Recruiting and retaining pregnant women from a community health center at the US—Mexico border for the Mothers and Youth Access clinical trial

Ramos‐Gomez, Francisco; Chung, Lisa H.; Beristain, Rocio Gonzalez; Santo, William; Jue, Bonnie; Weintraub, Jane A.; Gansky, Stuart A.

doi:10.1177/1740774508093980

Cited by 19 publications

(18 citation statements)

References 27 publications

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“…Initially, 551 women received baseline exams (some initially enrolled were not eligible because of medical conditions), and 301 of the 361 women randomized in the trial received the 12‐month PP dental examinations and questionnaires. Women retained in the trial were more likely to have higher household income and be Mexican/Mexican American than women from other ethnic backgrounds (e.g., Central American) .…”

Section: Resultsmentioning

confidence: 99%

Clinically determined and self‐reported dental status during and after pregnancy among low‐income Hispanic women

Weintraub

Finlayson

Gansky

et al. 2013

J Public Health Dent

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Objectives This analysis assessed, during and one-year after pregnancy: 1) the prevalence of and relationship between self-reported and clinically determined dental caries and oral health status, and whether self-reports are a potential proxy for professional determination; 2) factors associated with high levels of professionally determined or self-reported oral disease. Methods Data are from a randomized clinical trial of 301 pregnant, low-income Hispanic women at the California-Mexico border to compare two interventions to prevent early childhood caries. Interviews and dental examinations were conducted at enrollment (second trimester) and one-year post-partum (PP). Results During pregnancy and PP, 93% had untreated caries and most had gingival inflammation. Sensitivity and specificity of self-reported measures compared to dentists’ determinations were modest (ranging from 45–80% for sensitivity and 41–77% for specificity at both time points); positive predictive values for women reporting current tooth decay or fair/poor oral health were high (>94%), but negative predictive values were low (<23%). In a bivariate GEE model, factors associated with fair/poor self-reported oral health during and after pregnancy included self-reported dental symptoms (current tooth decay, bleeding gums without brushing), dental behaviors (not flossing) and number of decayed tooth surfaces. In a logistic regression model, the only significant factor PP associated with less extensive untreated disease was if women ever had their teeth cleaned professionally (OR=0.44). Conclusions There is a great need for dental treatment in this underserved population both during pregnancy and PP. Women may not be able to accurately recognize or act on their treatment needs. At baseline and PP, few demographic or behavioral factors were associated with either self-reported or clinically-determined oral disease (e.g., being less educated or acculturated and not flossing) in the bivariate analyses. Ever having a professional teeth cleaning significantly predicted less disease PP.

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Section: Resultsmentioning

confidence: 99%

Clinically determined and self‐reported dental status during and after pregnancy among low‐income Hispanic women

Weintraub

Finlayson

Gansky

et al. 2013

J Public Health Dent

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“…To gain acceptance and support, community members, including longstanding healthcare providers, the clinic board, local organization representatives, regional policy makers and local residents recommended recruitment strategies and hiring outreach coordinators. Further recruitment and retention details and success are described elsewhere 20 . Recruitment occurred between 2003 and 2004 and randomization between 2004 and 2006.…”

Section: Methodsmentioning

confidence: 99%

Mother and youth access (MAYA) maternal chlorhexidine, counselling and paediatric fluoride varnish randomized clinical trial to prevent early childhood caries

Ramos‐Gomez

Gansky²,

Featherstone³

et al. 2011

Int J Paed Dentistry

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Background Mexican-American children have a higher caries prevalence than the US average. The Mothers and Youth Access (MAYA) study was a randomized clinical trial initiated to address this problem. Aim Comparison of the efficacy of two prevention interventions in reducing early childhood caries (ECC). Design All 361 randomized mother-child dyads received oral health counseling. Beginning at 4 months postpartum, intervention mothers received chlorhexidine (CHX) mouthrinse for 3 months beginning 4 months postpartum and children received fluoride varnish (FV) every 6 months from age 12–36 months. Control group children received FV if precavitated lesions developed. Salivary mutans streptococci (MS) and lactobacilli were assessed. Results No significant difference in children’s 36-month caries incidence between groups; 34% in each group developed caries ((d2+fs) > 0). About half of control group developed precavitated lesions and received therapeutic FV. Maternal MS levels declined during CHX use, but increased when discontinued. Conclusions Maternal postpartum CHX regimen, oral health counseling, and preventive child FV applications were not more efficacious than maternal counseling with child therapeutic FV for precavitated lesions for ECC prevention. FV for young children with brief maternal CHX use and oral health counseling may need to be combined with additional or longer-term therapies to significantly reduce ECC in high-risk populations.

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“…[15] Low-SES populations also have characteristics that make followup more difficult, namely, elevated rates of substance abuse and mental health disorders, housing instability, intermittent telephone access and use, incarceration, and lesser exposure to research. [16][17][18] Lower education, low health literacy, and financial stress are also associated with incomplete research follow-up. [13] Cochrane systematic reviews [19] suggests that adequate retention rates can be achieved by implementing the following strategies: obtaining multiple contact details from participants, making frequent participant contact, and using incentives and participant reimbursement.…”

Section: Introductionmentioning

confidence: 99%

Predictors of retention in a randomised trial of smoking cessation in low-socioeconomic status Australian smokers

Courtney

Clare

Boland

et al. 2017

Addictive Behaviors

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Recruiting and retaining pregnant women from a community health center at the US—Mexico border for the Mothers and Youth Access clinical trial

Abstract: Background-Recruitment and retention in clinical trials of minorities is low, particularly in rural underserved populations. This has slowed progress in addressing racial/ethnic disparities in oral health.

Cited by 19 publications

References 27 publications

Clinically determined and self‐reported dental status during and after pregnancy among low‐income Hispanic women

Clinically determined and self‐reported dental status during and after pregnancy among low‐income Hispanic women

Mother and youth access (MAYA) maternal chlorhexidine, counselling and paediatric fluoride varnish randomized clinical trial to prevent early childhood caries

Predictors of retention in a randomised trial of smoking cessation in low-socioeconomic status Australian smokers

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