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Reda M, Sen A, Mustafa M. Prevention of caries and obesity in children with immigrant background in Norway- a study protocol for a cluster randomized controlled trial. BMC Oral Health 2023; 23:620. [PMID: 37658341 PMCID: PMC10474737 DOI: 10.1186/s12903-023-03329-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/18/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Immigrants are known to experience greater socioeconomic stress and poorer well-being and to suffer more from lifestyle- and diet-related disorders than native populations. There is also evidence that children of immigrant parents are at greater risk of diverse health problems than their host country cohorts. The aim of this study is to apply and evaluate the efficacy of an early life intervention program among parents/children with immigrant background to prevent childhood caries and obesity, thereby improving the children's general health, oral health, and quality of life. METHODS This is a study protocol for a cluster randomized controlled intervention follow-up study. In phase I of the study, the primary care health centers in the municipality of Bergen, Norway were randomly allocated to intervention or control groups. The intervention was carried out using the motivational interviewing technique and the common risk factor approach. The intervention group received guidance on diet/oral hygiene and the control group received standard care information. Parental knowledge and children at age 3 and 5 years old will be assessed in a prospective phase II follow-up study compared to native Norwegian controls. The primary outcome will be evaluation of change on parental oral health related knowledge and attitudes. The secondary outcome will assess the impact of the intervention on children's caries -, body mass index- and oral health related quality of life. DISCUSSION Collaboration between dental public health and primary health care personnel on the common risk approach motivational intervention offers opportunities to address key dietary behaviors that may prevent obesity and dental caries. Providing sustainable preventive measures decreases the burden of diseases and consequently reduces health inequalities, particularly among at-risk children. TRIAL REGISTRATION The study is registered as a clinical trial (ClinicalTrials.gov Identifier: NCT05758454: 7 March 2023). Ethical approval has already been granted by the Regional Ethical Committee (REK) (2015/ 27,639 /REK vest) and Sikt - Norwegian Agency for Shared Services in Education and Research (Reference number 778825).
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Affiliation(s)
- Mariam Reda
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Abhijit Sen
- Center for Oral Health Services and Research (TkMidt), Trondheim, Norway
- Department of Public Health and Nursing, Faculty of Medicine, and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Manal Mustafa
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway.
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Folayan MO, Finlayson T, Oginni AB, Alade MA, Adeniyi AA, El Tantawi M. Is oral rehydration therapy associated with early childhood caries in children resident in Ile-Ife, Osun State, Nigeria? Int J Paediatr Dent 2023; 33:74-81. [PMID: 35771168 DOI: 10.1111/ipd.13016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Oral rehydration therapy may increase the risk of early childhood caries (ECC) because of reduced pH in the oral environment. AIM To investigate associations between the use of oral rehydration therapy and the prevalence and severity of ECC in children resident in the Ife Central Local Government Area of Osun State, Nigeria. DESIGN This observational study assessed the prevalence and severity of caries, using the International Caries Detection and Assessment System (ICDAS) II index. The outcome variables were the prevalence and severity of ECC. The explanatory variable was the use of oral rehydration solution for the management of diarrhea in the 12 months preceding the study. A multivariable logistic regression analysis was conducted to determine associations between the explanatory and outcome variables. RESULTS Only 217 (14%) of the 1564 children had used oral rehydration solution for the management of diarrhea. Seventy-three (4.7%) children had ECC. The use of oral rehydration solution was not significantly associated with the prevalence and severity of ECC. CONCLUSION The study findings suggest that the use of oral rehydration therapy in the management of diarrhea may not be a risk factor for ECC in communities with low prevalence and severity of ECC and high prevalence of gastroenteritis.
