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Csima M, Podráczky J, Keresztes V, Soós E, Fináncz J. The Role of Parental Health Literacy in Establishing Health-Promoting Habits in Early Childhood. CHILDREN (BASEL, SWITZERLAND) 2024; 11:576. [PMID: 38790571 PMCID: PMC11119361 DOI: 10.3390/children11050576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/14/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024]
Abstract
In early childhood, children are extremely susceptible to the acquisition of habits and the establishment of health-promoting habits. Therefore, the patterns, routines, and rules transmitted and expected by the adults surrounding the child are of paramount importance and can correlate with the level of their health literacy. Our cross-sectional, quantitative, exploratory study aimed to examine the relationships between parental health literacy and preschool children's health-related habits, using simple, non-random sampling (n = 598). In addition to the sociodemographic characteristics, the measuring tool we compiled included the standardized European Health Literacy Survey Questionnaire (HLS-EU-Q16), as well as a set of questions containing 30 statements suitable for exploring children's habit systems. The health literacy of the parents involved in our study proved to be more favorable than that of the general population. Regarding children's habit systems, we found significant differences in several areas by age group (p < 0.05) and gender (p < 0.05). The levels of parental health literacy (0.003 ≤ p ≤ 0.048) and parents' education (p < 0.05) show a correlation with the children's health-related habit systems: the indicators of children with parents who have a higher level of health literacy and a higher level of education are more favorable in terms of established habits. In the long term, the formation of health-promoting habits may facilitate the internalization of favorable health behavior motives for the future, contributing to the establishment of positive physical, mental, and social health in adulthood.
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Affiliation(s)
- Melinda Csima
- Institute of Education, Hungarian University of Agriculture and Life Sciences, H-7400 Kaposvár, Hungary; (J.P.); (J.F.)
- MTA-MATE Early Childhood Research Group, H-7400 Kaposvár, Hungary; (V.K.); (E.S.)
| | - Judit Podráczky
- Institute of Education, Hungarian University of Agriculture and Life Sciences, H-7400 Kaposvár, Hungary; (J.P.); (J.F.)
- MTA-MATE Early Childhood Research Group, H-7400 Kaposvár, Hungary; (V.K.); (E.S.)
| | - Viktória Keresztes
- MTA-MATE Early Childhood Research Group, H-7400 Kaposvár, Hungary; (V.K.); (E.S.)
- Education and Society Doctoral School of Education, University of Pécs, H-7624 Pécs, Hungary
| | - Evelin Soós
- MTA-MATE Early Childhood Research Group, H-7400 Kaposvár, Hungary; (V.K.); (E.S.)
- Education and Society Doctoral School of Education, University of Pécs, H-7624 Pécs, Hungary
| | - Judit Fináncz
- Institute of Education, Hungarian University of Agriculture and Life Sciences, H-7400 Kaposvár, Hungary; (J.P.); (J.F.)
- MTA-MATE Early Childhood Research Group, H-7400 Kaposvár, Hungary; (V.K.); (E.S.)
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Guertin JR, Gilbert-Ouimet M, Dugas M, Carnovale V, Jalbert L, Svyntozelska O, Demers J, Matteau L, Bergeron F, LeBlanc A. Methods used to account for caregivers' sex and gender within studies examining the financial burden of caregivers of children and adolescents : Results from a scoping review. CLINICOECONOMICS AND OUTCOMES RESEARCH 2024; 16:35-53. [PMID: 38298908 PMCID: PMC10829241 DOI: 10.2147/ceor.s443077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
Background Interest in the financial burden of informal caregivers has been growing. Unfortunately, it remains unclear which method(s) should be used when quantifying this burden. Purpose We conducted a scoping review aimed at identifying which methods have been used to conduct such work and quantified their performance. We were also interested in examining how sex and gender considerations were considered within selected studies. Data Sources Using a standardized approach, we identified studies published between 2012 and 2022 that aimed to document the financial burden of caregivers to child and adolescent patients. Our search strategy was applied to the MEDLINE, Embase, CINHAL, and Academic Search Premier databases. Study Selection Manuscript selection was performed by pairs of reviewers. Data Extraction Data extraction was performed by one reviewer with a second reviewer performing quality control. Results were reported using a narrative approach. Data Synthesis We identified 9801 unique citations, of which 200 were included in our review. Selected studies covered various disease area (eg, infection/parasitic diseases [n = 31, 16%]) and included quantitative (n = 180, 90%), qualitative (n = 4, 2%) and mixed study designs (n = 16, 8%). Most studies (n = 182, 91%) used questionnaires/surveys, either alone or in combination with other methods, to assess caregivers' financial burden. Less than half (n = 93, 47%) of studies reported on caregivers' sex and none reported on their gender. Conclusion We conducted an unrestricted review of published studies examining caregiver's financial burden which allowed us to identify general methodological trends observed in this literature. We believe this work may help improve future studies focusing on this important issue.
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Affiliation(s)
- Jason Robert Guertin
- Centre de recherche du Centre de recherche du CHU de Québec-Université Laval, Quebec City, Quebec, Canada
- Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- Centre de recherche en organogénèse expérimentale de l’Université Laval/LOEX, Quebec City, Quebec, Canada
| | - Mahée Gilbert-Ouimet
- Centre de recherche du Centre de recherche du CHU de Québec-Université Laval, Quebec City, Quebec, Canada
- Department of Health Sciences, Université du Québec À Rimouski, Levis, Quebec, Canada
| | - Michèle Dugas
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center, Quebec City, Quebec, Canada
| | - Valérie Carnovale
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center, Quebec City, Quebec, Canada
| | - Laura Jalbert
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center, Quebec City, Quebec, Canada
| | - Olha Svyntozelska
- Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center, Quebec City, Quebec, Canada
| | - Juliette Demers
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center, Quebec City, Quebec, Canada
| | - Léonie Matteau
- Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- Department of Health Sciences, Université du Québec À Rimouski, Levis, Quebec, Canada
| | - Frédéric Bergeron
- Bibliothèque-Direction des services-conseils, Université Laval, Quebec City, Quebec, Canada
| | - Annie LeBlanc
- Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center, Quebec City, Quebec, Canada
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Menoncin BLV, Crema AFDA, Ferreira FDM, Zandoná AF, Menezes JVNBD, Fraiz FC. Parental oral health literacy influences preschool children's utilization of dental services. Braz Oral Res 2023; 37:e090. [PMID: 37672423 DOI: 10.1590/1807-3107bor-2023.vol37.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 04/24/2023] [Indexed: 09/08/2023] Open
Abstract
Parental behavior towards their children's oral health is strongly influenced by parent's Oral Health Literacy (OHL) level. This study evaluated the impact of parental OHL on preschool children's utilization of dental services. A cross-sectional study was conducted with parents of 419 children aged 3 to 5 years who answered a self-administered questionnaire about their perception of their children's oral health and whether their children had already been to a dental visit. Parental OHL level was assessed by the validated version of the Oral Health Literacy Adult Questionnaire (OHL-AQ) translated into Brazilian Portuguese. Univariate and multivariate Poisson regression analyses with robust variance were used for the data analysis (α = 0.05). Most children had already been to a dental visit (73%). Overall, 31.7% of the parents or guardians reported that their children had experienced dental pain or dental caries. Parental OHL level was classified by tercile as low, medium, and high. The final model showed independent associations between children who had already been to a dental visit and higher parental OHL level (PR = 1.16; 95%CI = 1.00-1.35) when compared to the lowest OHL level, higher parental educational level (PR = 1.39; 95%CI = 1.03-1.87) when compared to lower educational level, the report of children's pain and dental caries (PR = 1.22; 95%CI = 1.09-1.36) and married parents or parents in a common-law marriage (PR = 1.17; 95%CI = 1.03-1.93). The prevalence of children who had already been to a dental visit was higher among those parents with a higher OHL level when compared to those with a lower OHL level.
