JMIR Publications

ABSTRACT

Background:

In 2022, the World Health Organization highlighted the alarming state of oral health (OH) worldwide and urged action to include OH in initiatives on non-communicable diseases (NCDs). People's OH skills and attitudes need to be improved. The population must acquire an adequate level of OH literacy (OHL) and general health literacy (HL). The implementation of health promotion actions in the workplace, which is a part of most people's lives, appears has an opportunity. In France, civil servants regroup several socio-professional levels and represent an excellent model with results transposable to the population.

Objective:

This study aimed at determining the OHL and HL level of civil servants in France in order to implement specific prevention actions in their workplace.

Methods:

A cross-sectional study on the French civil servants was conducted in France from October 2023 to February 2024. Participants completed three validated questionnaires in French: (i) OH knowledge, (ii) Oral Health Literacy Instrument (OHLI-F composed of a reading comprehension and a numeracy sections) to assess the OHL level, and (iii) Short Test of Functional Health Literacy in Adults (s-TOHFLA) to assess the HL level. The scores of OH knowledge, OHLI-F and s-TOFHLA-F were reported as mean (SD) and 95% confidence intervals (CI). Theses scores were classified into three categories: adequate (75–100), marginal (60–74) and inadequate (0–59), Analysis of variance and binary logistic regression were performed. The OHLI-F reading comprehension and OHLI-F numeracy scores were compared using the Welch Two Sample t-test and the Paired t-test. For the correlation matrix, the Pearson correlation and the related test were computed.

Results:

1917 persons completed the three questionnaires with an adequate level of OHL (84.0%, n=1610), OH knowledge (90.6%, n=1736) and HL (99.9%, n=1915). The scores of s-TOHFLA (mean 98.2, SD 2.8) were higher than OHLI-F (mean 80.9, SD 7.9) and OH knowledge (mean 87.6, SD 10.5). OHLI-F was highly correlated with OH knowledge (P<.001) but OHLI-F and OH knowledge have a low correlation with s-TOHFLA (P=.43). The OHLI-F reading comprehension score were significantly higher than the OHLI-F numeracy score (P<.001). Age, education level, and professional category impact the three scores (P<.001). The professional category was a determinant of an adequate OHLI-F and OH knowledge score.

Conclusions:

Some French civil servants had inadequate or marginal levels of OH knowledge (9.5%) and OHL (16.0%) but none had an inadequate level of HL. Results highlighted the relevance of implementing OH promotion programs in the workplace. They should be non-standardized, adapted to the literacy level of professional categories of workers and focused on numeracy skills. Thus, appropriate preventive communication and improved literacy levels are the means to achieve greater disease equity and combat the burden of NCDs.