Oral Health of Early Head Start Children: A Qualitative Study of Staff, Parents, and Pregnant Women

Mofidi, Mahyar; Zeldin, Leslie P.; Rozier, R. Gary

doi:10.2105/ajph.2008.133827

Cited by 33 publications

(40 citation statements)

References 14 publications

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“…The specific areas of interest for the discussion were introduced using a semi-structured topic guide (Table 1). This was a short set of pre-selected topics that comprised open-ended questions based on previous work with similar groups in other countries [23,24,29,30]. These questions were revised so that they would be culturally compatible and reflect the Trinidadian context.…”

Section: Methodsmentioning

confidence: 99%

“…Qualitative studies of low-income families in Head Start programs in the US report that parents often saw the primary dentition as temporary teeth whose condition had little bearing on the future dentition [24] and though aware of some of the problems that could arise felt that general life demands made oral care a low priority [24]. Daly et al [25] found that parents in their study (white mothers attending a Sure-Start program in the UK), viewed the primary dentition as important and were keen to establish good oral health habits.…”

Section: Introductionmentioning

confidence: 99%

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Oral healthcare of preschool children in Trinidad: a qualitative study of parents and caregivers

2012

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BackgroundLittle is known about oral health in early childhood in the West Indies or the views and experiences of caregivers about preventive oral care and dental attendance The aims of this study were to explore and understand parents and caregivers’ experience of oral healthcare for their preschool aged children and how, within their own social context, this may have shaped their oral health attitudes and behaviours. These data can be used to inform oral health promotion strategies for this age group.MethodAfter ethical approval, a qualitative study was undertaken using a focus group approach with a purposive sample of parents and caregivers of preschool children in central Trinidad.Group discussions were initiated by use of a topic guide. Audio recording and field notes from the three focus groups, with a total of 18 participants, were transcribed and analysed using a thematic approach.ResultsDespite some ambivalence toward the importance of the primary teeth, the role of fluoride and confusion about when to take a child for their first dental visit, most participants understood the need to ensure good oral hygiene and dietary habits for their child. Problems expressed included, overcoming their own negative experiences of dentistry, which along with finding affordable and suitable dental clinics, affected their attitude to taking their child for a dental visit. There was difficulty in establishing good brushing routines and controlling sweet snacking in the face of many other responsibilities at home. Lack of availability of paediatric dental services locally and information on oral health care were also highlighted. Many expressed a need for more contact with dental professionals in non-clinic settings, for oral health care advice and guidance.ConclusionParents and caregivers in this qualitative study showed generally positive attitudes towards oral health but appear to have encountered several barriers and challenges to achieving ideal preventive care for their child, with respect to healthy diet, good oral hygiene and dental attendance. Oral health promotion should include effective dissemination of oral health information, more practical health advice and greater access to dental care for families with preschool children.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oral healthcare of preschool children in Trinidad: a qualitative study of parents and caregivers

2012

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“…Dental treatment is associated with improved OHRQoL [13–16], but outcomes can vary by the characteristics of families seeking treatment, including socioeconomic status and oral health literacy [17, 18]. The impact of clinical conditions on OHRQoL also can extend to the process of accessing treatment, which in and of itself can have a negative impact on low-income families, particularly when access to care is limited as it is with dentistry [19, 20]. …”

Section: Introductionmentioning

confidence: 99%

Enrollment in early head start and oral health-related quality of life

et al. 2017

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Purpose Dental problems in young children are wide-spread and can negatively impact quality of life. We examined the effect of enrollment in North Carolina Early Head Start (EHS)—a federally funded early education program for children under three years of age and their families—on oral health-related quality of life (OHRQoL). Methods In this quasi-experimental study, we interviewed 479 EHS and 699 Medicaid matched parent–child dyads at baseline (children’s average age 10 months) and 24 months later. Parents reported OHRQoL using the Early Childhood Oral Health Impact Scale (ECOHIS), a 0–52 point scale with higher scores representing more negative impacts. We used a marginalized semicontinuous two-part model to estimate: (1) the effect of EHS on the probability of reporting any follow-up impacts (ECOHIS ≥ 1), and (2) the difference in overall mean ECOHIS follow-up scores. We controlled for baseline ECOHIS, language, and EHS and non-EHS group imbalances using a propensity score. Results At follow-up, negative OHRQoL impacts were more often reported by parents of non-EHS than EHS children (45 versus 37%, P < .01). In the adjusted model, EHS parents reported a lower odds of negative OHRQoL impacts (OR 0.70; 95% CI 0.52, 0.94). Mean adjusted ECOHIS scores were not significantly different (EHS: 1.59 ± 3.34 versus non-EHS: 2.11 ± 3.85, P > 0.05). Conclusions This study is the first to demonstrate that families of young children enrolled in EHS report improved OHRQoL compared to their non-enrolled peers. These results highlight the potential effectiveness of improving the quality of life of low-resource families through early childhood education.

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“…For instance, some participants mentioned laziness as a reason for missing appointments, which reflects common stereotypes about poverty [26]. It also echoes the painful sentiment of people on social assistance: they feel misunderstood by oral health professionals [10,13,14,27] and, in a more general way, by society at large [28,29]. In fact, many people on social assistance actually work several hours per week in work reintegration programs, and therefore have limited availability for appointments during the day.…”

Section: Discussionmentioning

confidence: 99%

How health professionals perceive and experience treating people on social assistance: a qualitative study among dentists in Montreal, Canada

Bedos

Loignon

Landry³

et al. 2013

BMC Health Serv Res

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BackgroundIn Canada, the prevalence of oral diseases is very high among people on social assistance. Despite great need for dental treatment, many are reluctant to consult dental professionals, arguing that dentists do not welcome or value poor patients. The objective of this research was thus to better understand how dentists perceived and experienced treating people on social assistance.MethodsThis descriptive qualitative research was based on in-depth semi-structured interviews with 33 dentists practicing in Montreal, Canada. Generally organized in dentists’ offices, the interviews lasted 60 to 120 minutes; they were digitally recorded and later transcribed verbatim. The interview transcripts were coded with NVivo software, and data was displayed in analytic matrices. Three members of the research team interpreted the data displayed and wrote the results of this study.ResultsDentists express high levels of frustration with people on social assistance as a consequence of negative experiences that fall into 3 categories: 1) Organizational issues (people on social assistance ostensibly make the organization of appointments and scheduling difficult); 2) Biomedical issues (dentists feel unable to provide them with adequate treatment and fail to improve their oral health); 3) Financial issues (they are not lucrative patients). To explain their stance, dentists blame people on social assistance for neglecting themselves, and the health care system for not providing adequate coverage and fees. Despite dentists’ willingness to treat all members of society, an accumulation of frustration leads to feelings of powerlessness and discouragement.ConclusionsThe current situation is unacceptable; we urge public health planners and governmental health agencies to ally themselves with the dental profession in order to implement concrete solutions.

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Oral Health of Early Head Start Children: A Qualitative Study of Staff, Parents, and Pregnant Women

Cited by 33 publications

References 14 publications

Oral healthcare of preschool children in Trinidad: a qualitative study of parents and caregivers

Oral healthcare of preschool children in Trinidad: a qualitative study of parents and caregivers

Enrollment in early head start and oral health-related quality of life

How health professionals perceive and experience treating people on social assistance: a qualitative study among dentists in Montreal, Canada

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