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Affiliation(s)
| | | | - Fernanda de Morais Ferreira
- Universidade Federal de Minas Gerais - UFMG, Department of Oral Health for Children and Adolescents, Belo Horizonte, MG, Brazil
| | | | | | - Fabian Calixto Fraiz
- Universidade Federal do Paraná - UFPR, Department of Stomatology, Curitiba, PR, Brazil
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Velasco SRM, Moriyama CM, Bonecker M, Butini L, Abanto J, Antunes JLF. Relationship between oral health literacy of caregivers and the oral health-related quality of life of children: a cross-sectional study. Health Qual Life Outcomes 2022; 20:117. [PMID: 35907863 PMCID: PMC9338565 DOI: 10.1186/s12955-022-02019-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Oral health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate oral health decisions. However, scientific evidence about the oral health literacy of caregivers and the children’s oral health-related quality of life. The purpose of this study was to verify the relationship between the level of oral health literacy of caregivers and the children's oral health-related quality of life (OHRQOL). Methods This study was conducted with children aged 2 to 4 in Diadema, São Paulo, Brazil. Six hundred thirty children were examined to assess the prevalence of dental caries (dmft index). Parents were interviewed to obtain sociodemographic status, oral conditions, and oral health literacy (OHL). The variable outcome was the children's OHRQOL as assessed by the Early Childhood Oral Health Impact Scale (ECOHIS). We fitted zero-inflated negative binomial regression (ZINB) models to evaluate associations between the study outcome and covariates in terms of PR (Prevalence Ratios), RR (Rate Ratios), and their respective Confidence Intervals (95% CI). Results Children's OHRQOL was not associated with OHL. Dental caries had a negative impact on the children's quality of life (p < 0.05). A reduced impact on OHRQOL is also associated with having siblings (PR = 0.70, 95% CI 0.52–0.95). A higher age of the mother reduced OHRQOL impacts (PR = 0.72, 95% CI 0.52–0.98). Conclusions The factors associated with children's OHRQOL were the number of siblings, the mothers' age, and dental caries. This study observed no association between parental OHL and children's OHRQOL.
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Affiliation(s)
- Sofia Rafaela Maito Velasco
- Public Health School, University of São Paulo, São Paulo, Av. Dr. Arnaldo, 715 - Cerqueira César, São Paulo, SP, 01246-904, Brazil.
| | - Caroline Moraes Moriyama
- Department of Paediatric and Orthodontic Dentistry, University of Sao Paulo, São Paulo, SP, Brazil.,Department of Postgraduation Program in Dentistry, Metropolitana de Santos University, Santos, SP, Brazil
| | - Marcelo Bonecker
- Department of Paediatric and Orthodontic Dentistry, University of Sao Paulo, São Paulo, SP, Brazil
| | - Luciane Butini
- Oral Radiology in the School of Dentistry, School of Dentistry, São Leopoldo Mandic, Campinas, SP, Brazil
| | - Jenny Abanto
- Public Health School, University of São Paulo, São Paulo, Av. Dr. Arnaldo, 715 - Cerqueira César, São Paulo, SP, 01246-904, Brazil
| | - José Leopoldo Ferreira Antunes
- Public Health School, University of São Paulo, São Paulo, Av. Dr. Arnaldo, 715 - Cerqueira César, São Paulo, SP, 01246-904, Brazil
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Health Literacy in Early Childhood: A Systematic Review of Empirical Studies. CHILDREN 2022; 9:children9081131. [PMID: 36010022 PMCID: PMC9406303 DOI: 10.3390/children9081131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/15/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022]
Abstract
Early childhood plays a key role in the formation of healthy habits and the establishment of health literacy. Nonetheless, there are only a few research studies focusing on the health literacy level of children under the age of eight. The aim of our systematic review is to explore empirical research on health literacy related to early childhood. The research was conducted in accordance with the PRISMA protocol. This systematic review examines 12 studies published between 2013–2022. Results show that research focuses on different domains of health literacy for children. In relation to children’s food literacy, children understand the relationship between health and nutrition and they realize the health impact of obesity. The habits connected to oral health are strongly associated with parents’ knowledge of and behaviours around oral health. Results related to health care situations show that children are able to be actively involved in decision-making processes in connection with their health. Exploring young children’s health literacy is essential in order to be able to plan health promotion interventions, embedded into early childhood education. Picture-based messages or story-based messages supported by illustrations can help measure health literacy in early childhood and can support the formation of health literacy.
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Development and Validation of an Oral Health Literacy Measurement for Primary School Children in Thailand. Int J Dent 2022; 2022:9161619. [PMID: 35295405 PMCID: PMC8920617 DOI: 10.1155/2022/9161619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/09/2022] [Accepted: 02/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background Oral health promotion programs have been implemented in primary schools for many years in Thailand. Oral health literacy has been introduced as a health promotion outcome; however, no assessment tool has been developed for this age group. The objective of this study was to develop and validate the Test of Functional Health Literacy in Dentistry for Primary School Children (P-TOFHLiD). Materials and Methods. The P-TOFHLiD was developed by modifying contents and outlines using a previously validated tool for older adults, then verified by two experts for face validity. A cross-sectional study was conducted with samples collected from 118 grade-six students from two government schools in Chiang Mai Province, Thailand. The P-TOFHLiD and a previously validated word recognition test were administered, followed by oral examination to assess reliability, concurrent validity, convergent validity, and predictive validity and establish the cut-off score of the tool. The statistical analysis was performed using SPSS version 25. Results The internal reliability of P-TOFHLiD was good (α = 0.808). The correlation coefficient between the P-TOFHLiD and grade point average was 0.478 (p value <0.001), which is the represented concurrent validity of the tool. Coefficients between P-TOFHLiD and a word recognition test was 0.422 (p-value <0.001) for convergent validity. P-TOFHLiD was significantly correlated with the number of missing teeth from tooth decay (p-value <0.05), but the correlation coefficient was poor (r = −0.100). The cut-off scores for adequate oral health literacy were set at ≥21 out of the total scores of 26. Conclusion P-TOFHLiD presented good validity and reliability and was ready to use for oral health promotion program evaluation. However, the predictive validity of the P-TOFHLiD in predicting oral health status was questionable only.