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Affiliation(s)
| | | | | | - Michael Abimbola Alade
- Department of Child Dental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | | | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Goldfeld S, Francis KL, O’Connor E, Ludvigsson J, Faresjö T, Nikiema B, Gauvin L, Yang-Huang J, Abu Awad Y, McGrath JJ, Goldhaber-Fiebert JD, Faresjo Å, Raat H, Kragt L, Mensah FK. Comparative inequalities in child dental caries across four countries: Examination of international birth cohorts and implications for oral health policy. PLoS One 2022; 17:e0268899. [PMID: 36044409 PMCID: PMC9432734 DOI: 10.1371/journal.pone.0268899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 05/10/2022] [Indexed: 11/19/2022] Open
Abstract
Child dental caries (i.e., cavities) are a major preventable health problem in most high-income countries. The aim of this study was to compare the extent of inequalities in child dental caries across four high-income countries alongside their child oral health policies. Coordinated analyses of data were conducted across four prospective population-based birth cohorts (Australia, n = 4085, born 2004; Québec, Canada, n = 1253, born 1997; Rotterdam, the Netherlands, n = 6690, born 2002; Southeast Sweden, n = 7445, born 1997), which enabled a high degree of harmonization. Risk ratios (adjusted) and slope indexes of inequality were estimated to quantify social gradients in child dental caries according to maternal education and household income. Children in the least advantaged quintile for income were at greater risk of caries, compared to the most advantaged quintile: Australia: AdjRR = 1.18, 95%CI = 1.04–1.34; Québec: AdjRR = 1.69, 95%CI = 1.36–2.10; Rotterdam: AdjRR = 1.67, 95%CI = 1.36–2.04; Southeast Sweden: AdjRR = 1.37, 95%CI = 1.10–1.71). There was a higher risk of caries for children of mothers with the lowest level of education, compared to the highest: Australia: AdjRR = 1.18, 95%CI = 1.01–1.38; Southeast Sweden: AdjRR = 2.31, 95%CI = 1.81–2.96; Rotterdam: AdjRR = 1.98, 95%CI = 1.71–2.30; Québec: AdjRR = 1.16, 95%CI = 0.98–1.37. The extent of inequalities varied in line with jurisdictional policies for provision of child oral health services and preventive public health measures. Clear gradients of social inequalities in child dental caries are evident in high-income countries. Policy related mechanisms may contribute to the differences in the extent of these inequalities. Lesser gradients in settings with combinations of universal dental coverage and/or fluoridation suggest these provisions may ameliorate inequalities through additional benefits for socio-economically disadvantaged groups of children.
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Affiliation(s)
- Sharon Goldfeld
- Centre for Community Child Health, Royal Children’s Hospital, Melbourne, Victoria, Australia
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- * E-mail:
| | - Kate L. Francis
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Elodie O’Connor
- Centre for Community Child Health, Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Johnny Ludvigsson
- Crown Princess Victoria Children´s Hospital and Div of Pediatrics, Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Tomas Faresjö
- Dept of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden
| | - Beatrice Nikiema
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, Québec, Canada
- Cree Board of Health and Social Services of James Bay [CBHSSJB], Department of Program Development and Support, Mistissini, Québec, Canada
| | - Lise Gauvin
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, Québec, Canada
- École de Santé Publique, Université de Montréal, Montréal, Québec, Canada
| | - Junwen Yang-Huang
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Yara Abu Awad
- PERFORM Centre & Department of Psychology, Montreal, Canada
| | | | - Jeremy D. Goldhaber-Fiebert
- Stanford Health Policy, Centers for Health Policy and Primary Care and Outcomes Research, Department of Medicine, Stanford University, Stanford, California, United States of America
| | - Åshild Faresjo
- Dept of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden
| | - Hein Raat
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Lea Kragt
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Oral & Maxillofacial Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Fiona K. Mensah
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
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Al Naasan Z, Broadbent J, Smith M, Duncan W. Evaluation of a tailored oral health promotion intervention for Syrian former refugees in New Zealand. Health Promot Int 2022; 37:6697186. [PMID: 36102477 DOI: 10.1093/heapro/daac132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
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.
