Linking mother access to dental care and child oral health.
ABSTRACT The authors examined whether low-income mothers, who have a regular source of dental care (RSDC), rate the dental health of their young children higher than mothers without an RSDC.
From a population of 108,151 children enrolled in Medicaid aged 3 to 6 years and their low-income mothers in Washington state, a disproportionate stratified random sample of 11,305 children aged 3 to 6 years was selected from enrollment records in four racial/ethnic groups: 3791 Black; 2806 Hispanic; 1902 White; and 2806 other racial/ethnic groups. A mixed-mode survey was conducted to measure mother RSDC and mother ratings of child's dental health and pain. The unadjusted response rate was 44%, yielding the following eligible mothers: 816 Black, 1309 Hispanic, 1379 White, 237 Asian, and 133 American-Indian. Separate regression models for Black, Hispanic, and White mothers estimated associations between the mothers having an RSDC and ratings of child dental health.
Across racial/ethnic groups, mothers with an RSDC consistently rated their children's dental health 0.15 higher on a 1-to-5 scale (where '1' means 'poor' and '5' means 'excellent') than mothers without an RSDC, controlling for child and mother characteristics and the mothers' propensity to have an RSDC. This difference can be interpreted as a net movement of one level up the scale by 15% of the population.
Across racial/ethnic groups, low-income mothers who have a regular source of dental care rate the dental health of their young children higher than mothers without an RSDC.
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ABSTRACT: Objective: To make a diagnosis of oral health status and knowledge of mothers benefiting from system Chile Crece Contigo in the municipality of Alto Biobio and its possible relationship to sociodemographic variables. Design: Cross-sectional analytical study through a stratified cluster sampling was obtained a sample of 70 mothers. An oral exam was performed under the WHO criteria and applied a 23-item questionnaire in guided interview format in relation to measures of self-care, most prevalent diseases and dental anatomy. Results: The results show a DMFT of 14.6 ± 5.52 and were higher in multiparous and older than 20 years womens. The OHI-S reached a value of 0.83 ± 0.54, higher in multiparous. The CPITN was mainly level 2. With regard to oral health knowledge this reached a value of 13.03 ± 2.70, being higher in multiparous. Conclusions: The study population shows a very high level of oral damage and limited knowledge about oral-health; this worsens the Pehuenche population and with less instruction. The multiparous women and older is principally to begin emergency treatment leading to the loss of their teeth. Based in the scientific evidence and the findings of this study the inclusion of oral health component in the ChCC appears as a cost-effective measure to improve in the medium to long term the actual scenario.
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ABSTRACT: Fidelity assessments are integral to intervention research but few published trials report these processes in detail. We included plans for fidelity monitoring in the design of a community-based intervention trial. The study design was a randomized clinical trial of an intervention provided to low-income women to increase utilization of dental care during pregnancy (mother) or the postpartum (child) period. Group assignment followed a 2 x 2 factorial design in which participants were randomly assigned to receive either brief Motivational Interviewing (MI) or Health Education (HE) during pregnancy (prenatal) and then randomly reassigned to one of these groups for the postpartum intervention. The study setting was four county health departments in rural Oregon State, USA. Counseling was standardized using a step-by-step manual. Counselors were trained to criteria prior to delivering the intervention and fidelity monitoring continued throughout the implementation period based on audio recordings of counselor-participant sessions. The Yale Adherence and Competence Scale (YACS), modified for this study, was used to code the audio recordings of the counselors' delivery of both the MI and HE interventions. Using Interclass Correlation Coefficients totaling the occurrences of specific MI counseling behaviors, ICC for prenatal was .93, for postpartum the ICC was .75. Participants provided a second source of fidelity data. As a second source of fidelity data, the participants completed the Feedback Questionnaire that included ratings of their satisfaction with the counselors at the completion of the prenatal and post-partum interventions. Coding indicated counselor adherence to MI protocol and variation among counselors in the use of MI skills in the MI condition. Almost no MI behaviors were found in the HE condition. Differences in the length of time to deliver intervention were found; as expected, the HE intervention took less time. There were no differences between the overall participants' satisfaction ratings of the HE and MI sessions by individual counselor or overall (p > .05). Trial design, protocol specification, training, and continuous supervision led to a high degree of treatment fidelity for the counseling interventions in this randomized clinical trial and will increase confidence in the interpretation of the trial findings.Trial registration: ClinicalTrials.gov: NCT01120041.BMC Oral Health 02/2014; 14(1):15. DOI:10.1186/1472-6831-14-15 · 1.15 Impact Factor