Measuring Digital Oral Health Literacy in the Social Media Era: Psychometric Validation of the Romanian Version of the Social Media Oral Health Literacy Questionnaire (SMOHLQ)

社交媒体时代数字口腔健康素养的测量:社交媒体口腔健康素养问卷(SMOHLQ)罗马尼亚语版的心理测量学验证

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Abstract

Background/Objectives: Online environment and social media platforms have become major sources of health information, influencing behaviors and decision-making related to oral health. The Aim of This Study was to culturally adapt and psychometrically validate the Romanian version of the Social Media Oral Health Literacy Questionnaire (SMOHLQ) and to assess oral health literacy levels among dental students. Material and Methods: An observational cross-sectional study was conducted among 304 fourth- and fifth-year dental students. The Romanian version of the SMOHLQ underwent cultural adaptation and psychometric evaluation using descriptive statistics, exploratory factor analysis (principal axis factoring with oblimin rotation), Cronbach's alpha coefficient, intraclass correlation coefficient (ICC), Pearson correlations, and ANOVA analysis. Results: Exploratory factor analysis confirmed a three-dimensional structure consisting of access and understanding, critical appraisal, and behavioral impact domains. Internal consistency was high for the overall scale (Cronbach's α = 0.856) and good across subscales (α = 0.744-0.836). Pearson correlations showed significant associations between dimensions (r = 0.162-0.603, p < 0.001). ICC values indicated good score stability. ANOVA analyses revealed significant differences across demographic subgroups (p < 0.05). Mean scores were higher for cognitive dimensions (MS = 4.20-4.54) compared with behavioral impact (MS = 2.87). Conclusions: The Romanian version of the SMOHLQ demonstrated satisfactory psychometric properties, supporting its reliability and construct validity as a tool for assessing digital oral health literacy in the context of social media use.

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