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Affiliation(s)
- Zeina Al Naasan
- Department of Oral Sciences, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Jonathan Broadbent
- Department of Oral Sciences, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Moira Smith
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Warwick Duncan
- Department of Oral Sciences, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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Epidemiological profile of early childhood caries in a sub-urban population in Nigeria. BMC Oral Health 2021; 21:415. [PMID: 34425793 PMCID: PMC8383461 DOI: 10.1186/s12903-021-01780-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background The aim of the study was to determine the prevalence and severity of early childhood caries (ECC) in children 6–71-months; identify the teeth most at risk for ECC; and identify risk indicators associated with significant caries index (SiC) score in different age groups. Methods This was a cross-sectional study that collected data (using a household survey) on the ECC risk indicators (frequency of tooth brushing, consumption of refined carbohydrate in-between-meals, daily use of fluoridated toothpaste, and dental service utilization in the 12 months) in Ile-Ife, Nigeria. We computed the prevalence of ECC using the International Caries Detection and Assessment System (ICDASI (d1–6)) index; caries severity using the ICDAS-2(d1–2) and ICDAS-3(d3–6) for non-cavitated and cavitated lesions respectively, decayed missing, filled teeth (dmft), and surfaces (dmfs) and SiC indices; and caries complications using the pulp (p), ulceration (u), fistula (f) and abscesses (a) (pufa) index, for children 6–11-months-old, 12–23-months-old, 23–35-months-old, 35–47-months-old; 48–59-months-old and 60–71-months-old. The differences in the mean dmft, dmfs, pufa scores, and ICDAS 1, 2, and 3 scores, and proportion of children with each ECC risk indicator were computed. Logistic regression analysis was conducted to identify risk indicators for the ECC SiC index score for each age group. Results The prevalence of ECC was 4.7%: 2.9% had non-cavitated lesions and 2.8% had cavitated lesions. The mean (SD) dmft, dmfs and pufa scores were 0.13 (0.92), 0.24 (1.91) and 0.04 (0.46) respectively. The dmft and dmfs scores were highest among the 24–35-months-olds while the SiC score was highest among the 12–23-months-olds. There were no significant differences in dmft, dmfs, and pufa scores between the different age groups. Toothbrushing more than once a day was the only factor associated with the SiC score: it decreases the odds for the SiC score in children 48–59-months-old. The teeth worst affected by ECC were #85 and #61. Conclusion The prevalence, severity and risk indicator for ECC seems to differ for each age group. The granular details on the risk profile of children with ECC in this population with a low ECC prevalence and burden can allow for the planning of age-targeted interventions.
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Pani SC, Al-Sibai SA, Rao AS, Kazimoglu SN, Mosadomi HA. Parental Perception of Oral Health-related Quality of Life of Syrian Refugee Children. J Int Soc Prev Community Dent 2017; 7:191-196. [PMID: 28852635 PMCID: PMC5558253 DOI: 10.4103/jispcd.jispcd_212_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 07/10/2017] [Indexed: 11/04/2022] Open
Abstract
AIMS AND OBJECTIVES The conflict in Syria has resulted in the displacement of over 5 million people, many of whom intend to return home at the cessation of hostilities. Oral health plays a critical role in early childhood and this study aimed to qualitatively and quantitatively assess the oral health-related quality of life (OHRQoL) of these children. MATERIALS AND METHODS The quantitative assessment of OHRQoL was done using a validated Arabic version of the short-form Parental-Caregiver Perceptions Questionnaire-8 (P-CPQ-8). The P-CPQ-8 was administered to 22 sets of parents of children in a community center catering to urban refugees. A focus group interview and thematic analysis of nine mothers were used to gain a qualitative insight into the problems that could affect the OHRQoL of their children. RESULTS The P-CPQ-8 revealed that oral symptoms were the greatest concern of the parents with dental pain being the most commonly reported condition. Although mothers reported higher P-CPQ-8 scores among all domains than fathers, there were no significant differences in the concerns of the fathers and the mothers. The focus group interview raised three major themes - (1) access to dental care, (2) pain felt by the child, and (3) oral hygiene of the child. CONCLUSION The parents interviewed in this study were aware of the importance of oral hygiene but reported being unable to look after their children's teeth. Children who are refugees from the Syrian conflict face significant OHRQoL challenges.
