Education intervention with respect to the oral health knowledge, attitude, and behaviors of refugee families: A randomized clinical trial of effectiveness

Opportunities and practices supporting responsive health care for forced migrants: lessons from transnational practice and a mixed-methods systematic review

Background

For those displaced across borders, significant adversity before, during and after displacement journeys, including attitudes and structures in countries of transit and arrival, contributes to considerable risk of poor physical and mental health, and poor and exclusionary experiences of health care.

Objectives

We aimed to understand the opportunities and practices that can support better healthcare responses for forced migrants.

Design

We integrated (1) local stakeholder perspectives, from workshops and dialogue; (2) evidence and knowledge from a mixed-methods systematic review; and (3) learning from five case examples from current international practice.

Review methods and data sources

We ran database searches (American Psychological Association PsycINFO, EMBASE, the Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, MEDLINE, National Institute for Health and Care Research Journals Library) in February 2022, searched relevant agency websites and conducted backward and forward citation searches, extracted data, assessed methodological quality and integrated qualitative and quantitative findings.

Case examples

We studied three services in the UK, one in Belgium and one in Australia, conducting semistructured interviews with providers, collaborators and service users, and making site visits and observations if possible.

Results

The review identified 108 studies. We identified six domains of impact: (1) benefit from and creation of community, including linkages with formal (health) services; (2) the formation of networks of care that included traditional and non-traditional providers; (3) proactive engagement, including conducting care in familiar spaces; (4) considered communication; (5) informed providers and enhanced attitudes; and (6) a right to knowledge (respecting the need of new arrivals for information, knowledge and confidence in local systems). The case examples drew attention to the benefits of a willingness to innovate and work outside existing structures, 'micro-flexibility' in interactions with patients, and the creation of safe spaces to encourage trust in providers. Other positive behaviours included engaging in intercultural exchange, facilitating the connection of people with their cultural sphere (e.g. nationality, language) and a reflexive attitude to the individual and their broader circumstances. Social and political structures can diminish these efforts.

Limitations

Review: wide heterogeneity in study characteristics presented challenges in drawing clear associations from the data. Case examples: we engaged only a small numbers of service users and only with service users from some services.

Conclusions

We found that environments that enable good health and enable people to live lives of meaning are vital. We found that these environments require flexibility and reflexivity in practice, intercultural exchange, humility and a commitment to communication. We suggest that a broader range of caring practitioners can, and should, through intentional and interconnected practice, contribute to the health care of forced migrants. Opening up healthcare systems to include other state actors (e.g. teachers and settlement workers) and a range of non-state actors, who should include community leaders and peers and private players, is a key step in this process.

Future work

Future work should focus on the health and health service implications of immigration practices, the inclusion of peers in a range of healthcare roles, alliance-building across unlikely collaborators and the embedding of intercultural exchange in practice.

Study registration

This study is registered as PROSPERO (CRD42021271464).

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR132961) and is published in full in Health and Social Care Delivery Research; Vol. 13, No. 13. See the NIHR Funding and Awards website for further award information.

A Systematic Review and Meta-Analysis of Interventions Targeted to Parents for Improving the Oral Health of Children from Culturally and Linguistically Diverse (CALD) Backgrounds

A high prevalence of dental caries is a significant health problem, especially in the pediatric population. Low-income minority groups, including the refugee and immigrant populations, are at higher risk of compromised oral health. It has been suggested that migrant parents do not have enough understanding of oral health, risk factors associated with dental caries, or the progress of dental decay. This systematic review aims to study quantitative literature on oral health interventions, health promotion programs, or behaviour change interventions targeting the parents/ caregivers of culturally and linguistically diverse (CALD) children. A systematic search of electronic databases, including MEDLINE, EMBASE, PUBMED, CINAHL, SCOPUS, WEB OF SCIENCE, COCHRANE, and PROQUEST, was conducted until August 2023. Randomised (RCT) or non-randomised controlled trials (NRCTs) were included. Two reviewers independently assessed the quality of the included studies using the Cochrane Risk of Bias (RoB) 2.0 and ROBINS-I tools. Meta-analysis was performed as appropriate. The initial search from the databases retrieved 2073 articles. After the removal of duplicates, 1683 articles remained. Finally, 69 articles were reviewed in full text, and 15 articles were considered eligible in this review. The RoB assessment for RCTs rated three as low-risk and three as high-risk. The serious RoB in these NRCTs mostly pertained to measurement bias based on self-reporting oral health behaviours. The meta-analysis pooling of results (for RCTs and NRCTs) favoured interventions for CALD parents' oral health knowledge [0.73 (95% CI, 0.08 to 1.38) for RCTs, 1.73 (95% CI; 1.45 to 2.02) for NRCTs] and attitudes [0.86 (95% CI, 0.31 to 1.42)]. Relatively high heterogeneity was observed. Oral health educational interventions can be effective in improving the oral health literacy of CALD parents' oral health knowledge and attitudes, especially when facilitated by lay health advisors. However, the low quality of evidence due to high heterogeneity and high RoB further highlighted the need for well-designed RCTs targeting CALD parents.

