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Cruz S, Holland H, Chi DL. Validating a Conceptual Model on Topical Fluoride Hesitancy With Latino Parents. HEALTH EDUCATION & BEHAVIOR 2024:10901981241231500. [PMID: 38372277 DOI: 10.1177/10901981241231500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Fluoride hesitancy is a growing public health challenge and interventions to address it may need to be tailored for minoritized subgroups to address oral health inequities. The goals of this qualitative study were to investigate the extent to which an existing conceptual model on topical fluoride hesitancy is applicable to Latino parents and whether applicability differed between Spanish-speaking Latino (SL) and English-speaking Latino (EL) parents. We conducted semi-structured one-on-one interviews with non-Latino English-speaking parents (N = 50), SL parents (n = 8), and EL parents (n = 8). We coded the transcripts deductively and compared our findings both qualitatively and quantitatively to an existing model on topical fluoride hesitancy comprising 21 categories classified into six domains. We compared frequencies across model domains and categories for Latino versus non-Latino parents as well as for SL versus EL parents. Latino parents were represented across all six domains and 21 categories of the conceptual model. Comparing Latino and non-Latino parents, representation was similar across Domains 1 to 3 (necessity, chemicals, and harm); Latino parents were more highly represented in Domains 4 to 6 (uncertainty, pressure, and choice) compared with non-Latino parents. A larger proportion of EL parents thought a healthy diet was more important than fluoride (Category 1d) and a larger proportion of SL parents felt they did not know enough about fluoride (Category 4a). An existing conceptual model on topical fluoride hesitancy was generally a good fit for SL and EL parents. However, differential representation across model categories suggests that fluoride-related communication and intervention approaches may need to be tailored to Latino parents based on language preference.
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Anwar AI, Panna SS, Akbar FH. Differences in Early Childhood Caries Status on Parental Stress Levels and Socioeconomic Status in Makassar City, Indonesia, During the COVID-19 Pandemic. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
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Floríndez LI, Como DH, Floríndez DC, Vigen C, Floríndez FM, Cermak SA. Identifying Gaps in Oral Care Knowledge, Attitudes, and Practices of Latinx Parents/Caregivers of Children With and Without Autism Spectrum Disorders. Health Equity 2021; 5:185-193. [PMID: 33937604 PMCID: PMC8080905 DOI: 10.1089/heq.2020.0078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose: This pilot study used data from a survey to examine the knowledge, attitudes, and practices about oral care of Latinx parents/caregivers of children with or without autism spectrum disorder (ASD) to identify gaps to focus future intervention. Methods: Sixty English-speaking Latinx parents/caregivers who had a child between 4 and 14 years with or without ASD (n=31 ASD, n=29 typically developing [TD]) completed a questionnaire on oral health knowledge, practices, access to care, and demographics. Caregiver responses were compared, and gaps in knowledge and practices were identified. Results: There were no significant differences in parent age, child age, income, insured status, or overall knowledge scores, only a significant difference in education (p=0.02), with the ASD group reporting less. Scores for knowledge, attitudes, access and practice were all nonsignificantly positively correlated, as was attitudes with access and practice. However, knowledge and attitudes were significantly negatively correlated. Additional significant findings were parents who had lower income and education, had lower oral knowledge scores, decreased frequency of dental visits, increased feelings of being discriminated against, children with increased fear of the dentist, and decreased ease of finding a dentist. Conclusion: Factors such as income, education, ethnicity, and having a child with ASD can influence what Latinx parents and caregivers know about oral health and how their children experience receiving dental care. Latinx parents/caregivers of children with and without ASD report barriers to dental care, including difficulty attending visits or feeling stigmatized by their dental provider due to their ethnicity. Fear of the dentist is significantly correlated with ASD diagnosis and lower social demographics of the parent, and may contribute to a reduction in preventative oral care visits as well. Health care providers should consider these perspectives when providing care to this population to mitigate further oral health inequities.