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Imes EP, Ginnis J, Shrestha P, Simancas-Pallares MA, Divaris K. Guardian Reports of Children's Sub-optimal Oral Health Are Associated With Clinically Determined Early Childhood Caries, Unrestored Caries Lesions, and History of Toothaches. Front Public Health 2022; 9:751733. [PMID: 35004573 PMCID: PMC8739514 DOI: 10.3389/fpubh.2021.751733] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Parents'/guardians' perceptions of their children's oral health are useful proxies of their clinically determined caries status and are known to influence dental care-seeking behavior. In this study, we sought to examine (1) the social and behavioral correlates of fair/poor child oral health reported by guardians and (2) quantify the association of these reports with the prevalence of early childhood caries (ECC), unrestored caries lesions and toothaches. Methods: We used guardian-reported child oral health information (dichotomized as fair/poor vs. excellent/very good/good) obtained via a parent questionnaire that was completed for n = 7,965 participants (mean age = 52 months; range = 36-71 months) of a community-based, cross-sectional epidemiologic study of early childhood oral health in North Carolina between 2016 and 2019. Social, demographic, oral health-related behavioral data, and reports on children's history of toothaches (excluding teething) were collected in the same questionnaire. Unrestored ECC (i.e., caries lesions) was measured via clinical examinations in a subset of n = 6,328 children and was defined as the presence of one or more tooth surfaces with an ICDAS ≥ 3 caries lesion. Analyses relied on descriptive and bivariate methods, and multivariate modeling with average marginal effect (A.M.E.) estimation accounting for the clustered nature of the data. Estimates of association [prevalence ratios (PR) and adjusted marginal effects (AME) with 95% confidence intervals (CI)] were obtained via multilevel generalized linear models using Stata's svy function and accounting for the clustered nature of the data. Results: The prevalence of fair/poor oral health in this sample was 15%-it increased monotonically with children's age, was inversely associated with parents' educational attainment, and was higher among Hispanics (21%) and African Americans (15%) compared to non-Hispanic whites (11%). Brushing less than twice a day, not having a dental home, and frequently consuming sugar-containing snacks and beverages were significantly associated with worse reports (P < 0.0005). Children with fair/poor reported oral health were twice as likely to have unrestored caries lesions [prevalence ratio (PR) = 2.0; 95% confidence interval (CI) = 1.8-2.1] and 3.5 times as likely to have experienced toothaches [PR = 3.5; 95% CI = 3.1-3.9] compared to those with better reported oral health. Conclusions: Guardian reports of their children's oral health are valuable indicators of clinical and public health-important child oral health status. Those with fair/poor guardian-reported child oral health have distinguishing characteristics spanning socio-demographics, oral-health related practices, diet, and presence of a dental home.
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Affiliation(s)
- Emily P Imes
- Doctor of Dental Surgery (DSS) Curriculum, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jeannie Ginnis
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Poojan Shrestha
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Miguel A Simancas-Pallares
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kimon Divaris
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Lopez A, Hoeft KS, Guerra C, Barker JC, Chung LH, Burke NJ. Spanish-speaking Mexican-American parents' experiences while navigating the dental care system for their children. J Public Health Dent 2022; 82:99-104. [PMID: 34981539 DOI: 10.1111/jphd.12495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 12/10/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The purpose of this study is to describe Mexican-American parents' experiences navigating the dental care system for their children. METHODS Thirty in-depth qualitative interviews were conducted with Spanish-speaking caregivers of young children in an urban county of Northern California, asking about their experiences navigating dental care for their children. Interviews were digitally recorded, translated, transcribed, coded, and analyzed using standard qualitative procedures. RESULTS Caregivers reported challenges that highlight how various aspects of navigating the health care system are elemental to oral health literacy. These included making appointments, finding a provider they trust, using their dental insurance, and communicating with the dental care provider. CONCLUSIONS When addressing oral health literacy, it is important to consider the navigational components to improve children's oral health literacy.
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Affiliation(s)
- Andrea Lopez
- Public Health Program, Kinesiology Department, California State University Bakersfield, Bakersfield, California, USA
| | - Kristin S Hoeft
- Department of Anthropology, History, and Social Medicine, University of California, San Francisco, California, USA.,Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, California, USA
| | - Claudia Guerra
- Department of Anthropology, History, and Social Medicine, University of California, San Francisco, California, USA
| | - Judith C Barker
- Department of Anthropology, History, and Social Medicine, University of California, San Francisco, California, USA
| | - Lisa H Chung
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, California, USA
| | - Nancy J Burke
- Department of Anthropology, History, and Social Medicine, University of California, San Francisco, California, USA.,Department of Public Health, University of California, Merced, California, USA
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MORIYAMA CM, VELASCO SRM, BUTINI L, ABANTO J, ANTUNES JLF, BÖNECKER M. How oral health literacy and parental behavior during the meals relate to dental caries in children. Braz Oral Res 2022; 36:e131. [DOI: 10.1590/1807-3107bor-2022.vol36.0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
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Brega AG, Johnson RL, Jiang L, Wilson AR, Schmiege SJ, Albino J. Influence of Parental Health Literacy on Change over Time in the Oral Health of American Indian Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115633. [PMID: 34070347 PMCID: PMC8197463 DOI: 10.3390/ijerph18115633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 11/26/2022]
Abstract
In cross-sectional studies, parental health literacy (HL) is associated with children’s oral health. It is unclear, however, whether HL influences pediatric outcomes. We examined the relationship of HL with change over time in parental oral health knowledge, beliefs, and behaviors, as well as pediatric oral health outcomes. We used longitudinal data from a study designed to reduce dental decay in American Indian children (N = 579). At baseline and annually for three years, parents answered questions assessing HL; oral health knowledge, beliefs, and behaviors; and pediatric oral health status. The number of decayed, missing, and filled tooth surfaces (dmfs) was computed based on annual dental evaluations. Linear mixed models showed that HL was significantly associated with all constructs, except dmfs, at their reference time points and persistently across the three-year study period. HL predicted change over time in only one variable, parents’ belief that children’s oral health is determined by chance or luck. HL is strongly associated with oral health knowledge, beliefs, behaviors, and status prospectively but is not a key driver of change over time in these oral health constructs.
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Affiliation(s)
- Angela G. Brega
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
- Correspondence: ; Tel.: +1-303-724-1470
| | - Rachel L. Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (R.L.J.); (S.J.S.)
| | - Luohua Jiang
- Department of Epidemiology & Biostatistics, Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, CA 92697, USA;
| | - Anne R. Wilson
- Department of Pediatric Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Sarah J. Schmiege
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (R.L.J.); (S.J.S.)
| | - Judith Albino
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
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The Oral Health Inequities between Special Needs Children and Normal Children in Asia: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2021; 9:healthcare9040410. [PMID: 33918280 PMCID: PMC8065439 DOI: 10.3390/healthcare9040410] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/19/2021] [Accepted: 03/21/2021] [Indexed: 12/31/2022] Open
Abstract
This meta-analysis aimed to analyze the oral health inequalities among special needs children during 2004-2019 in Asia to reveal the importance and the needs of establishing integrated and equitable special needs dentistry care system in Indonesia. PubMed, Scopus, Cochrane Library, Web of Science, and Wiley Online Library were systematically searched for full-text observational studies published from 1 January 2004 to 15 January 2020, in English in Asia. Studies that included children under 18 years of age with special needs and compared them to healthy controls were selected. Study quality was assessed using the Joanna Briggs Institute 2017 Critical Appraisal Checklist. Risk of bias was assessed using the ROBINS-E tool. The decayed, missing, and filled permanent teeth (DMFT) index indicated that special needs children who suffer from intellectual disability or autism spectrum disorder had significantly more caries than normal children (p < 0.001). The special needs children who had more caries than normal children lived in countries that had a high average DMFT value among 12 years old children (p < 0.001), and these two variables showed a positive correlation in meta-regression analysis (p < 0.001). Having an integrated and equitable care system and elevating children's oral health are important to maintain special needs children's oral health.