Associated factors of dental caries among middle-aged adults in Guizhou Province, China (2019-2020)

BACKGROUND

The Fourth National Oral Health Epidemiological Survey (FNOHES) reported an 89% caries prevalence among adults aged 35-44 in China. This study explored the current prevalence and determinants of dental caries in Guizhou Province, where socioeconomic conditions have changed. We aimed to identify factors influencing dental caries to inform future oral health policies and preventive strategies tailored to the region.

METHOD

A total of 2,040 middle-aged adults from 11 districts and counties in Guizhou participated. Categorical variables were analyzed using chi-squared tests, and logistic regression identified key factors. Quantitative measures, such as the DMFT index, were used to assess the overall dental health of the participants.

RESULT

The statistical analysis showed a caries prevalence of 79.6% and a mean DMFT of 3.11. Caries were more prevalent in urban areas and among females. Significant factors associated with caries included gender, residence, ethnicity, smoking status, toothpick use, dental visits, and self-rated oral health.

CONCLUSION

The prevalence of dental caries remains globally high, as reflected in both developing and developed countries. Targeted interventions, particularly for females, urban residents, and ethnic minorities, are recommended. Public health initiatives should prioritize promoting safer oral hygiene practices and smoking cessation programs, including education on managing post-cessation cravings for sugary foods. Further research, including longitudinal studies, is needed to evaluate intervention effectiveness.

Effects of an intervention on immigrant parents' knowledge and attitudes toward their children's oral health: A cluster randomized trial in Norway

There are no interventional studies on the oral health of immigrant children in Norway. This study aimed to assess the effectiveness of a culturally adapted oral health intervention for parental knowledge, attitude to oral hygiene, attitude to diet, and indulgence (permissiveness toward oral hygiene and sugar intake) concerning their children's oral health. A cluster randomized control trial, including immigrant parents of newborns, was conducted at seven health centers in Bergen (Norway) involving a 2-session one-to-one motivational interviews, toothbrushing demonstrations and pamphlets in the participants' native languages at baseline and after 6 months. Mean differences in outcome scores were assessed and compared between intervention and control groups using generalized linear mixed model. In an intention-to-treat (ITT) analysis (n = 345), the estimated mean difference in parental attitude to diet and indulgence between the groups indicated more improvement in the control than in the intervention group in the adjusted models. For all outcomes within both groups, a slight positive change was observed in marginal mean scores from baseline to follow-up. The two culturally adapted intervention sessions had no impact on oral health-related knowledge, attitudes, and indulgence of immigrant parents. These findings suggest that more comprehensive interventions may be needed to improve parental knowledge and attitudes toward children's oral health. Trial Registration number: ClinicalTrials.gov Identifier: NCT05758454.

Interventions to Improve Health Among Refugees in the United States: A Systematic Review

Refugees arriving to the U.S. experience a high burden of both communicable and non-communicable diseases. There is a potential to improve health outcomes for refugees through well-developed, comprehensive interventions, but the effectiveness of such interventions is poorly understood. The purpose of this review is to identify, characterize and evaluate the effectiveness of patient-level healthcare interventions for U.S. refugee populations. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Medline via PubMed, Web of Science, Embase, and CINAHL were searched for articles that included a population of refugees of any age, included an intervention aimed at improving health, included an evaluation of the intervention's outcomes, and were conducted in the U.S. from 2000 to 2022. Thirty-seven studies were included, and we identified three main intervention modalities: healthcare provision/management, resource provision, and education. Interventions targeted general health, infectious disease, women's health, diet/exercise, health literacy, oral health, diabetes, family health, and substance use. The outcomes measured included knowledge, satisfaction, behavioral outcomes, and physical health markers. This review demonstrates that a few health conditions, namely tuberculosis, have been addressed with large-scale, sustained interventions. Other conditions (general health and women's health) have been addressed through piecemeal, short-term interventions. The evaluation of interventions often focuses on knowledge or satisfaction rather than health or behavior change outcomes. Future work should focus on the best strategies for developing sustainable interventions that meet the needs of the diverse population of refugees in the U.S.