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Affiliation(s)
- Lucía I Floríndez
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Dominique H Como
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Daniella C Floríndez
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Cheryl Vigen
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | | | - Sharon A Cermak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
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Floríndez LI, Floríndez DC, Price ME, Floríndez FM, Como DH, Polido JC, Baezconde-Garbanati L, Pyatak E, Cermak SA. Exploring Eating Challenges and Food Selectivity for Latinx Children with and without Autism Spectrum Disorder Using Qualitative Visual Methodology: Implications for Oral Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3751. [PMID: 33916808 PMCID: PMC8038332 DOI: 10.3390/ijerph18073751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 01/16/2023]
Abstract
Diet and food choices significantly impact teeth, including enamel quality and development of dental caries. However, studies focusing on diet and its relation to oral care in Latinx children with and without Autism Spectrum Disorders (ASD) have been minimally addressed in research. This qualitative study used an inclusive visual methodology to explore what Latinx caregivers learned about their child's diet preferences and food routines in relation to their oral health. As a secondary aim, the study sought to explore whether notable differences in diet emerged between Latinx children with and without ASD. Participants were 32 Latinx caregivers from 18 families with children with and without Autism (n = 8 with a typically developing child and n = 10 with a child with ASD) who completed a food journal activity and photo elicitation interview. Interviews were thematically coded for themes pertaining to parents' perceptions of their child's diet and oral health. Findings of this study indicate that the process of taking photos helped Latinx caregivers to better situate the barriers and behaviors influencing everyday food routines in their children within the context of relating to their overall oral health. Via their active participation in the research process, parents were empowered to note strategies they could employ that would directly impact their child's oral health outcomes, such as reducing juice intake and monitoring sugar consumption. Therefore, visual research methodologies are an important strategy for researchers to consider in order to empower participants to be part of the research process and part of the outcomes, and to offer better understanding of the lived experience of populations underrepresented in the literature, such as Latinx children with and without ASD and their families.
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Affiliation(s)
- Lucía I. Floríndez
- Department of Nursing Research, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA
| | | | - Mia E. Price
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (M.E.P.); (D.H.C.); (E.P.); (S.A.C.)
| | | | - Dominique H. Como
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (M.E.P.); (D.H.C.); (E.P.); (S.A.C.)
| | - Jose C. Polido
- Division of Dentistry, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA;
| | | | - Elizabeth Pyatak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (M.E.P.); (D.H.C.); (E.P.); (S.A.C.)
| | - Sharon A. Cermak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (M.E.P.); (D.H.C.); (E.P.); (S.A.C.)
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Rai NK, Tiwari T. Oral Health Behavior Change in Mexican-American Caregivers: A Community-Based Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183409. [PMID: 31540018 PMCID: PMC6765947 DOI: 10.3390/ijerph16183409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 11/16/2022]
Abstract
An oral health prevention intervention was conducted with Mexican-American (MA) caregivers, focused on improving their oral health knowledge, behavior, and self-efficacy. Five in-person intervention sessions were conducted with caregivers, followed by a 15 min skill-building exercise. A goal-setting sheet was provided, and two goals were chosen for fulfilment during the three month intervention period. The data on parental oral health knowledge, behavior, and self-efficacy were collected pre- and post-intervention using a portion of Basic Factors Research Questionnaire (BRFQ). Paired t-tests were conducted to test significant differences in the means of pre- and post-intervention oral health behavior, knowledge, and self-efficacy scores, and pre- and post-intervention individual item scores. Forty six primary caregivers were enrolled. There were significant differences in the means of pre- and post-intervention oral health knowledge (p = 0.003), oral health behavior (p = 0.0005), and self-efficacy scores (p = 0.001). The individual item mean scores showed that there was a significant increase in the number of times caregivers checked for spots (p = 0.016) and a significant decrease in the consumption of sweet or sugary drinks (p = 0.032) post-intervention. Most of the caregivers believed that cavities were caused by germs in the mouth (p = 0.001), sharing utensils with children was bad for their teeth (p < 0.001), and fluoride toothpaste was best for a child’s teeth (p < 0.001). The intervention resulted in improved caregiver oral health knowledge, behavior, and self-efficacy.