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Affiliation(s)
- Sharat Chandra Pani
- Department of Preventive Dental Sciences, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
| | - Salam Atef Al-Sibai
- Department of Research Center, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
| | - Akanksha S Rao
- Department of Research Center, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
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Hoffman LM, Rollins L, Henry Akintobi T, Erwin K, Lewis K, Hernandez N, Miller A. Oral Health Intervention for Low-Income African American Men in Atlanta, Georgia. Am J Public Health 2017; 107:S104-S110. [PMID: 28661811 PMCID: PMC5497882 DOI: 10.2105/ajph.2017.303760] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To describe the Minority Men's Oral Health Dental Access Program (MOHDAP) intervention and report participants' outcomes and satisfaction. METHODS MOHDAP was designed to increase the oral health knowledge of low-income, African American men in Atlanta, GA, in 2013. A community-based participatory approach and needs assessment guided the intervention development, which consisted of 3 educational modules delivered over a 2-day period. All participants (n = 45; mean age = 50 years) were African American men. We assessed changes in oral health knowledge and attitudes at baseline and postintervention via survey. RESULTS After the intervention, the percentage of correct responses to questions about gingivitis increased by 24.2% (P = .01), about use of a hard (instead of a soft) toothbrush increased by 42.2% (P < .01), and knowledge of ways to prevent gum diseases increased by 16.0% (P = .03). The percentage agreeing with erroneous statements decreased 11.3% (P = .02) regarding oral health-related fatalism and oral health self-care and 17.4% (P = .05) regarding saving front versus back teeth. CONCLUSIONS Community-based oral health educational interventions designed for African American men may reduce oral health disparities among this population.
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Affiliation(s)
- LaShawn M Hoffman
- LaShawn M. Hoffman, Latrice Rollins, Tabia Henry Akintobi, Katherine Erwin, and Natalie Hernandez are with the Morehouse School of Medicine, Atlanta, GA. Kimberly Lewis is with the Fulton County Department of Health and Wellness, Atlanta. Assia Miller is with McKing Consulting Corporation, Atlanta
| | - Latrice Rollins
- LaShawn M. Hoffman, Latrice Rollins, Tabia Henry Akintobi, Katherine Erwin, and Natalie Hernandez are with the Morehouse School of Medicine, Atlanta, GA. Kimberly Lewis is with the Fulton County Department of Health and Wellness, Atlanta. Assia Miller is with McKing Consulting Corporation, Atlanta
| | - Tabia Henry Akintobi
- LaShawn M. Hoffman, Latrice Rollins, Tabia Henry Akintobi, Katherine Erwin, and Natalie Hernandez are with the Morehouse School of Medicine, Atlanta, GA. Kimberly Lewis is with the Fulton County Department of Health and Wellness, Atlanta. Assia Miller is with McKing Consulting Corporation, Atlanta
| | - Katherine Erwin
- LaShawn M. Hoffman, Latrice Rollins, Tabia Henry Akintobi, Katherine Erwin, and Natalie Hernandez are with the Morehouse School of Medicine, Atlanta, GA. Kimberly Lewis is with the Fulton County Department of Health and Wellness, Atlanta. Assia Miller is with McKing Consulting Corporation, Atlanta
| | - Kimberly Lewis
- LaShawn M. Hoffman, Latrice Rollins, Tabia Henry Akintobi, Katherine Erwin, and Natalie Hernandez are with the Morehouse School of Medicine, Atlanta, GA. Kimberly Lewis is with the Fulton County Department of Health and Wellness, Atlanta. Assia Miller is with McKing Consulting Corporation, Atlanta
| | - Natalie Hernandez
- LaShawn M. Hoffman, Latrice Rollins, Tabia Henry Akintobi, Katherine Erwin, and Natalie Hernandez are with the Morehouse School of Medicine, Atlanta, GA. Kimberly Lewis is with the Fulton County Department of Health and Wellness, Atlanta. Assia Miller is with McKing Consulting Corporation, Atlanta
| | - Assia Miller
- LaShawn M. Hoffman, Latrice Rollins, Tabia Henry Akintobi, Katherine Erwin, and Natalie Hernandez are with the Morehouse School of Medicine, Atlanta, GA. Kimberly Lewis is with the Fulton County Department of Health and Wellness, Atlanta. Assia Miller is with McKing Consulting Corporation, Atlanta