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Alvey J, Divaris K, Lytle L, Vann W, Lee J. What Child Oral Health-Related Behaviors Can First-time Mothers Actualize? A Pragmatic Prospective Study. JDR Clin Trans Res 2020; 5:366-375. [PMID: 31835968 PMCID: PMC7495947 DOI: 10.1177/2380084419892554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION First-time pregnant women are considered to be receptive to health information, rendering the prenatal period an opportune time to provide helpful information on the importance of child-related oral health. However, little is known about pregnant women's knowledge of child oral health-related behaviors (COHBs) during pregnancy and their implementation after birth. We sought to address this knowledge gap by a prospective investigation of intended and actualized oral health behaviors among first-time pregnant women. METHODS We examined relationships between intended and actualized COHBs and their correlations with changes in oral health knowledge, health literacy, general self-efficacy, and dental neglect in a cohort of first-time pregnant clients at Women, Infants, and Children sites in North Carolina-participants of a large community-based study. The COHBs were related to diet (i.e., frequency of fruit juice and sweet snacks consumption and nighttime bottle-feeding) and oral hygiene practices (e.g., performance of daily oral hygiene and use of fluoridated toothpaste). Analyses relied on descriptive statistics and bivariate tests (Student's t and McNemar's). Data were collected from 48 participants (White, 44%; African American, 40%; Native American, 17%) at baseline and again at least 12 months after the birth of their first child. RESULTS On average, most mothers actualized 3 of 5 COHBs (range, 1 to 4). Significant differences between before and after birth were noted for frequency of sweet snacks consumption and putting the baby in bed with a bottle. No correlation was found between knowledge, literacy, self-efficacy, neglect, and sociodemographic characteristics and COHB actualization. CONCLUSION Our findings suggest that first-time mothers in the studied population are likely to implement some but not all positive intended COHBs during pregnancy. Interventions are needed to assist women in implementing these practices. We support that, for prenatal interventional efforts to reap positive benefits, messaging should be personalized and include specific guidance on how to implement these recommendations. KNOWLEDGE TRANSFER STATEMENT A knowledge gap exists in our understanding of the relationship between first-time mothers' intended and actualized child oral health behaviors, with implications in the optimal timing of infant and early childhood oral health messaging. Our findings suggest that first-time mothers are likely to implement some but not all positive behaviors that they intended to adopt during pregnancy. Interventions are needed to assist women in implementing these practices.
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Affiliation(s)
- J. Alvey
- Division of Pediatric and Public Health,
Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - K. Divaris
- Division of Pediatric and Public Health,
Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings
School of Global Public Health, University of North Carolina, Chapel Hill, NC,
USA
| | - L. Lytle
- Department of Health Behavior, Gillings
School of Global Public Health, University of North Carolina, Chapel Hill, NC,
USA
| | - W.F. Vann
- Division of Pediatric and Public Health,
Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - J.Y. Lee
- Division of Pediatric and Public Health,
Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
- Department of Health Policy and
Management, Gillings School of Global Public Health, University of North Carolina,
Chapel Hill, NC, USA
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Nelson S, Slusar MB, Curtan S, Selvaraj D, Hertz A. Formative and Pilot Study for an Effectiveness-Implementation Hybrid Cluster Randomized Trial to Incorporate Oral Health Activities into Pediatric Well-Child Visits. Dent J (Basel) 2020; 8:E101. [PMID: 32882958 PMCID: PMC7559918 DOI: 10.3390/dj8030101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/05/2020] [Accepted: 08/28/2020] [Indexed: 12/04/2022] Open
Abstract
Background: Dental caries in pediatric patients are noted to have broad impacts on systemic health and well-being. Thus, utilizing an effectiveness-implementation hybrid I design, the Pediatric Providers Against Cavities in Children's Teeth (PACT) trial is investigating multi-level interventions at the practice (incorporation of oral health in electronic medical record [EMR]) and provider levels (theory-based didactic and skills training to communicate oral health facts to parent/caregiver, give a prescription to see a dentist and a list of area dentists) to increase dental utilization among 3 to 6 year old Medicaid-enrolled children attending well-child visits (WCV). The formative and pilot work for the larger main trial are presented. Methods: Formative work-Focus groups with 26 participants (Community leaders, providers, parent/caregivers); and key informant interviews with practice leadership (n = 4). Topics discussed were: core oral health (OH) information to communicate at WCVs and study logistics. Transcripts were coded and analyzed using Atlas.ti; Pilot study was refined using the formative findings and was conducted at two pediatric practices to test the implementation of: the provider didactic and skills training curriculum; EMR incorporation of four OH questions; logistics of incorporating OH activities at a WCV; and parent/caregiver recruitment. Results: Formative work showed that providers and parent/caregivers required knowledge of dental caries, and a list of area Medicaid-accepting dentists. Providers and practice leadership advised on the logistics of incorporating oral health into WCVs. All groups suggested asking parent/caregivers their preferred method of contact and emphasizing importance of OH to motivate participation. Utilizing these findings, the curriculum and protocol was revised. The pilot study in two practices successfully implemented the protocol as follows: all seven providers were trained in two 45 min didactic education and skills session; incorporation of OH questions into practices EMR; recruited 86 child-parent dyads (95% participation) at the WCV; providers delivered the OH intervention to parent/caregivers in <2 min and 90% completed EMR documentation of OH questions. These findings were instrumental in finalizing the main PACT trial in 18 practices. The RE-AIM framework is used in the main trial to collect effectiveness and implementation measures at baseline and follow-up visits. Conclusions: The formative and pilot findings were instrumental in refining the OH intervention and protocol which has resulted in successful implementation of the main trial. Trial Registration: Clinical trials.gov, Registered 9 November 2017, NCT03385629.
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Affiliation(s)
- Suchitra Nelson
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, OH 44106-4905, USA; (S.C.); (D.S.)
| | - Mary Beth Slusar
- Department of Sociology, California State University Northridge, Northridge, CA 91330, USA;
| | - Shelley Curtan
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, OH 44106-4905, USA; (S.C.); (D.S.)
| | - David Selvaraj
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, OH 44106-4905, USA; (S.C.); (D.S.)
| | - Andrew Hertz
- University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA;
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Brega AG, Jiang L, Johnson RL, Wilson AR, Schmiege SJ, Albino J. Health Literacy and Parental Oral Health Knowledge, Beliefs, Behavior, and Status Among Parents of American Indian Newborns. J Racial Ethn Health Disparities 2020; 7:598-608. [PMID: 32385848 PMCID: PMC8053009 DOI: 10.1007/s40615-019-00688-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/16/2019] [Accepted: 12/19/2019] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To examine the relationship between health literacy (HL) and parental oral health knowledge, beliefs, behavior, and self-reported oral health status (OHS) among parents of American Indian (AI) children. METHODS This analysis used baseline data from a randomized controlled trial that tested an oral health intervention with parents of AI newborns. Participants were recruited in parent-child dyads (N = 579). Parents completed items assessing sociodemographic characteristics, HL, and parental oral health knowledge, beliefs, behavior, and self-reported OHS. We examined the correlation of HL with each oral health construct, controlling for parent age and income. RESULTS On average, parents felt quite confident in their HL skills, performed well on questions assessing parental oral health knowledge, and endorsed beliefs likely to encourage positive parental oral health behaviors (e.g., confidence that one can successfully engage in such behaviors). Parents with more limited HL had significantly less knowledge, perceived cavities to be less severe, perceived more barriers and fewer benefits to recommended oral health behaviors, were less confident they could engage in these behaviors, and were more likely to believe their children's oral health was under the control of the dentist or a matter of chance (P values < 0.001). Limited HL was not associated with behavior (P > 0.05) but was linked to worse self-reported OHS (P = 0.040). CONCLUSIONS HL was associated with parental oral health knowledge, beliefs, and self-reported OHS. Oral health education interventions targeting AI families should facilitate development of knowledge and positive oral health beliefs among parents with more limited HL skills.