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Affiliation(s)
- Nayanjot K Rai
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - Tamanna Tiwari
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
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Floríndez LI, Floríndez DC, Floríndez FM, Como DH, Pyatak E, Baezconde-Garbanati L, Polido JC, Cermak SA. Oral Care Experiences of Latino Parents/Caregivers with Children with Autism and with Typically Developing Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2905. [PMID: 31416123 PMCID: PMC6721061 DOI: 10.3390/ijerph16162905] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/03/2019] [Accepted: 08/09/2019] [Indexed: 12/17/2022]
Abstract
As a result of various barriers, several pediatric populations are at risk for poor oral health, including children with disabilities and children from under-represented populations, such as Latinos. To this end, this study aimed to better understand the factors that affect the oral health experiences of 32 Latino parents/caregivers from 18 families (n = 8 with a typically developing child and n = 10 with a child with Autism). Using a qualitative descriptive methodology, each family was interviewed twice. Interviews were audio-recorded, transcribed verbatim, and coded thematically to identify the individual, social, systemic, and culturally rooted factors contributing to oral health disparities in the families. The three themes that arose were "Why would I want to start trouble?": Latino parents' dissatisfaction with dental treatments, costs, and fear of the dentist and health care providers because of their ethnic minority status as key factors inhibiting receipt of dental care; "We have to put our children first": prioritizing the oral care activities of their children over their own individual oral care needs; and "We always keep baking soda around": familial and cultural influences on oral care habits. Understanding the oral health beliefs and experiences of Latino parents and caregivers of children with and without autism is critical for developing targeted prevention and intervention programs and reducing oral health disparities.
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Affiliation(s)
- Lucía I Floríndez
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA.
| | | | | | - Dominique H Como
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Elizabeth Pyatak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | | | - Jose C Polido
- Division of Dentistry, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - Sharon A Cermak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
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Nicksic NE, Massie AW, Byrd-Williams CE, Kelder SH, Sharma SV, Butte NF, Hoelscher DM. Dietary Intake, Attitudes toward Healthy Food, and Dental Pain in Low-Income Youth. JDR Clin Trans Res 2019; 3:279-287. [PMID: 30938601 DOI: 10.1177/2380084418774039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Few studies have examined the relation between food consumption and related attitudes and dental pain among children. The objective of this study is to examine the associations of healthy and unhealthy food items, attitudes toward healthy food, and self-efficacy of eating healthy with dental pain among children. A cross-sectional analysis was performed using child survey data from the Texas Childhood Obesity Research Demonstration (TX CORD) project. Fifth-grade students ( n = 1,020) attending 33 elementary schools in Austin and Houston, Texas, completed the TX CORD Child Survey, a reliable and valid survey instrument focused on nutrition and physical activity behaviors. All nutrition questions ask about the number of times food and beverage items were consumed on the previous day. Dental pain was reported as mouth or tooth pain in the past 2 wk that made their mouth hurt so much that they could not sleep at night. Mixed-effects logistic regression models were used to test the association between 10 unhealthy food items, 9 healthy food items, 2 health attitudes, and self-efficacy with dental pain. All models controlled for sociodemographic variables. In total, 99 (9.7%) students reported dental pain. Dental pain was associated with intake of the following unhealthy items: soda, fruit juice, diet soda, frozen desserts, sweet rolls, candy, white rice/pasta, starchy vegetables, French fries/chips, and cereal (adjusted odds ratio [AOR], 1.27-1.81, P < 0.01). The intake of other vegetables (AOR, 1.56; P < 0.01), a healthy item, and the attitude that healthy food tastes good (AOR, 1.59; P = 0.04) were also positively associated with dental pain. The attitude of eating healthier leads to fewer health problems (AOR, 0.50) and self-efficacy for healthy eating (AOR, 0.44) were negatively associated with dental pain ( P < 0.01). Interventions should focus on improving oral health by reducing intake of unhealthy foods and educating children and families on the importance of diet as a means of reducing dental caries. Knowledge Transfer Statement: The results of this study can be used to inform researchers on potential food items and psychosocial measures to examine in low-income, minority populations for longitudinal research. These results would also be useful to educators who could incorporate oral health care and nutrition education into school curriculums.