Impact of the COVID-19 Pandemic on Oral Health Behaviors Among Children in Iran

OBJECTIVES

Parents are responsible for their children's oral health. This study evaluated parents' knowledge, attitudes, and performance on their children's oral health before and after an educational intervention and the impact of COVID-19 on these variables.

MATERIAL AND METHODS

This quasi-experimental study included 227 children aged 6-8 years who were referred to 11 Shiraz medical centers from July to December 2021. Data were collected from questionnaires and interviews. After completing the questionnaire, oral health education was provided immediately and then monthly thereafter using dental models and pamphlets. After 3 months, a questionnaire assessed the education's effectiveness. Data were analyzed using independent t-tests, one-way analysis of variance (ANOVA), paired t-tests, and Pearson's correlation.

RESULTS

A total of 163 participants (71.80%) completed all phases, including the second questionnaire. Participants showed moderate knowledge (77.30%), attitude (89.00%), and performance (80.40%). Neither knowledge nor attitude before the intervention had a significant association with demographic characteristics. Parents' education, number of children, and maternal employment were significantly associated with performance (p = 0.002, p = 0.040, p < 0.001, respectively). The intervention significantly enhanced these variables (p < 0.001). In terms of COVID-19, 72.40% of participants expressed good knowledge about transmission, 52.80% showed moderate concern, and 54% had poor performance. Parental knowledge, attitude, and performance changed significantly following the intervention (p = 0.030, p < 0.001, p < 0.001, respectively).

CONCLUSIONS

Educational intervention significantly improved parents' knowledge, attitudes, and performance toward children's oral health. Because of the poor performance of parents during the COVID-19 pandemic, we recommend the implementation of continuing education and preventive oral health programs.

Exploring the Effectiveness of Dental Public Health Education in Enhancing Student Competency for Refugee Care

BACKGROUND

As global migration rises, dental professionals must be prepared to treat refugee communities' particular oral health needs, emphasizing the need of education and training in readiness to treat these underserved groups.

AIM

The objective of this study was to evaluate the effectiveness of the Dental Public Health (DPH) Field Study course on fifth-year dental students' willingness to provide care for refugee patients.

METHODS

In this descriptive study, fifth-year students at Hacettepe University's Faculty of Dentistry were invited to participate in this study. Students were categorized into two groups based on whether they had completed the DPH field study course. Participants completed a questionnaire assessing their self-reported knowledge, experience, and attitudes toward refugee patients. Data were analyzed using Chi-square and Fisher's exact tests.

RESULTS

Students who completed the DPH field study course reported gaining most of their knowledge about refugees from the course, whereas those who did not complete the course primarily obtained their information through social media. Furthermore, attitudes toward caring for refugee patients were significantly more positive among students who had completed the course (P<0.05). However, the willingness to volunteer for programs providing oral health care to refugee patients was higher among students who had not completed the course. Additionally, a higher rate of volunteering was significantly associated with students who were satisfied with their profession (P<0.05) and tended to be higher among female students (P>0.05).

CONCLUSION

The DPH field study course positively influenced students' knowledge, experience, and willingness to provide care for refugee patients. Moreover, volunteering to participate in oral health care programs was positively correlated with a professional satisfaction and female gender. Further research involving a larger and more diverse group of students from different faculties is recommended to validate these findings.

Impact of an Oral Health Education Program on the Oral Health Literacy of Refugees