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Affiliation(s)
- Angela G Brega
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13055 East 17th Avenue, Aurora, CO, 80045, USA.
| | - Luohua Jiang
- Department of Epidemiology, School of Medicine, University of California Irvine, 205B Irvine Hall, Irvine, CA, 92697, USA
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Anne R Wilson
- Department of Pediatric Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Aurora, CO, 80045, USA
| | - Sarah J Schmiege
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Judith Albino
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13055 East 17th Avenue, Aurora, CO, 80045, USA
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15
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Taoufik K, Divaris K, Kavvadia K, Koletsi-Kounari H, Polychronopoulou A. Development of a Greek Oral health literacy measurement instrument: GROHL. BMC Oral Health 2020; 20:14. [PMID: 31941482 PMCID: PMC6964004 DOI: 10.1186/s12903-020-1000-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 01/03/2020] [Indexed: 11/23/2022] Open
Abstract
Background Oral health literacy is an important construct for both clinical and public health outcomes research. The need to quantify and test OHL has led to the development of measurement instruments and has generated a substantial body of recent literature. A commonly used OHL instrument is REALD-30, a word recognition scale that has been adapted for use in several languages. The objective of this study was the development and testing of the Greek language oral health literacy measurement instrument (GROHL). Methods Data from 282 adult patients of two private dental clinics in Athens, Greece were collected via in-person interviews. Forty-four words were initially considered and tested for inclusion. Item response theory analysis (IRT) and 2-parameter logistic models assessing difficulty and discriminatory ability were used to identify an optimal scale composition. Internal consistency was examined using Cronbach’s alpha and test-retest reliability was measured using intraclass correlation coefficient (ICC) in a subset of 20 participants over a two-week period. Convergent validity was tested against functional health literacy screening (HLS) items, dental knowledge (DK), oral health behaviors (OHBs), oral health-related quality of life (OHRQoL; OHIP-14 index), as well as self-reported oral and general health status. Results From an initial item pool of 44 items that were carried forward to IRT, 12 were excluded due to no or little variance, 10 were excluded due to low item-test correlation, and 2 due to insignificant contribution to the scale, i.e., difficulty parameter estimate with p > 0.05. The twenty remaining items composed the final index which showed favorable internal consistency (alpha = 0.80) and test-retest reliability (ICC = 0.95). The summary score distribution did not depart from normality (p = 0.32; mean = 11.5; median = 12; range = 1–20). GROHL scores were positively correlated with favorable oral hygiene behaviors and dental attendance, as well as HLS, DK and education level. Conclusion The GROHL demonstrated good psychometric properties and can be used for outcomes research in clinical and public health settings.
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Affiliation(s)
- Konstantina Taoufik
- Department of Community and Preventive Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Kimon Divaris
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.,Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Katerina Kavvadia
- Department of Pediatric Dentistry, School of Dentistry, University of Louisville, Louisville, KY, USA
| | - Haroula Koletsi-Kounari
- Department of Community and Preventive Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Argy Polychronopoulou
- Department of Community and Preventive Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Lisboa SO, Assunção CM, Junkes MC, Yokoyama MF, Couto ACF, Fraiz FC, Paiva SM, Ferreira FM. Do Parents’ Oral Health Literacy Levels Influence Their Response to Interventions to Improve Their Knowledge of Traumatic Dental Injuries? PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Montes GR, Bonotto DV, Ferreira FM, Menezes JVNB, Fraiz FC. Caregiver’s oral health literacy is associated with prevalence of untreated dental caries in preschool children. CIENCIA & SAUDE COLETIVA 2019; 24:2737-2744. [DOI: 10.1590/1413-81232018247.18752017] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 10/21/2017] [Indexed: 11/22/2022] Open
Abstract
Abstract The aim of this study was to evaluate the relationship between oral health literacy (OHL) among caregivers and untreated dental caries among preschoolers. A cross-sectional study was conducted involving 415 preschool children and their caregivers from Curitiba, Brazil. The children were examined for dental caries and dental plaque. The caregivers’ OHL was evaluated using an instrument translated and validated for Brazilian Portuguese: the Brazilian Rapid Estimate of Adult Literacy in Dentistry-30. The prevalence of children with untreated caries was 42.9% (95%CI: 38.1-47.7%). A low degree of OHL was found among 15.7% (95%CI: 12.2-19.2) of caregivers. The multivariable Poisson regression analysis indicated a higher prevalence of untreated caries among children whose caregivers had a low OHL (PR = 1.35; 95% CI: 1.01-1.79), those with visible plaque (PR = 1.28; 95% CI: 1.01-1.62) and those who never or only occasionally had their teeth brushed by their caregivers (PR = 1.48; 95% CI: 1.16-1.91) in comparison to those without these conditions. In conclusion, a higher prevalence of untreated dental caries was found among preschool children whose caregivers had a low degree of OHL.
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18
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Smith AJ, Moretti AJ, Brame J, Wilder RS. Knowledge, attitudes and behaviours of patients regarding interdental deplaquing devices: A mixed-methods study. Int J Dent Hyg 2019; 17:369-380. [PMID: 31152632 DOI: 10.1111/idh.12410] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 02/18/2019] [Accepted: 05/19/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This mixed-methods study assessed patients' oral health literacy, motivation level and barriers regarding interdental plaque control. METHODS Participants (n = 49) from a study comparing the use of Glide® Pro-Health Floss Original (F) or GUM® Curved Soft-Picks® Advance (SP) completed daily diaries and questionnaires regarding motivation, tiredness, confidence and satisfaction for their deplaquing method. The Mantel-Haenszel chi-square test was utilized. Data were also collected from 19 participants who attended focus group discussions regarding their oral health habits, knowledge, motivators and barriers with interdental plaque control. Discussions were digitally recorded, transcribed and imported into ATLAS.ti 7.5.15 to identify themes. RESULTS There were no statistically significant differences between the two groups in relation to age, sex or ethnicity. F users reported statistically significant higher agreement about ability to remove food/debris (P = 0.01), cleaning thoroughly (P = 0.02) and clean feeling of the mouth (P = 0.01). SP users reported higher ease/efficiency of use (P = 0.01), convenience (P = 0.003), easy to hold (P = 0.0001) and easy use away from home (P = 0.008). Daily diaries revealed higher motivation and compliance/ease of use (SP). During the focus groups, some reported that they did not feel clean unless they deplaqued interdentally; however, most reported that they lacked motivation due to constraints on time, no desire due to lack of immediate or tangible rewards, and lack of knowledge on proper use of interdental devices or the benefits of using them. CONCLUSION This study showed that the lack of compliance may be due to poor literacy and lack of motivation in patients due to gaps in patient education.
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Affiliation(s)
- Avie Jackie Smith
- Department of Periodontology, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - Antonio J Moretti
- Department of Periodontology, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - Jennifer Brame
- Department of Periodontology, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - Rebecca S Wilder
- Department of Dental Ecology, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
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Baskaradoss JK. Relationship between oral health literacy and oral health status. BMC Oral Health 2018; 18:172. [PMID: 30355347 PMCID: PMC6201552 DOI: 10.1186/s12903-018-0640-1] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/15/2018] [Indexed: 11/10/2022] Open
Abstract
Background Health literacy has been found to be a strong predictor of an individuals’ health, health behavior and health outcomes. Lower literacy has been linked to problems with the use of preventive services, delayed diagnoses of medical conditions, poor adherence to medical instructions, poor self-management skills, increased mortality risks, poor health outcomes, and higher health care costs. The aim of this study is to determine the relationship between oral health literacy (OHL) and oral health status among patients attending a University-affiliated dental clinic. Methods A convenience sample of participants was drawn from the dental patients presenting at School of Dental Medicine (SODM), Case Western Reserve University (CWRU). Information about the subjects’ demographic details, income, family size, insurance type and smoking history were collected using a data collection form. Data about the patients’ periodontal and caries risk assessment, caries experience and periodontal status was extracted from the patients’ electronic dental records. The Comprehensive Measure of Oral Health Knowledge (CMOHK) was used to record the oral health literacy. The median CMOHK score was 18, and this was used to categorize the sample into limited OHL (≤18) and adequate OHL (> 18) groups. A multivariate logistic regression model was built to examine the associations between the various independent variables and OHL levels. Results Data of 150 respondents were analyzed. More than half of the participants were female (55.3%) and the majority were Caucasian (60%). The average age of participants was 53.3 years [standard deviation (SD) 16.8]. Higher percentage of African Americans and individuals with low education had limited OHL levels (p < 0.05). The mean decayed, missing, and filled teeth (DMFT) score for this population was 7.33 ± 2.68. Subjects with limited OHL had significantly higher mean values for missing teeth (p < 0.05) and lower mean values for filled teeth (p < 0.05) as compared with subjects with adequate OHL Significantly, higher percentage of subjects with limited OHL had severe periodontitis as compared with those with adequate OHL (p = 0.04). Multivariate analysis found that the periodontal status was significantly associated with the OHL scores (p = 0.015). Conclusion Subjects with limited OHL levels had poorer periodontal health. Improving the OHL of patients may help in the efforts to improve the adherence to medical instructions, self-management skills and the overall treatment outcomes. Future research could focus on assessing the impact of OHL interventions on the oral health, which could be valuable for clinical practitioners.