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Affiliation(s)
- N E Nicksic
- 1 University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, USA
| | - A W Massie
- 2 Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, USA
| | - C E Byrd-Williams
- 2 Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, USA
| | - S H Kelder
- 2 Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, USA
| | - S V Sharma
- 3 Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - N F Butte
- 4 USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - D M Hoelscher
- 2 Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, USA
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Macy JT, Moser EAS, Hirsh AT, Monahan PO, Eckert GJ, Maupomé G. Factors associated with seeking preventive dental care: an integrative model exploration of behaviors in Mexican immigrants in Midwest America. BMC Oral Health 2018; 18:37. [PMID: 29530026 PMCID: PMC5848600 DOI: 10.1186/s12903-018-0502-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 03/05/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Mexican immigrants in the United States suffer from poor oral health. The objective of the current study was to explore the utility of applying theory-based factors associated with seeking preventive dental care in a sample of Mexican American adults. METHODS Data were collected from a cross-sectional survey of a sample of 157 people of Mexican origin (64% female; age 34 ± 11 years) recruited primarily from church congregations and lay community organizations in Central Indiana. Using the Integrative Model of Behavioral Prediction as the guiding framework, structural equation modeling was used to test factors associated with intention to seek preventive dental care. RESULTS Attitude towards seeking preventive dental care (estimate = 0.37; p < .0001) and self-efficacy for seeking preventive dental care (estimate = 0.68; p < .0001) were associated with intention to seek preventive dental care. The association between dental beliefs and intention to seek preventive dental care was mediated by attitude and self-efficacy (indirect effect = 0.26, p = .002), and the association between past behavior and intention to seek preventive dental care was mediated by self-efficacy (indirect effect = 0.26, p = .003). CONCLUSIONS These findings suggest that interventions to increase preventive dental care seeking behavior among Mexican Americans should focus on changing attitudes toward seeking preventive dental care and on increasing self-efficacy to seek preventive dental care. Findings also support the use of interventions to influence dental beliefs.
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Affiliation(s)
- Jonathan T. Macy
- Department of Applied Health Science, Indiana University School of Public Health, 1025 East 7th Street, Room 116, Bloomington, IN 47405 USA
| | | | - Adam T. Hirsh
- Indiana University-Purdue University, Indianapolis, IN USA
| | | | | | - Gerardo Maupomé
- Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN USA
- Indiana University Network Science Institute, Bloomington, IN USA
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Rawahi SHA, Asimakopoulou K, Newton JT. Factors related to reducing free sugar intake among white ethnic adults in the UK: a qualitative study. BDJ Open 2018; 4:17024. [PMID: 29607093 PMCID: PMC5842859 DOI: 10.1038/bdjopen.2017.24] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 12/07/2017] [Indexed: 01/08/2023] Open
Abstract
Objective/Aims: To determine the barriers and enablers to behavioural change to reduce free sugar intake related to dental caries in a sample of UK adults who identify their ethnicity as White. Materials and methods: Qualitative study comprising semi-structured interviews of 27 participants. Interviews were recorded, transcribed and analysed using thematic analysis methods. The Capability-Opportunity-Motivation-Behaviour model (COM-B) and the Theoretical Domains Framework (TDF) were used to guide the derivation of themes. Results: Data saturation occurred at 27 interviews. The COM-B Model and TDF domains captured various factors that may influence the consumption of free sugar. TDF elements which are reflected in the study are: Knowledge; Psychological skills; Memory, attention, and decision processes; Behavioural regulation; Physical skills; Social influence; Environmental context and resources; Social and professional role and identity; Beliefs about capabilities; Beliefs about consequence; Intentions and goals reinforcement; and Emotions. COM-B Model elements which are reflected in the study are: psychological capabilities, physical capabilities, social opportunities, physical opportunities, reflective motivation, and automatic motivation. Discussion and conclusion: The COM-B model and TDF framework provided a comprehensive account of the barriers and facilitators of reducing sugar intake among white ethnic groups.