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Truong M, Gibbs L, Pradel V, Morris M, Gwatirisa P, Tadic M, de Silva A, Hall M, Young D, Riggs E, Calache H, Gussy M, Watt R, Gondal I, Waters E. A Cultural Competence Organizational Review for Community Health Services: Insights From a Participatory Approach. Health Promot Pract 2017; 18:466-475. [DOI: 10.1177/1524839916689546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mandy Truong
- University of Melbourne, Carlton, Victoria, Australia
| | - Lisa Gibbs
- University of Melbourne, Carlton, Victoria, Australia
| | | | - Michal Morris
- The Centre for Culture, Ethnicity and Health, Richmond, Victoria, Australia
| | - Pauline Gwatirisa
- The Centre for Culture, Ethnicity and Health, Richmond, Victoria, Australia
| | | | | | - Martin Hall
- North Richmond Community Health, Richmond, Victoria, Australia
| | - Dana Young
- University of Melbourne, Carlton, Victoria, Australia
| | - Elisha Riggs
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Hanny Calache
- University of Melbourne, Carlton, Victoria, Australia
- La Trobe University, Melbourne, Victoria, Australia
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | - Mark Gussy
- University of Melbourne, Carlton, Victoria, Australia
- La Trobe University, Melbourne, Victoria, Australia
| | | | - Iqbal Gondal
- Monash University, Clayton, Victoria, Australia
- Federation University Australia, Mount Helen, Australia
- Pakistan Australia Association, Melbourne, Victoria, Australia
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Valerio MA, Rodriguez N, Winkler P, Lopez J, Dennison M, Liang Y, Turner BJ. Comparing two sampling methods to engage hard-to-reach communities in research priority setting. BMC Med Res Methodol 2016; 16:146. [PMID: 27793191 PMCID: PMC5084459 DOI: 10.1186/s12874-016-0242-z] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 10/08/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Effective community-partnered and patient-centered outcomes research needs to address community priorities. However, optimal sampling methods to engage stakeholders from hard-to-reach, vulnerable communities to generate research priorities have not been identified. METHODS In two similar rural, largely Hispanic communities, a community advisory board guided recruitment of stakeholders affected by chronic pain using a different method in each community: 1) snowball sampling, a chain- referral method or 2) purposive sampling to recruit diverse stakeholders. In both communities, three groups of stakeholders attended a series of three facilitated meetings to orient, brainstorm, and prioritize ideas (9 meetings/community). Using mixed methods analysis, we compared stakeholder recruitment and retention as well as priorities from both communities' stakeholders on mean ratings of their ideas based on importance and feasibility for implementation in their community. RESULTS Of 65 eligible stakeholders in one community recruited by snowball sampling, 55 (85 %) consented, 52 (95 %) attended the first meeting, and 36 (65 %) attended all 3 meetings. In the second community, the purposive sampling method was supplemented by convenience sampling to increase recruitment. Of 69 stakeholders recruited by this combined strategy, 62 (90 %) consented, 36 (58 %) attended the first meeting, and 26 (42 %) attended all 3 meetings. Snowball sampling recruited more Hispanics and disabled persons (all P < 0.05). Despite differing recruitment strategies, stakeholders from the two communities identified largely similar ideas for research, focusing on non-pharmacologic interventions for management of chronic pain. Ratings on importance and feasibility for community implementation differed only on the importance of massage services (P = 0.045) which was higher for the purposive/convenience sampling group and for city improvements/transportation services (P = 0.004) which was higher for the snowball sampling group. CONCLUSIONS In each of the two similar hard-to-reach communities, a community advisory board partnered with researchers to implement a different sampling method to recruit stakeholders. The snowball sampling method achieved greater participation with more Hispanics but also more individuals with disabilities than a purposive-convenience sampling method. However, priorities for research on chronic pain from both stakeholder groups were similar. Although utilizing a snowball sampling method appears to be superior, further research is needed on implementation costs and resources.