Inadequate comprehension of healthcare information contributes to poor health outcomes. Ethnic minorities are one of the populations most affected by low health and oral health literacy (OHL). The hypothesis of the current study was that an oral health education program (OHEP) can improve the OHL, oral health awareness and behaviors of refugees. We also hypothesized that there will be a difference between OHL in English and native language in the Pre-intervention phase. Fifty-two adult refugees participated in an educational program that included a comprehensive and culturally sensitive PowerPoint presentation and hands-on learning activities on oral health topics. The study used a cross-sectional pre-post study design. Before the program (Pre-intervention group), participants completed 2 surveys: Sociodemographic Survey and Oral Health Perceptions of Refugees in a bilingual format, and the Estimate of Oral Health Literacy-Bilingual40 (EOHL-BL40) in English, and in the participants' native language. Immediately after an OHEP (Post-intervention group), participants completed the EOHL-BL40 survey in English only. Two weeks after OHEP (Follow-up intervention), participants completed again the Sociodemographic Survey and Oral Health Perceptions of Refugees and the Estimate of Oral Health Literacy-Bilingual40 (EOHL-BL40) in English only. The mean percentage of words understood on Pre-intervention EOHL-BL40 survey were significantly higher in native languages (47.3% ±3.7%) compared with survey in English (15.3% ±1.2%, P < 0.001). Post-intervention scores, immediately after educational program, were higher (28.6% ±2.4%), P < 0.001) for survey in English compared with the Pre-intervention (15.3% ±1.2%). The follow-up (2 weeks later) scores (25.5% ±2.4) were slightly lower than Post-intervention but still significantly higher (P < 0.001) than Pre-intervention. Results for both Sociodemographic Survey and Oral Health Perceptions of Refugees surveys were similar: the OHEP positively affected oral health awareness and oral health behaviors. Results of the study suggested that OHEP may improve oral health literacy, oral health awareness, and personal oral hygiene practices of refugees.

Enhancing the health knowledge and health literacy of recently resettled refugees through classroom-based instructional methods

Health education can elevate health literacy, which is associated with health knowledge, health-seeking behaviors and overall improved health outcomes. Refugees are particularly vulnerable to the effects of low health knowledge and literacy, which can exacerbate already poor health stemming from their displacement experience. Traditional learning methods including classroom-based instruction are typically how health-related information is presented to refugees. Through a series of interactive classes focused on specific health topics relevant to the resettled refugee population, this study evaluated the effectiveness of a classroom-based health education model in enhancing the health knowledge of recently resettled refugees. We used the Wilcoxon signed-rank test to evaluate differences in pre- and post-class knowledge through test performance. We found a significant improvement in health knowledge in two refugee groups: females and those who were employed. Culturally and socially sensitive considerations including language inclusiveness, class timing, transportation and childcare provisions are important when creating an educational program for individuals with refugee backgrounds. Developing focused approaches to instruction that enhance health knowledge could lead to better health literacy and ultimately improve health-related behaviors and outcomes in the refugee population.

Health Coaching-Based Interventions for Oral Health Promotion: A Scoping Review

BACKGROUND

Health coaching-based interventions can support behaviour change to improve oral health. This scoping review aims to identify key characteristics of health coaching-based interventions for oral health promotion.

METHODS

The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist and the Joanna Briggs Institute manual for evidence synthesis were used in this review. A search strategy using medical subject heading terms and keywords was developed and applied to search the following databases: CINAHL, Ovid, PubMed, Cochrane Library and Scopus. Thematic analysis was used to synthesise the data.

RESULTS

Twenty-three studies met the inclusion criteria and were included in this review. These studies were predominantly based on health coaching and motivational interviewing interventions applied to oral health promotion. The following are the characteristics of health coaching-based interventions extracted from themes of the included studies: (a) Health professionals should be trained on the usage of motivational interviewing/health coaching interventions; (b) oral health professionals should acquire motivational techniques in their practice to engage patients and avoid criticisms during the behaviour change process; (c) routine brief motivational interviewing/health coaching intervention sessions should be introduced in dental clinics; (d) traditional oral health education methods should be supplemented with individually tailored communication; and (e) for cost-effectiveness purposes, motivational interviewing/health coaching strategies should be considered.

CONCLUSIONS

This scoping review reveals that health coaching-based techniques of health coaching and motivational interviewing can significantly impact oral health outcomes and behaviour change and can improve oral health professional-patient communication. This calls for the use of health coaching-based techniques by dental teams in community and clinical settings. This review highlights gaps in the literature, suggesting the need for more research on health coaching-based intervention strategies for oral health promotion.

Study protocol for a real-world evaluation of an integrated child and family health hub for migrant and refugee women

INTRODUCTION

Continuity of child and family healthcare is vital for optimal child health and development for developmentally vulnerable children. Migrant and refugee communities are often at-risk of poor health outcomes, facing barriers to health service attendance including cultural, language, limited health literacy, discrimination and unmet psychosocial needs. 'Integrated health-social care hubs' are physical hubs where health and social services are co-located, with shared referral pathways and care navigation.

AIM

Our study will evaluate the impact, implementation and cost-benefit of the First 2000 Days Care Connect (FDCC) integrated hub model for pregnant migrant and refugee women and their infants.