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Affiliation(s)
- Said Harith Al Rawahi
- Social & Behavioural Sciences Unit, Department of Population and Patient Health, Dental Institute, King's College London, Tower Wing, London, UK
| | - Koula Asimakopoulou
- Social & Behavioural Sciences Unit, Department of Population and Patient Health, Dental Institute, King's College London, Tower Wing, London, UK
| | - Jonathon Timothy Newton
- Social & Behavioural Sciences Unit, Department of Population and Patient Health, Dental Institute, King's College London, Tower Wing, London, UK
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Wilson AR, Mulvahill MJ, Tiwari T. The Impact of Maternal Self-Efficacy and Oral Health Beliefs on Early Childhood Caries in Latino Children. Front Public Health 2017; 5:228. [PMID: 28894733 PMCID: PMC5581360 DOI: 10.3389/fpubh.2017.00228] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 08/14/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Latino children experience one of the highest rates of early childhood caries requiring interventions based on valid conceptual frameworks. The Health Belief Model has relevance as a predictor of compliance with health recommendations based on perceptions of a health condition and behaviors to avoid the condition. The model encompasses four perceptual constructs (susceptibility, severity, benefits, barriers) and, for complex conditions, includes self-efficacy as an extended model. This study evaluated individual (self-efficacy and health beliefs) and cultural (acculturation status) level factors and the inter-relationship to determine if items assessed for the Extended Health Belief Model (EHBM) were valid measures of maternal factors. METHODS A cross-sectional study was conducted with 100 mother-child dyads at the Dental Center of Children's Hospital Colorado, Aurora, CO, USA. Participating mothers completed a survey in English or Spanish with items from the Basic Research Factors Questionnaire encompassing sociodemographic characteristics, oral health knowledge and behavior, and psychosocial measures including the EHBM. Language preference was a proxy for maternal acculturation. Children were examined to measure decayed, missing, and filled tooth surfaces. Internal consistency reliability of each subscale was evaluated using Cronbach's alpha. Convergent validity was assessed using linear regression to evaluate the association of the EHBM subscales with oral health-related measures and language preference. RESULTS The benefits and self-efficacy scales reflected good reliability. Maternal education was the strongest predictor of health beliefs with significant associations for barriers, benefits, and susceptibility. Perceived benefits increased with each additional year in the household. There was a significant association between maternal oral health knowledge and higher perceived benefits and increased self-efficacy, and the same was found for higher knowledge of dental utilization which was also associated with children perceived as having increased susceptibility to early childhood caries. Less acculturated participants perceived more barriers to behavioral adherence and fewer barriers as knowledge increased. As dental utilization knowledge improved for Spanish-speaking participants, they perceived greater benefits from adherent oral health behavior compared to English-speaking participants. CONCLUSION Items assessed for the EHBM were valid as measures of maternal factors influencing children's oral health outcomes in a Latino population.
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Affiliation(s)
- Anne R. Wilson
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Matthew J. Mulvahill
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Tamanna Tiwari
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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Maida CA, Marcus M, Hays RD, Coulter ID, Ramos-Gomez F, Lee SY, McClory PS, Van LV, Wang Y, Shen J, Lau B, Spolsky VW, Crall JJ, Liu H. Qualitative methods in the development of a parent survey of children's oral health status. J Patient Rep Outcomes 2017; 2:7. [PMID: 29757326 PMCID: PMC5934927 DOI: 10.1186/s41687-018-0033-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 02/01/2018] [Indexed: 11/10/2022] Open
Abstract
Background Parents’ perceptions of their 8–17-year-old children’s oral health status were assessed using a sample from diverse dental clinics in Greater Los Angeles County to identify constructs for a survey instrument. Methods Focus groups with 29 parents or guardians were conducted to identify themes that informed development of survey items. The draft items were administered to a different group of 32 parents or guardians in cognitive interviews, and revised for subsequent field-testing. Results Thematic and narrative analyses were performed after the focus groups and key lay-oriented dimensions were uncovered, notably the relationship between oral health, systemic health and the life course. In the cognitive interviews, parents entered multiple responses to questions related to the look of their child’s teeth, and their overall perception of tooth color. Parents also assessed their child’s fear or discomfort with the dental experience, and other social and psychological concerns related to oral health status. The temporal dimensions of certain items were specified; for example, oral pain and mood items were revised to include duration of the symptom or mood state. As parents tended to confuse oral health maintenance and prevention, these two related concepts were separated into two items. Based on the qualitative work, we revised items in preparation for a field test. Conclusions As a PRO measurement study, qualitative research informed a field test survey to assess factors associated with oral health status and the individual’s perceptions and subjective views of these constructs for eventual item development for epidemiological and clinical use.