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Affiliation(s)
- Jagan Kumar Baskaradoss
- Division of Dental Public Health, Department of Developmental and Preventive Sciences, Faculty of Dentistry, Kuwait University, P.O.Box: 24923, -13110, Safat, Kuwait.
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Firmino RT, Ferreira FM, Martins CC, Granville-Garcia AF, Fraiz FC, Paiva SM. Is parental oral health literacy a predictor of children's oral health outcomes? Systematic review of the literature. Int J Paediatr Dent 2018; 28:459-471. [PMID: 29984431 DOI: 10.1111/ipd.12378] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The scientific evidence regarding the association between parental oral health literacy (OHL) and children's oral health is unclear. AIM To evaluate the scientific evidence concerning the association between parental OHL and children's oral health outcomes. DESIGN Eight databases were searched. Studies that evaluated oral health outcomes among children and measured parental OHL through a validated tool were included. Two independent reviewers selected studies, extracted data and analysed the risk of bias. RESULTS Eleven studies were included. Most (n = 6) had a high risk of bias. Most studies evaluating dental caries found association between lower parental OHL and higher prevalence/experience of dental caries. Poor oral health-related quality of life was associated with decreased parental OHL (P < 0.05). Studies diverged on the association between OHL and the number of filled, extracted teeth, and dental visits. There was no association between children's tooth brushing frequency, use of toothpaste, oral health claim, oral health expenditures and parental OHL. The literature was inconclusive regarding the association between night bottle feeding, negative parental perception of the child's oral health and OHL. CONCLUSION Low parental OHL was associated with dental caries among their children. It is too soon to assume an association between OHL and the remaining outcomes.
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Affiliation(s)
- Ramon Targino Firmino
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernanda Morais Ferreira
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carolina Castro Martins
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Saul Martins Paiva
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Reda SM, Krois J, Reda SF, Thomson WM, Schwendicke F. The impact of demographic, health-related and social factors on dental services utilization: Systematic review and meta-analysis. J Dent 2018; 75:1-6. [PMID: 29673686 DOI: 10.1016/j.jdent.2018.04.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/03/2018] [Accepted: 04/12/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Regular and/or preventive dental services utilization is an indicator of healthcare access and associated with improved health outcomes. We assessed the proportion of individuals regularly/preventively utilizing dental services, and how this was affected by demographic, health-related and social factors. SOURCES Three electronic databases (Medline, Embase, Central) were searched (2005-2017). STUDY SELECTION We included observational studies investigating the association between preventive/regular dental service utilization and age, oral and general health, edentulism, family structure and health literacy. DATA The proportion of individuals with regular/preventive utilization overall and in different sub-groups were extracted. Random-effects meta-analyses, with subgroup analyses by region, were performed. Meta-regression was used to assess whether and how associations changed with time and countries' human developmental status (HDI). 103 studies on 7,395,697 participants from 28 countries were included. The global mean (95% CI) proportion of individuals regularly/preventively utilizing dental services was 54% (50-59%). In countries with higher HDI, more individuals regularly/preventively utilized services (p < 0.001). Age did not have a significant impact on utilization in adults (OR = 1.00; 0.89-1.12). Utilization was significantly lower in younger than older children (OR = 0.52; 0.46-0.59), individuals with poorer general health (OR = 0.73; 0.65-0.80) and poorer oral health (OR = 0.64; 0.52-0.75), edentulous individuals (OR = 0.32; 0.23-0.41), and individuals with less supportive family structures (OR = 0.81; 0.73-0.89) or poor health literacy (OR = 0.41; 0.01-0.81). The observed differences within populations did not significantly change with time and were universally present. CONCLUSIONS Regular/preventive utilization varied widely between and within countries. Understanding and tackling the reasons underlying this may help to consistently improve utilization. CLINICAL SIGNIFICANCE Higher developmental status of countries is reflected in greater regular/preventive utilization of dental services. However, large demographic, health-related and social differences in utilization remain. These may contribute to dental health inequalities.
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Affiliation(s)
- Seif Magdy Reda
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Germany
| | - Sophie Franziska Reda
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Germany
| | - William Murray Thomson
- Sir John Walsh Research Institute, Faculty of Dentistry, The University of Otago, Dunedin, New Zealand
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Germany.
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Firmino RT, Martins CC, Faria LDS, Martins Paiva S, Granville-Garcia AF, Fraiz FC, Ferreira FM. Association of oral health literacy with oral health behaviors, perception, knowledge, and dental treatment related outcomes: a systematic review and meta-analysis. J Public Health Dent 2018; 78:231-245. [PMID: 29498754 DOI: 10.1111/jphd.12266] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 01/26/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To conduct a systematic review and meta-analysis regarding the association of oral health literacy (OHL) with oral health behaviors, perception, knowledge, and dental treatment related outcomes. METHODS Eight electronic databases were searched up until June 2017. Studies regarding the aforementioned outcomes measuring OHL through a validated instrument and in which OHL was an explanatory variable were included. Two independent reviewers selected studies, extracted data, and analyzed the risk of bias of the studies. Meta-analysis using random effect modeling was undertaken. Pooled estimates were calculated with 95 percent confidence interval (CI) and odds ratios (OR). RESULTS Twenty-five studies were included in the systematic review and three in the meta-analysis. Most studies were cross-sectional (n = 21) and had a high risk of bias (n = 17). The meta-analysis showed no association between OHL and frequency of visit to the dentist for adults, either through bivariate analysis (OR = 1.25; 95 percent CI: 0.95-1.63) or multivariate analysis (OR = 1.90; 95 percent CI: 0.77-4.84). Dental anxiety and night bottle-feeding were associated with low OHL (P < 0.05). Most studies regarding tooth brushing frequency found no association with OHL. Most studies regarding oral health knowledge related outcomes reported an association with higher OHL. The literature was inconclusive regarding the association between OHL and dental treatment outcomes, oral health behaviors, and oral health perception. CONCLUSIONS The current scientific evidence suggests that no association exists between OHL and any of the outcomes investigated. Further prospective studies with a higher methodological quality are necessary to confirm the evidence.
