Racial discrimination, self-efficacy, and oral health behaviours in adolescents

Associations between self-efficacy, social support, racial discrimination, and adolescents oral health

OBJECTIVE

This study aimed to develop a conceptual model exploring the relationships between perceived social support (PSS), self-efficacy, racial discrimination, and oral health (OH) in adolescents.

METHODS

A cross-sectional study of adolescents aged 12-18 was conducted at a university dental clinic. Participants completed a questionnaire on demographics, OH, PSS, general self-efficacy, and task-specific self-efficacy (TSSE). Structural Equation Modeling (SEM) was used for analysis.

RESULTS

A total of 252 adolescents participated in the study, with an average age of 14 years; 60% were female, 81% were born in Canada, 56% identified as White, and 20% perceived discrimination. PSS was positively associated with general self-efficacy (p = 0.002), TSSE for dental visits (p = 0.004), dietary habits (p = 0.004), and tooth-brushing (p = 0.002), while also elevating sugar consumption (p = 0.002). PSS (p = 0.048) and discrimination (p = 0.01) reduced tooth-brushing frequency. Self-efficacy for dietary habits (p = 0.005) and tooth-brushing (p = 0.002) positively correlated with increased tooth-brushing, while self-efficacy for dietary habits decreased sugar consumption (p = 0.001). Self-efficacy for tooth-brushing was linked to reduced dental visits (p = 0.02). PSS indirectly increased brushing frequency (p = 0.02) and reduced dental-care utilization (p = 0.004). Discrimination indirectly reduced self-efficacy for dental visits (p = 0.003) but increased self-efficacies for tooth-brushing (p = 0.01) and dietary habits (p = 0.03).

CONCLUSION

PSS was directly related to increased self-efficacy, while discrimination indirectly affected OH. Oral health was associated with self-efficacy for dietary habits and tooth-brushing, but not dental visits alone.

IMPLICATIONS FOR HEALTH EQUITY

The findings underscore the critical need to address systemic inequities in oral health care access. By exploring the interplay between social support, discrimination, and self-efficacy, this study highlights actionable pathways to reduce disparities and improve oral health outcomes among adolescents.

Perceived racial discrimination, resilience, and oral health behaviours of adolescents with immigrant backgrounds

INTRODUCTION

Unmet oral health needs remain a significant issue among immigrant adolescents, often exacerbated by experiences of racial discrimination. This study aimed to examine the associations between perceived discrimination and oral health behaviours in adolescents with immigrant backgrounds and explore the potential moderating role of resilience on this association.

METHODS

Ethical approval for this cross-sectional study was obtained from the University of Alberta Research Ethics Board. Participants were 12 to 18-year-old adolescents from immigrant backgrounds. Participants were recruited through nine community organizations using a snowball sampling technique. After obtaining active parental consent and assent from the adolescent, the participants completed a questionnaire covering demographics, oral health behaviours, and perceived racial discrimination and resilience. Perceived racial discrimination and resilience were measured using validated scales. Descriptive statistics summarized variables. Logistic regression assessed associations, controlling for confounding factors. Resilience's moderating impact was analyzed via the interaction model of regression analysis.

RESULTS

In this cross-sectional study of 316 participants, average age of 15.3 (SD = 1.9) years, and a median age of 15 years (Inter Quartile Range-12-18), 76% reported discrimination experiences. Adjusted analysis showed that an increase of one unit in the total discrimination distress score was associated with 51% less likelihood of categorizing self-rated oral health as good (OR = 0.49, 95% CI: 0.29-0.81). The odds of brushing teeth more than twice a day, as opposed to once a day, decreased by 58% with one unit increase in the total discrimination distress score (OR = 0.42, 95% CI: 0.25-0.71). The odds of visiting the dentist for an urgent procedure instead of a regular check-up were 2.3 times higher with a unit increase in the total discrimination distress score (OR = 2.3: 95% CI:1.3-4.0) Resilience did not moderate the observed association.

CONCLUSION

Perceived racial discrimination was associated with the pattern for dental attendance, tooth brushing frequency, and self-rated oral health. Resilience did not moderate the observed association.