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Affiliation(s)
- Carl A Maida
- 1School of Dentistry, Division of Public Health & Community Dentistry and Division of Oral Biology & Medicine, University of California, Los Angeles, Box 951668, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668 USA
| | - Marvin Marcus
- 2School of Dentistry, Division of Public Health & Community Dentistry, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Ron D Hays
- 3Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, Los Angeles, USA.,Department of Health Policy and Management, Fielding School of Public Health, Los Angeles, CA 90095 USA.,5RAND Corporation, Santa Monica, CA 90401 USA
| | - Ian D Coulter
- 2School of Dentistry, Division of Public Health & Community Dentistry, University of California, Los Angeles, Los Angeles, CA 90095 USA.,5RAND Corporation, Santa Monica, CA 90401 USA
| | - Francisco Ramos-Gomez
- 6School of Dentistry, Division of Growth & Development, Section of Pediatric Dentistry, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Steve Y Lee
- 7School of Dentistry, Division of Constitutive & Regenerative Sciences, Section of Restorative Dentistry, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Patricia S McClory
- 6School of Dentistry, Division of Growth & Development, Section of Pediatric Dentistry, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Laura V Van
- 8School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Yan Wang
- 2School of Dentistry, Division of Public Health & Community Dentistry, University of California, Los Angeles, Los Angeles, CA 90095 USA.,Department of Biostatistics, Fielding School of Public Health, Los Angeles, CA 90095 USA
| | - Jie Shen
- 2School of Dentistry, Division of Public Health & Community Dentistry, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Bryant Lau
- 10College of Letters and Science, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Vladimir W Spolsky
- 2School of Dentistry, Division of Public Health & Community Dentistry, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - James J Crall
- 2School of Dentistry, Division of Public Health & Community Dentistry, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Honghu Liu
- 2School of Dentistry, Division of Public Health & Community Dentistry, University of California, Los Angeles, Los Angeles, CA 90095 USA.,Department of Biostatistics, Fielding School of Public Health, Los Angeles, CA 90095 USA.,Department of Medicine, Division of General Internal Medicine and Health Services Research, Los Angeles, CA 90095 USA
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Hoeft KS, Barker JC, Shiboski S, Pantoja-Guzman E, Hiatt RA. Effectiveness evaluation of Contra Caries Oral Health Education Program for improving Spanish-speaking parents' preventive oral health knowledge and behaviors for their young children. Community Dent Oral Epidemiol 2016; 44:564-576. [PMID: 27517458 DOI: 10.1111/cdoe.12250] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 06/30/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the effectiveness of the Contra Caries Oral Health Education Program (CCOHEP) for improving low-income, Spanish-speaking parents' oral health knowledge and behaviors for their young children. Mexican American children in the United States suffer disproportionately high prevalence and severity of early childhood caries, yet few evaluated, theory-based behavioral interventions exist for this population. CCOHEP is a theory-based curriculum consisting of four 2-h interactive classes designed for and by Spanish speakers and led by designated community health educators (promotoras). Topics included children's oral hygiene, caries etiology, dental procedures, nutrition, child behavior management, and parent skill-building activities. METHODS Low-income Spanish-speaking parents/caregivers of children aged 0-5 years were recruited through community services in an agricultural city in California. Survey questions from the Oral Health Basic Research Facts Questionnaire measuring oral health-related behaviors and knowledge were verbally administered before, immediately after, and 3 months after attendance at CCOHEP. Five questions measured aspects of parental toothbrushing for their children (frequency, using fluoridated toothpaste, brushing before bed, not drinking or eating after nighttime brushing, adult assistance), three questions measured other oral health behaviors, and 16 questions measured oral health-related