CONCLUSION The process of cross-cultural adaptation of the Clear Communication Index provided an adapted version to the Brazilian Portuguese language.

What Has Changed in the Dental Prosthesis Procedures in Primary Health Care In Brazil?

The study aimed to identify the changes in the provision of dental prosthetics procedures in the Brazilian primary care. Secondary data from the Brazilian "National Programme for Improving Access and Quality of Primary Care" was assessed and three similar questions related to dental prostheses execution that were answered by the same 9,698 oral health teams, in 2011/2012 and 2013/2014, were compared. There was a 4.3% increase in the number of teams that identified individuals with prosthetic needs; a 0.8% increase in the number of teams that performed impression for prosthetic purposes; and the number of teams that reported performing dental prostheses consultations increased by 0.6%. Overall, there was a small modification in the number of teams that provided dental prosthesis procedures in Brazil.

Conditions and Perceptions of Oral Health in Brazilian Pregnant Women

Objective: To identify the prevalence of caries and periodontal diseases, and factors associated with caries and perceptions of dental care by pregnant women, before and after the educational intervention. Material and Methods: 121 pregnant women from the municipality of Matozinhos (Minas Gerais State, Brazil) participated in this study. Caries and periodontal diseases, sociodemographic characteristics, and access to dental service were evaluated. Perceptions were analyzed before and after the action of operative groups. In addition to descriptive statistical analysis, the DMFT index, dichotomized by the median value, was associated with family income and perceptions of treatment need and health, using the Pearson's and linear trend chi-square tests. The McNemar's chi-square test was used for comparisons before and after educational interventions. A significance level of p<0.05 was used. Results: The DMFT was equal to 12.00 (±6.33), with 52.2% of carious teeth. Most of the pregnant women showed some level of periodontal disease or dental calculus. Caries was neither associated with family income (p=0.469) and need for dental treatment (p=0.161) nor with health perception (p=0.506). There was an improvement regarding the perception of dental care during pregnancy after educational intervention (p<0.001). Conclusion: The conditions of oral health and oral health care in pregnant women are worrisome. Educational interventions improved the perceptions of dental care, and they pointed out the need dentists have as effective members of the prenatal team.

Saúde bucal em gestantes: percepção e aspectos clínicos subsidiando ações no serviço / Oral health in pregnant women: perception and clinical subsidizing actions in service

O atendimento odontológico a gestantes parece, ainda, ser realizado de maneira incipiente, sendo importante que esse tipo de assistência ocorra segundo protocolos. O presente estudo buscou, inicialmente, realizar a análise de dados previamente coletados no município de Matozinhos/MG para que os mesmos fossem convertidos em instrumentos para a melhoria das condições de saúde bucal das gestantes. Avaliaram-se doenças cárie e periodontal, por única examinadora calibrada (Coeficientes Cohen Kappa iguais a 0,94, 0,75 e 0,65 para cárie, índice periodontal comunitário - CPI e índice de perda de inserção periodontal - PIP, respectivamente) características sociodemográficas, autopercepção e de acesso ao serviço utilizando-se os critérios do programa SB Brasil...