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Affiliation(s)
- Melissa A. Valerio
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health in San Antonio, 7411 John Smith Drive, Suite 1100, San Antonio, TX 78229 USA
| | - Natalia Rodriguez
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio (UTHSCSA), 7411 John Smith Drive, Suite 1050, San Antonio, TX 78229 USA
| | - Paula Winkler
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio (UTHSCSA), 7411 John Smith Drive, Suite 1050, San Antonio, TX 78229 USA
- South Central Area Health Education Center (AHEC), UTHSCSA, 7411 John Smith Drive, Suite 1050, San Antonio, TX 78229 USA
| | - Jaime Lopez
- Frio County AgriLife Extension, 400 S. Pecan Street, Pearsall, TX 78061 USA
| | - Meagen Dennison
- Karnes County AgriLife Extension, 115 N. Market Street, Karnes City, TX 78118 USA
| | - Yuanyuan Liang
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio (UTHSCSA), 7411 John Smith Drive, Suite 1050, San Antonio, TX 78229 USA
- Department of Epidemiology and Biostatistics, UTHSCSA, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
| | - Barbara J. Turner
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio (UTHSCSA), 7411 John Smith Drive, Suite 1050, San Antonio, TX 78229 USA
- Department of Medicine, UTHSCSA, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
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Keboa MT, Hiles N, Macdonald ME. The oral health of refugees and asylum seekers: a scoping review. Global Health 2016; 12:59. [PMID: 27717391 PMCID: PMC5055656 DOI: 10.1186/s12992-016-0200-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 09/26/2016] [Indexed: 02/07/2023] Open
Abstract
Introduction Improving the oral health of refugees and asylum seekers is a global priority, yet little is known about the overall burden of oral diseases and their causes for this population. Objective To synthesize available evidence on the oral health of, and access to oral health care by this population. Methods Using a scoping review methodology, we retrieved 3321 records from eight databases and grey literature; 44 publications met the following inclusion criteria: empirical research focused on refugees and/or asylum seekers’ oral health, published between 1990 and 2014 in English, French, Italian, Portuguese, or Spanish. Analysis included descriptive and thematic analysis, as well as critical appraisal using the Critical Appraisal Skills Programme (CASP) criteria for quantitative and qualitative studies. Results The majority of publications (86 %) were from industrialized countries, while the majority of refugees are resettled in developing countries. The most common study designs were quantitative (75 %). Overall, the majority of studies (76 %) were of good quality. Studies mainly explored oral health status, knowledge and practices; a minority (9 %) included interventions. The refugee populations in the studies showed higher burden of oral diseases and limited access to oral health care compared to even the least privileged populations in the host countries. Minimal strategies to improve oral health have been implemented; however, some have impressive outcomes. Conclusions Oral health disparities for this population remain a major concern. More research is needed on refugees in developing countries, refugees residing in refugee camps, and interventions to bridge oral health disparities. This review has utility for policymakers, practitioners, researchers, and other stakeholders working to improve the oral health of this population.
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Affiliation(s)
- Mark Tambe Keboa
- Division of Oral Health and Society, Faculty of Dentistry, McGill University 2001 McGill College, Montréal, QC, H3A 1G1, Canada.
| | - Natalie Hiles
- Ingram School of Nursing, McGill University, Wilson Hall, 3506 University Street, Montreal, QC, H3A 2A7, Canada
| | - Mary Ellen Macdonald
- Division of Oral Health and Society, Faculty of Dentistry, McGill University 2001 McGill College, Montréal, QC, H3A 1G1, Canada
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Riggs E, Rajan S, Casey S, Kilpatrick N. Refugee child oral health. Oral Dis 2016; 23:292-299. [PMID: 27385659 DOI: 10.1111/odi.12530] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/01/2016] [Indexed: 11/30/2022]
Abstract
The number of people forced to flee their homes and move around the world is increasing rapidly. Such refugee populations are not only more likely to have poor physical, mental and social health outcomes but also to experience difficulties accessing health services in their new country. In particular, children from refugee backgrounds are at increased risk of poor oral health which in time is associated with poor adult oral health and impacts on child health (e.g. growth and development) and well-being. To date, there is little evidence about the nature and extent of their oral health problems nor interventions to improve their oral health status. This article summarises the evidence surrounding the oral health status of children from refugee backgrounds. In addition, a systematic review of the international literature over the past 10 years is presented which identifies interventions to improve the oral health of these vulnerable paediatric populations. Based on this evidence, potential strategies available to dental service providers to optimise provision of responsive dental care are discussed.