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Affiliation(s)
- Ramon Targino Firmino
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carolina Castro Martins
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Larissa Dos Santos Faria
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Saul Martins Paiva
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Fernanda Morais Ferreira
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Palumbo R. Examining the impacts of health literacy on healthcare costs. An evidence synthesis. Health Serv Manage Res 2017; 30:197-212. [PMID: 29034727 DOI: 10.1177/0951484817733366] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Scholars and practitioners share a significant concern about rising healthcare costs. Health literacy is widely presented as a solution to this momentous issue, paving the way for a more appropriate access to care and therefore, for cost savings. However, to date little is still known about the ultimate effects of better health literacy on healthcare costs. Drawing from the findings of a systematic literature review which ultimately involved 29 papers retrieved from Scopus-Elsevier and PubMed. This manuscript is aimed at shedding light on the relationship between health literacy and healthcare costs. The inadequate ability of patients to understand health information and to navigate the healthcare system was found to be an important predictor of inappropriateness in the access to health care. In addition, people living with problematic health literacy are discouraged to be engaged in the provision of health services and are expected to show poor self-efficacy in dealing with their health-related conditions. From this point of view, poor health literate patients are assumed to be at high risk of exacerbation of their health problems, which in turn contributes in rising healthcare costs. In spite of these findings, both policy makers and practitioners seem to overlook the importance of health literacy. Eventually, the joint intervention on laws, policies, organizational strategies, and practices is crucial to handle the challenges related to limited health literacy.
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Cartes-Velásquez RA, Luengo Machuca L. Adaptation and validation of the oral health literacy instrument for the Chilean population. Int Dent J 2017; 67:215-220. [DOI: 10.1111/idj.12288] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Cartes-Velasquez R, Araya C, Flores R, Luengo L, Castillo F, Bustos A. A motivational interview intervention delivered at home to improve the oral health literacy and reduce the morbidity of Chilean disadvantaged families: a study protocol for a community trial. BMJ Open 2017; 7:e011819. [PMID: 28710202 PMCID: PMC5577873 DOI: 10.1136/bmjopen-2016-011819] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Oral health education/promotion interventions have been identified as cost-efficient tools to improve the oral health of the population. These interventions are regularly made in contexts where the target population is captive, for example, in health centres. In Chile, there are no oral health interventions delivered at home. METHODS AND ANALYSIS This community trial covers two disadvantaged urban areas in the province of Concepción. Both sectors have public preschool education coverage with a traditional programme (TP) to promote oral health. The intervention will comprise four to six visits by dental hygienists trained in the delivery of a standardised oral health promotion programme using motivational interviewing (MI) at home. The experimental group will receive TP and MI, while the control group will receive only TP. If a positive and significant effect of MI is found, this will be administered to the control group. For a 50% reduction in the incidence of caries, a sample size of 120 preschoolers per group is estimated. Data will be gathered on demographic and socioeconomic variables; oral health outcomes using WHO oral health indicators (the prevalence and severity of caries, periodontal disease, dentofacial anomalies and oral hygiene); the oral health literacy of caregivers, measured by the Rapid Estimation of Adult Literacy in Dentistry and the Oral Health Literacy Instrument, both validated for the Chilean population. Assessments will take place at baseline and at 12-month follow-up. ETHICS AND DISSEMINATION The university bioethics committee approved this study (EI/21/2014). We will submit the trial's results for presentation at international scientific meetings and to peer-reviewed journals. TRIAL REGISTRATION NUMBER ACTRN12615000450516.
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Affiliation(s)
- Ricardo Cartes-Velasquez
- Department of Preventive and Public Health Dentistry, Universidad de Concepción, School of Dentistry, Concepcion, Chile
| | - Carlos Araya
- Department of Preventive and Public Health Dentistry, Universidad de Concepción, School of Dentistry, Concepcion, Chile
| | - Raúl Flores
- Department of Preventive and Public Health Dentistry, Universidad de Concepción, School of Dentistry, Concepcion, Chile
| | - Luis Luengo
- Department of Preventive and Public Health Dentistry, Universidad de Concepción, School of Dentistry, Concepcion, Chile
| | - Francisca Castillo
- Department of Preventive and Public Health Dentistry, Universidad de Concepción, School of Dentistry, Concepcion, Chile
| | - Alex Bustos
- Department of Preventive and Public Health Dentistry, Universidad de Concepción, School of Dentistry, Concepcion, Chile
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Fragelli CMB, Souza JFD, Bussaneli DG, Jeremias F, Santos-Pinto LD, Cordeiro RDCL. Survival of sealants in molars affected by molar-incisor hypomineralization: 18-month follow-up. Braz Oral Res 2017; 31:e30. [PMID: 28489117 DOI: 10.1590/1807-3107bor-2017.vol31.0030] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 03/06/2017] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to evaluate the clinical survival of sealants applied in first permanent molars (FPMs) affected by molar-incisor hypomineralization (MIH), at 18 months of follow-up. Forty-one first permanent molars were selected from 21 children, 6-8 years of age. MIH was classified by one calibrated examiner (kappa = 0.80) according to EAPD criteria. The inclusion criteria were fully erupted FPMs with MIH or sound FPMs (without MIH) for which sealant treatment was indicated. The FPMs were assigned to two groups: CG (control group) and HG (MIH group). Both groups were treated with sealant (FluroShield). Clinical follow-up was performed from baseline to 18 months to assess anatomical form, marginal adaptation, retention and presence of caries, according to criteria set by the United States Public Health Service-Modified, and was conducted by a blinded examiner (kappa = 0.80). The actuarial method was used to evaluate the survival of the sealants. The survival rates for the groups were compared using Fisher's exact test (α = 5%). The cumulative survival rates were 81% at 1 month, 68.8% at 6 months, 68.8% at 12 months, and 62.6% at 18 months for CG, and 88% at 1 month, 84% at 6 months, 76% at 12 months, and 72% at 18 months for HG. No significant difference was found between the groups. The sealants in molars affected by MIH presented a survival rate similar to the sealants in the control, suggesting that sealants may be an adequate approach for preventing carious lesions in MIH-affected molars.
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Affiliation(s)
- Camila Maria Bullio Fragelli
- Universidade do Estado de São Paulo - Unesp, Araraquara Dental School, Department of Orthodontics and Pediatric Dentistry, Araraquara, São Paulo, Brazil
| | - Juliana Feltrin de Souza
- Universidade Federal do Paraná - UFPR, School of Dentistry, Department of Stomatology, Curitiba, Paraná, Brazil
| | - Diego Girotto Bussaneli
- Universidade do Estado de São Paulo - Unesp, Araraquara Dental School, Department of Orthodontics and Pediatric Dentistry, Araraquara, São Paulo, Brazil
| | - Fabiano Jeremias
- Universidade do Estado de São Paulo - Unesp, Araraquara Dental School, Department of Orthodontics and Pediatric Dentistry, Araraquara, São Paulo, Brazil
| | - Lourdes Dos Santos-Pinto
- Universidade do Estado de São Paulo - Unesp, Araraquara Dental School, Department of Orthodontics and Pediatric Dentistry, Araraquara, São Paulo, Brazil
| | - Rita de Cássia Loiola Cordeiro
- Universidade do Estado de São Paulo - Unesp, Araraquara Dental School, Department of Orthodontics and Pediatric Dentistry, Araraquara, São Paulo, Brazil
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The Association of Oral Health Literacy and Oral Health Knowledge with Social Determinants in Pregnant Brazilian Women. J Community Health 2016; 41:1027-32. [DOI: 10.1007/s10900-016-0186-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Shih SF, Liu CH, Liao LL, Osborne RH. Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan. BMC Public Health 2016; 16:280. [PMID: 27000035 PMCID: PMC4802836 DOI: 10.1186/s12889-016-2879-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 02/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people's control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan's sixth grade school children. METHODS Using a population-based survey, 162,209 sixth grade (11-12 years old) school children were assessed. The response rate at school level was 83%, with 70% of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates. RESULTS The sample consisted of 48.9% girls, 3.8% were indigenous and the mean BMI was 19.55 (SD = 3.93). About 6% of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32). The overall proportion of obese children was 15.2%. Children in the highest health literacy quartile were less likely to be obese (12.4%) compared with the lowest quartile (17.4%). After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR) = 0.94, p < 0.001) and underweight (RRR = 0.83, p < 0.001). Those who did not have regular physical activity, or had sugar-sweetened beverage intake (RRR > 1.10, p < 0.0001) were more likely to report being overweight or obese. CONCLUSIONS This study demonstrates strong links between health literacy and obesity, even after adjusting for key potential confounders, and provides new insights into potential intervention points in school education for obesity prevention. Systematic approaches to integrating a health literacy curriculum into schools may mitigate the growing burden of disease due to obesity.