knowledge. Analyses of within-person changes between pre- and post-tests and again between post-test and 3-month follow-up consisted of McNemar's test for binary outcomes and sign tests for ordinal outcomes. RESULTS Overall, 105 caregivers participated in CCOHEP (n = 105 pretest, n = 95 post-test, n = 79 second post-test). At baseline, all parents self-reported doing at least one aspect of toothbrushing correctly, but only 13% reported performing all five aspects according to professional guidelines. At post-test, 44% of parents reported completing all aspects of toothbrushing according to professional guidelines (P < .001). Statistically significant improvements were seen in 4 aspects of toothbrushing (P ≤ .008) between pretest and post-test (all but adult assistance). The second post-test showed 3 of these improvements were maintained, while adult assistance and the other reported behaviors improved (P ≤ .008). Between pretest and post-test, checking child's teeth monthly and frequency of sweet drinks consumption improved (P ≤ .008), while frequency of eating sweet foods did not change. Knowledge was high at baseline (mean 12.8 of 16), but 6 knowledge items improved significantly between pretest and post-test. Improvements were maintained at second post-test. CONCLUSIONS Contra Caries Oral Health Education Program improved low-income Spanish-speaking parents' oral hygiene knowledge and self-reported behaviors for their young children, and change was sustained 3 months after the end of the intervention. Future, more rigorous evaluation of the intervention is recommended.
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Affiliation(s)
- K S Hoeft
- Department of Epidemiology & Biostatistics, Center to Address Disparities in Children's Oral Health (CAN DO), University of California, San Francisco, San Francisco, CA, USA.
| | - J C Barker
- Department of Anthropology, History & Social Medicine, Center to Address Disparities in Children's Oral Health (CAN DO), University of California, San Francisco, San Francisco, CA, USA
| | - S Shiboski
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - E Pantoja-Guzman
- Department of Anthropology, History & Social Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - R A Hiatt
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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Trubey RJ, Moore SC, Chestnutt IG. Children's toothbrushing frequency: the influence of parents' rationale for brushing, habits and family routines. Caries Res 2015; 49:157-64. [PMID: 25634461 DOI: 10.1159/000365152] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 06/09/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To assess the relationship between parental and family factors and children's toothbrushing frequency at different times of day. METHODS A cross-sectional questionnaire survey of predominantly low-socio-economic status parents of children aged 3-6 years (n = 296) in South Wales, UK. Data were collected on the child's weekly toothbrushing frequency (morning and evening), the parents' rationale for brushing their child's teeth in the morning and evening, the strength of a parent's habit for brushing a child's teeth in the morning and evening, and the extent to which the family's daily routines were stable from day to day. Socio-demographic details were also collected. RESULTS Reported weekly brushing frequency was significantly (p < 0.001) higher in the morning (mean ± SD: 6.57 ± 1.37) than the evening (mean ± SD: 5.99 ± 2.15). Parents had significantly (p < 0.001) more interest in the cosmetic benefits of toothbrushing in the morning compared to the evening. Multivariate analysis showed that an increasing focus on the cosmetic benefits of toothbrushing was associated with significantly (p < 0.05) less weekly brushing in the evening. The extent to which brushing a child's teeth was 'habitual' was significantly (p < 0.001) associated with weekly toothbrushing frequency at both times of day. CONCLUSIONS Parents' rationale for brushing their children's teeth can vary at both an individual level and at different times of day. Understanding these variations is important in designing interventions to improve brushing frequency for at-risk children. The results also demonstrate habituation as being an important factor in understanding toothbrushing frequency. Further research is required to understand the mechanisms involved in habit formation and maintenance with children's oral hygiene behaviour.