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Affiliation(s)
- E Riggs
- Healthy Mothers Healthy Families, Murdoch Childrens Research Institute, The Royal Children's Hospital, Victoria, Australia.,General Practice and Primary Health Care Academic Centre, University of Melbourne, Victoria, Australia
| | - S Rajan
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - S Casey
- Sector Development & Partnerships, Foundation House, The Victorian Foundation for Survivors of Torture Inc, Melbourne, Victoria, Australia
| | - N Kilpatrick
- Cleft Services, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, Murdoch Childrens Research Institute, University of Melbourne, Melbourne, Victoria, Australia
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12
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Gibbs L, Waters E, Christian B, Gold L, Young D, de Silva A, Calache H, Gussy M, Watt R, Riggs E, Tadic M, Hall M, Gondal I, Pradel V, Moore L. Teeth Tales: a community-based child oral health promotion trial with migrant families in Australia. BMJ Open 2015; 5:e007321. [PMID: 26068509 PMCID: PMC4466605 DOI: 10.1136/bmjopen-2014-007321] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The Teeth Tales trial aimed to establish a model for child oral health promotion for culturally diverse communities in Australia. DESIGN An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from migrant backgrounds. Mixed method, longitudinal evaluation. SETTING The intervention was based in Moreland, a culturally diverse locality in Melbourne, Australia. PARTICIPANTS Families with 1-4-year-old children, self-identified as being from Iraqi, Lebanese or Pakistani backgrounds residing in Melbourne. Participants residing close to the intervention site were allocated to intervention. INTERVENTION The intervention was conducted over 5 months and comprised community oral health education sessions led by peer educators and follow-up health messages. OUTCOME MEASURES This paper reports on the intervention impacts, process evaluation and descriptive analysis of health, knowledge and behavioural changes 18 months after baseline data collection. RESULTS Significant differences in the Debris Index (OR=0.44 (0.22 to 0.88)) and the Modified Gingival Index (OR=0.34 (0.19 to 0.61)) indicated increased tooth brushing and/or improved toothbrushing technique in the intervention group. An increased proportion of intervention parents, compared to those in the comparison group reported that they had been shown how to brush their child's teeth (OR=2.65 (1.49 to 4.69)). Process evaluation results highlighted the problems with recruitment and retention of the study sample (275 complete case families). The child dental screening encouraged involvement in the study, as did linking attendance with other community/cultural activities. CONCLUSIONS The Teeth Tales intervention was promising in terms of improving oral hygiene and parent knowledge of tooth brushing technique. Adaptations to delivery of the intervention are required to increase uptake and likely impact. A future cluster randomised controlled trial would provide strongest evidence of effectiveness if appropriate to the community, cultural and economic context. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12611000532909).