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Affiliation(s)
- Shu-Fang Shih
- />Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da-An District 106, Taipei, Taiwan
| | - Chieh-Hsing Liu
- />Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da-An District 106, Taipei, Taiwan
| | - Li-Ling Liao
- />Department of Health Management, I-Shou University, No. 8, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City, 82445 Taiwan
| | - Richard H. Osborne
- />Deakin University Centre for Population Health Research, School of Health and Social Development, Geelong, Victoria Australia
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Wen C, Yanyan Z, Jinghu J, Jing-xian Z, Xuepeng S, Xing Q, Chengge H. [Factors influencing oral insurance among children in Chengdu]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2015; 33:593-6. [PMID: 27051951 PMCID: PMC7030359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 09/12/2015] [Indexed: 11/14/2023]
Abstract
OBJECTIVE This study aimed to investigate the value of child oral health for Chengdu parents, their intentions, and factors influencing their decision to acquire oral insurance coverage for their childrens. METHODS A total of 562 Chengdu parents were interviewed using questionnaires by convenient sampling, and the results were analyzed using SPSS 20.0. RESULTS The age of children (B = -1.741, P = 0.004), age of parents (B = 2.031, P = 0.003), level of oral discomfort (B = 0.569, P = 0.000), incurring/not incurring oral care expenses in the previous year (B = 1.897, P = 0.014), the last time parents' had teeth cleaned (B = 0.777, P = 0.006), and acquiring/not acquiring commercial insurance coverage (B = 1.632, P = 0.031) significantly influenced the intention of acquiring child oral insurance. CONCLUSION Child oral health, health and insurance awareness of parents, and other factors influenced the intention of parents to purchase oral insurance coverage for their children, which were significant to establish pediatric dental insurance.
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Wen C, Yanyan Z, Jinghu J, Jing-xian Z, Xuepeng S, Xing Q, Chengge H. [Factors influencing oral insurance among children in Chengdu]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2015; 33:593-596. [PMID: 27051951 PMCID: PMC7030359 DOI: 10.7518/hxkq.2015.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 09/12/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE This study aimed to investigate the value of child oral health for Chengdu parents, their intentions, and factors influencing their decision to acquire oral insurance coverage for their childrens. METHODS A total of 562 Chengdu parents were interviewed using questionnaires by convenient sampling, and the results were analyzed using SPSS 20.0. RESULTS The age of children (B = -1.741, P = 0.004), age of parents (B = 2.031, P = 0.003), level of oral discomfort (B = 0.569, P = 0.000), incurring/not incurring oral care expenses in the previous year (B = 1.897, P = 0.014), the last time parents' had teeth cleaned (B = 0.777, P = 0.006), and acquiring/not acquiring commercial insurance coverage (B = 1.632, P = 0.031) significantly influenced the intention of acquiring child oral insurance. CONCLUSION Child oral health, health and insurance awareness of parents, and other factors influenced the intention of parents to purchase oral insurance coverage for their children, which were significant to establish pediatric dental insurance.
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Lapidos A, Shaefer HL, Gwozdek A. Toward a better understanding of dental appointment-keeping behavior. Community Dent Oral Epidemiol 2015; 44:85-91. [DOI: 10.1111/cdoe.12193] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 07/31/2015] [Indexed: 11/27/2022]
Affiliation(s)
| | - H. Luke Shaefer
- School of Social Work; University of Michigan; Ann Arbor MI USA
| | - Anne Gwozdek
- Department of Periodontics and Oral Medicine; School of Dentistry; University of Michigan; Ann Arbor MI USA
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Nelson TM, Huebner CE, Kim A, Scott JM, Pickrell JE. Parent-reported distress in children under 3 years old during preventive medical and dental care. Eur Arch Paediatr Dent 2014; 16:283-90. [PMID: 25514877 DOI: 10.1007/s40368-014-0161-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/28/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE This study examined factors related to young children's distress during preventive oral health visits. Additionally, associations between parent-reported child behaviour during the dental visit and during previous medical visits were tested. METHODS One hundred twenty-two children under 3 years of age enrolled in a government insurance programme for low-income children were seen for examination, prophylaxis, and fluoride application at a university-based dental clinic. Child distress was rated by parents on a numerical rating scale. RESULTS The average age of children enrolled was 23.5 ± 7.3 months. The majority (55.7 %) were judged to have little or no distress pre-examination. Mild or no distress during the examination was reported for 42.6 % of the children and severe distress was reported for 39.4 %. Intensity of distress during the examination was not associated with the child's age, gender, dental health, or previous experience with dental care. Distress was also unrelated to the caregiver's education level or own dental health. Intensity of distress was associated with the child's pre-dental examination distress and distress during prior medical examinations and injections. CONCLUSIONS Dental professionals can better anticipate child distress by assessing children before a dental examination and enquiring about previous medical experiences. Strategies to prepare parents and alleviate distress may help children cope with the preventive dental visit.
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Affiliation(s)
- T M Nelson
- Department of Pediatric Dentistry, University of Washington, 6222 NE 74th Street, Seattle, WA, 98115, USA,
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Divaris K, Lee JY, Baker AD, Gizlice Z, Rozier RG, DeWalt DA, Vann WF. Influence of caregivers and children's entry into the dental care system. Pediatrics 2014; 133:e1268-76. [PMID: 24753522 PMCID: PMC4006434 DOI: 10.1542/peds.2013-2932] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Early preventive dental visits are essential in improving children's oral health, especially young children at high risk for dental caries. However, there is scant information on how these children enter the dental care system. Our objectives were as follows: (1) to describe how a population-based cohort of young Medicaid-enrolled children entered dental care; and (2) to investigate the influence of caregiver characteristics on their children's dental care-seeking patterns. METHODS We relied on Medicaid claims and interview data of caregiver-child dyads who were enrolled in the Carolina Oral Health Literacy study during 2007-2008. The analytical cohort comprised 1000 children who had no dental visits before enrollment. Additional information was collected on sociodemographic characteristics, oral health status, health literacy, dental neglect, and access to care barriers. Our analyses relied on descriptive, bivariate, and multivariate methods. RESULTS During the 25-month median follow-up period, 39% of the children (mean baseline age: 16 months) entered the dental care system, and 13% of their first encounters were for emergency care. Caregivers' dental neglect emerged as a significant predictor of nonentrance. Children with reported oral health problems at baseline were more likely to enter the dental care system compared with children with better oral health, but they were also more likely to require emergency care. CONCLUSIONS Caregivers have a pivotal role in children's oral health and care. Interventions aimed at improving children's oral health should involve community outreach to engage caregivers in a culturally appropriate manner when their children are infants or toddlers.
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Affiliation(s)
- Kimon Divaris
- Department of Pediatric Dentistry, School of Dentistry,
| | - Jessica Y. Lee
- Department of Pediatric Dentistry, School of Dentistry,,Department of Health Policy and Management, Gillings School of Global Public Health
| | | | - Ziya Gizlice
- Center for Health Promotion and Disease Prevention, and
| | - R. Gary Rozier
- Department of Health Policy and Management, Gillings School of Global Public Health
| | - Darren A. DeWalt
- Department of General Medicine and Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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