MATERIALS AND METHODS

This study has three components. Component 1 is a non-randomised controlled trial to compare the FDCC model of care with usual care. This trial will allocate eligible women to intervention and control groups based on their proximity to the Hub sites. Outcome measures include: the proportion of children attending child and family health (CFH) nurse services and completing their CFH checks to 12 months of age; improved surveillance of growth and development in children up to 12 months, post partum; improved breastfeeding rates; reduced emergency department presentations; and improved maternal well-being. These will be measured using linked medical record data and surveys. Component 2 will involve a mixed-method implementation evaluation to clarify how and why FDCC was implemented within the sites to inform future roll-out. Component 3 is a within-trial economic evaluation from a healthcare perspective to assess the cost-effectiveness of the Hubs relative to usual care and the implementation costs if Hubs were scaled and replicated.

ETHICS AND DISSEMINATION

Ethical approval was granted by the South Eastern Sydney Local Health District Human Research Ethics Committee in July 2021 (Project ID: 020/ETH03295). Results will be submitted for publication in peer-reviewed journals and presented at relevant conferences.

TRIAL REGISTRATION NUMBER

ACTRN12621001088831.

Evaluation of a tailored oral health promotion intervention for Syrian former refugees in New Zealand

To investigate a health promotion strategy to improve oral health among former refugees in New Zealand. Former refugees were recruited (n = 63) and answered a questionnaire about their oral home care, smoking, sugar consumption and use of dental services. Participants then joined either focus group sessions to co-design oral health educational material (n = 39) or to be dentally examined for oral hygiene, periodontal health, gingivitis and dental caries and receive motivational instructions to improve their oral health habits (n = 20). Health messages using dual-language leaflets (covering oral home care, smoking, diet and access to services) were subsequently individually delivered monthly to all participants via a mobile phone application. After 6 months, follow-up questionnaires were sent to all participants and those who had been dentally examined were re-examined. Half of those who did not brush twice daily at baseline (54.1%) had increased brushing to at least twice daily by follow-up; 76.9% of those who consumed sugary drinks at least twice daily, reduced their sugar intake. No smokers quit smoking, however, 52.4% reported reducing the number of cigarettes or engaging in smoking cessation activities. Among those who had been dentally examined, plaque scores, gingivitis and periodontal pocketing all decreased significantly. Culturally and linguistically tailored oral health promotion interventions led to improved oral health behaviours for this group of former refugees over a 6 months follow-up period. We expect this to not only improve the oral health quality of life for this population, but also reduce the burden on the health system.

Advancing a programme theory for community-level oral health promotion programmes for humanitarian migrants: a realist review protocol

INTRODUCTION

Humanitarian migrants often suffer from poor health, including oral health. Reasons for their oral health conditions include difficult migration trajectories, poor nutrition and limited financial resources. Oral health promotion is crucial for improving oral health-related quality of life of humanitarian migrants. While community-level oral health promotion programmes for humanitarian migrants have been implemented (eg, in host countries and refugee camps), there is scant literature evaluating their transferability or effectiveness. Given that these programmes yield unique context-specific outcomes, the purpose of this study is to understand how community-level oral health promotion programmes for humanitarian migrants work, in which contexts and why.

METHODS AND ANALYSIS

Realist review, a theory-driven literature review methodology, incorporates a causal heuristic called context-mechanism-outcome configurations to explain how programmes work, for whom, and under which conditions. Using Pawson's five steps of realist review (clarifying scope and drafting an initial programme theory; identifying relevant studies; quality appraisal and data extraction; data synthesis; and dissemination of findings), we begin by developing an initial programme theory using the references of a scoping review on the oral health of refugees and asylum seekers and through hand searching in Google Scholar. Following stakeholder validation of our initial programme theory, we will locate additional evidence by searching in four databases (Ovid Medline, Ovid Embase, Cochrane Library and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) to test and refine our initial programme theory into a middle-range realist programme theory. The resultant theory will explain how community-level oral health promotion programmes for humanitarian migrants work, for whom, in which contexts and why.

ETHICS AND DISSEMINATION

Since this study is a review and no primary data collection will be involved, institutional ethics approval is not required. The findings of this study will be disseminated in peer-reviewed journals, local and international conferences, and via social media.

TRIAL REGISTRATION NUMBER

CRD42021226085.