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Affiliation(s)
- Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Elizabeth Waters
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Bradley Christian
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Lisa Gold
- Deakin Health Economics, Deakin University, Burwood, Victoria, Australia
| | - Dana Young
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
- Merri Community Health Services, Brunswick, Victoria, Australila
| | - Andrea de Silva
- Dental Health Services Victoria, Carlton, Victoria, Australia
- Melbourne Dental Health School, University of Melbourne, Carlton, Victoria, Australia
| | - Hanny Calache
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | - Mark Gussy
- Department of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Richard Watt
- Epidemiology and Public Health, University College London, London, UK
| | - Elisha Riggs
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Carlton, Victoria, Australia
| | - Maryanne Tadic
- Merri Community Health Services, Brunswick, Victoria, Australila
| | - Martin Hall
- North Richmond Community Health Limited, Richmond, Victoria, Australia
| | - Iqbal Gondal
- Internet Commerce Security Lab, Federation University Australia and Pakistan Australia Association Melbourne, Caulfield, Victoria, Australia
| | - Veronika Pradel
- Merri Community Health Services, Brunswick, Victoria, Australila
| | - Laurence Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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13
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Christian B, Young D, Gibbs L, de Silva A, Gold L, Riggs E, Calache H, Tadic M, Hall M, Moore L, Waters E. Exploring child dental service use among migrant families in metropolitan Melbourne, Australia. Aust Dent J 2015; 60:200-4. [PMID: 25989365 DOI: 10.1111/adj.12321] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study describes and explores factors related to dental service use among migrant children. METHODS A cross-sectional analysis of baseline data from Teeth Tales, an exploratory trial implementing a community based child oral health promotion intervention. The sample size and target population was 600 families with 1-4 year old children from Iraqi, Lebanese and Pakistani backgrounds residing in metropolitan Melbourne. Participants were recruited into the study using purposive and snowball sampling techniques. RESULTS Most (88%; 550/625) children had never visited the dentist (mean (SD) age 3.06 years (1.11)). In the fully adjusted model the variable most significantly associated with child dental visiting was parent reported 'no reason for child to visit the dentist' (OR = 0.07, p < 0.001). Of those children whose parents reported their child had no reason to visit the dentist, 22% (37/165) experienced dental caries with 8% (13/165) at the level of cavitation. CONCLUSIONS Dental service use by migrant preschool children was very low. The relationship between perceived dental need and dental service use is currently not aligned. One in 10 children of select migrant background had visited a dentist, which is in the context of 1 in 3 with dental caries. To improve utilization, health services should consider organizational cultural competence, outreach and increased engagement with the migrant community.
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Affiliation(s)
- B Christian
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,North Richmond Community Health Limited, Richmond, Victoria, Australia
| | - D Young
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,Merri Community Health Services, Brunswick, Victoria, Australia
| | - L Gibbs
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,North Richmond Community Health Limited, Richmond, Victoria, Australia
| | - A de Silva
- Dental Health Services, Victoria, Australia
| | - L Gold
- Deakin Health Economics, Deakin University, Victoria, Australia
| | - E Riggs
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Victoria, Australia
| | - H Calache
- Dental Health Services, Victoria, Australia
| | - M Tadic
- Merri Community Health Services, Brunswick, Victoria, Australia
| | - M Hall
- North Richmond Community Health, Richmond, Victoria, Australia
| | - L Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - E Waters
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,North Richmond Community Health Limited, Richmond, Victoria, Australia
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14
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Tiwari T, Sharma T, Harper M, Zacher T, Roan R, George C, Swyers E, Toledo N, Batliner T, Braun PA, Albino J. Community Based Participatory Research to Reduce Oral Health Disparities in American Indian Children. JOURNAL OF FAMILY MEDICINE 2015; 2:1028. [PMID: 26090520 PMCID: PMC4469184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Community based participatory research is an approach aimed to equitably involve community members, representatives, and academic researchers in all aspects of the research process. Using this methodology can help integrate cultural knowledge into interventions, supporting researchers to effectively partner with communities in addressing health disparities. The Center for Native Oral Health Research (CNOHR) collaborates with two American Indian (AI) tribes to advance oral health knowledge and practice, including the conduct of randomized controlled clinical trials of culturally sensitive behavioral interventions for primary prevention of early childhood caries (ECC). This manuscript describes the development of researcher-community partnership, and the development and implementation of the two clinical trial in the community. It also gives a detailed account of the strategies developed through the community input in recruitment and retention of the study participants and finally the lessons learnt during the study implementation.
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Affiliation(s)
- T Tiwari
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - T Sharma
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - M Harper
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - T Zacher
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - R Roan
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - C George
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - E Swyers
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - N Toledo
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - T Batliner
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - PA Braun
- Children’s Outcomes Research Program, University of Colorado Anschutz Medical Campus, USA
| | - J Albino
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
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