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J Immigr Minor Health. 2014 Aug;16(4):622-30. doi: 10.1007/s10903-013-9846-0.

Health literacy, acculturation, and the use of preventive oral health care by Somali refugees living in massachusetts.

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Refugee and Immigrant Health Program, Massachusetts Department of Public Health, 305 South Street, Jamaica Plain, MA, 02130, USA,


This study investigated the impact of English health literacy and spoken proficiency and acculturation on preventive dental care use among Somali refugees in Massachusetts. 439 adult Somalis in the US ≤10 years were interviewed. English functional health literacy, dental word recognition, and spoken proficiency were measured using STOFHLA, REALD, and BEST Plus. Logistic regression tested associations of language measures with preventive dental care use. Without controlling for acculturation, participants with higher health literacy were 2.0 times more likely to have had preventive care (P = 0.02). Subjects with higher word recognition were 1.8 times as likely to have had preventive care (P = 0.04). Controlling for acculturation, these were no longer significant, and spoken proficiency was not associated with increased preventive care use. English health literacy and spoken proficiency were not associated with preventive dental care. Other factors, like acculturation, were more predictive of care use than language skills.

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