Oral Health Status among Migrants from Middle- and Low-Income Countries to Europe: A Systematic Review

Introduction. Economic inequality, political instability and globalization have contributed to the constant growth of the migration phenomenon in recent years. In particular, a total of 4.2 million people migrated to Europe during 2019 and most of them settled in Germany, France and Italy. Objectives. The objective of this study was to conduct a systematic review of studies analyzing the oral health condition among migrants from middle- and low-income countries to Europe and assessing the eventual association between their sociodemographic and socioeconomic characteristics and oral health status. Materials and Methods. A systematic review was conducted in PubMed, Cochrane Library, Scopus and Science Direct databases. After titles, abstracts and full-text examination, only 27 articles were selected on the basis of inclusion criteria and consequently included for quality assessments and data extraction. Results. Most of the studies reported a higher prevalence of caries experience, a poorer periodontal health and more difficulties in accessing dentalcare services among migrant groups compared with the non-migrant population. Inequalities were mostly associated with ethnic background, economic condition and social grade. Conclusion. Our review demonstrates the lack of dental health among migrants, underlining that their cultural beliefs and their social and economic living conditions could influence their oral health.

Oral Health Knowledge Gaps and Their Impact on the Role of Pediatricians: A Multicentric Study

PURPOSE

This study aimed to evaluate the current level of pediatricians to promote oral health. In particular, the study sought to determine whether years of experience were associated with the dentistry knowledge of pediatricians.

MATERIALS AND METHODS

Online recruitment was used to obtain a sample of pediatricians from the United States of America, Greece, and Saudi Arabia. These three countries are the participants in this research project. The participants completed an anonymous, online, self-administered questionnaire. This questionnaire is available upon request. The differences in responses to knowledge questions, attitude questions, and solution questions were examined with respect to years of experience. Poisson regression models were used to examine whether these differences were statistically significant.

RESULTS

A total of 313 pediatricians participated in the study. The study found moderate levels of dental knowledge among pediatricians. A total of 53.4% reported that they had adequate knowledge to make the right recommendations on oral health for patients and parents. Compared to the participants in a residency program, the participants with 5 to 10 years of experience were over 2.72 times as likely to report adequate knowledge, and participants with 10 years of experience or more were nearly 1.98 times as likely to report adequate knowledge. There was a significant association between dentistry knowledge questions and attitude.

CONCLUSION

The current level of influence of pediatricians in promoting pediatric oral health is limited to moderate. The gaps in oral health knowledge remain an issue, even among a broad sample of pediatricians from Greece, Saudi Arabia, and the United States, particularly pediatricians with less work experience.

A Randomized Clinical Trial Preventive Outreach Targeting Dental Caries and Oral-Health-Related Quality of Life for Refugee Children

Objective: The study assessed a preventive outreach educational intervention targeting improvements in dental caries and oral-health-related quality of life in the children of refugee families by comparing pre- and postintervention outcomes. Methods: This randomized controlled clinical trial assessed the outcomes at baseline and three times over six months using the WHO oral health assessment form (DMFT/dmft) and the parent version of the Michigan Oral-Health-Related Quality of Life scale. Children and at least one of their parents/caretakers were educated on oral health topics in two one-hour sessions. Results: Of the 66 enrolled families, 52 (72%) completed the six-month follow-up. DMFT/dmft scores increased significantly in both the control and intervention groups (p < 0.05); differences in the changes in the DMFT/dmft and MOHRQoL-P scores from baseline to the three- and six-month follow-up visits between groups were not significant (p > 0.05). Conclusions: Oral health education programs targeting a diverse group of refugee children and their parents/caregivers single-handedly did not reduce the increased number of caries lesions or improve oral-health-related quality of life.

Education intervention with respect to the oral health knowledge, attitude, and behaviors of refugee families: A randomized clinical trial of effectiveness

Objectives

The study assessed the effectiveness of an oral health educational and behavioral intervention program in improving the knowledge, attitudes, and behaviors of refugee families.

Methods

This randomized 2‐arms, controlled, single site, clinical trial assessed the dental knowledge, attitudes, and behaviors related to oral health at baseline and three times over the course of the 6 months of the intervention in recent refugee families. Participating families were educated on five topics in oral health in two 1‐hour sessions utilizing existing oral health education materials adapted to be linguistically and culturally appropriate for demonstration and instruction. Culturally competent techniques and motivational interviewing styles were also implemented during sessions. Pre/post surveys were used to assess changes to knowledge, attitudes, and behavior among refugee family participants.

Results

Out of the 66 families enrolled in the program, 52 (72 percent) completed visits over the course of 6 months. Differences between the intervention and control groups were not significant between baseline and 3 to 6 months later (P > 0.05).

Conclusions

A short‐term, culturally informed oral health educational and behavioral intervention program did not improve oral health‐related knowledge, attitudes, or behaviors in a diverse group of recent refugee families.