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Affiliation(s)
- Rob J Trubey
- Violence and Society Research Group, Cardiff University School of Dentistry, Cardiff, UK
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Maupome G, Aguirre-Zero O, Westerhold C. Qualitative description of dental hygiene practices within oral health and dental care perspectives of Mexican-American adults and teenagers. J Public Health Dent 2014; 75:93-100. [PMID: 25329495 DOI: 10.1111/jphd.12076] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 08/30/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The objectives of this study were to identify dental hygiene themes voiced by adults and teenagers of Mexican origin [or Mexican Americans (MAs)] and place these themes within the larger landscape of oral health and dental care perceptions. METHODS Interviews with urban-based MAs were analyzed to identify barriers, beliefs, and behaviors influencing engagement in dental hygiene practices. RESULTS Adult (n = 16, ages 33-52) and teenage (n = 17, ages 14-19) MAs reported themes pertaining to structural factors (financial and economic-related barriers, the dual challenges of reduced access to care vis-à-vis successfully navigating the dental care system, and the effects of reduced social support derived from migration) and to individual factors (different agendas between MAs and health systems for dental care utilization and indications for oral self-care, including limited dental hygiene instruction from professionals and larger impacts from school-based and mass media). Also, prior experiences with dental hygiene, prevention, and associated themes were characterized by a range of attitudes from fatalistic to highly determined agency. Good family upbringing was instrumental for appropriate dental hygiene, anteceding good oral health; and outlining a loose structure of factors affecting oral health such as diet, having "weak" teeth, or personal habits. CONCLUSIONS Themes from adults and teenagers in the Midwest United States were generally similar to other groups of MA parents and younger children. Dental hygiene was not salient relative to other oral health and dental care matters. Several opportunities for improvement of knowledge and enhancing motivation for dental hygiene practices were identified, both within and outside professional resources.
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Affiliation(s)
- Gerardo Maupome
- Preventive and Community Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA
| | | | - Chi Westerhold
- Preventive and Community Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA
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Jamieson LM, Armfield JM, Parker EJ, Roberts-Thomson KF, Broughton J, Lawrence HP. Development and evaluation of the Stages of Change in Oral Health instrument. Int Dent J 2014; 64:269-77. [DOI: 10.1111/idj.12119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Examining the accuracy of caregivers' assessments of young children's oral health status. J Am Dent Assoc 2013; 143:1237-47. [PMID: 23115154 DOI: 10.14219/jada.archive.2012.0071] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Caregivers' perceptions of their young children's oral health status (OHS) are a strong determinant of whether the children visit a dentist. Our aims were to quantify the correlation between caregivers' assessments and their children's clinically determined restorative treatment needs, while investigating factors related to this association. METHODS One hundred eight caregivers assessed their children's OHS by answering a question on the self-reported National Health and Nutrition Examination Survey III instrument. Children underwent clinical oral examinations at one of two study sites of the Carolina Oral Health Literacy Project: a dental school-based clinic and a community-based health clinic. Examiners recorded the children's clinical treatment needs by using a modification of the caries severity index. The authors quantified concordance between the two measures with use of the Spearman rank correlation (ρ) and Kendall τ rank correlation, whereas they assessed differences in sociodemographic factors and oral health literacy (OHL) levels by using a homogeneity χ(2) test (P < .2 criterion). RESULTS The concordance between caregivers' assessments and clinically determined OHS was lower for younger children (< 2 years, ρ = 0.29 versus = 2 years, ρ = 0.63 [homogeneity P = .03]), a pattern that was evident in the community clinic but not in the university clinic. Caregivers' age, education and OHL did not influence the accuracy of self-reports. CONCLUSIONS For children younger than 2 years, caregivers' assessments correlated poorly with clinical needs, which routinely were underestimated. Practice Implications. These findings underscore the importance of preventive dental visits at a young age and the early establishment of a dental home.
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