Access to and utilization of oral health care by homeless children/families
The Surgeon General called dental caries the silent epidemic, suffered disproportionately by the poor. Homeless mothers/children are especially vulnerable as they lack access to dental care. This prospective study elucidated predictors of access, oral health, and the effectiveness of shelter-based care. A convenience sample of 120 homeless families (children n=236) provided predictor factors at intake and one month later. Nearly half the children (n=98) had dental caries. Ten independent variables explained 33% of the variance of access barriers; the most influential were mental health (B=-.426), oral health beliefs (B=.243), and victimization (B=.185). Ten independent variables explained 24.3% of the variance of oral health: mother's age (B5.351), number of children at the shelter (B=.337), and race (B=.154) had the most influence. Shelter-based care was effective in improving access: 43% of families secured dental appointments and perceived access barriers decreased after shelter-based care (t=4.695; p=<.001).
Available from: Marguerite Ann Dimarco
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ABSTRACT: INTRODUCTION: Childhood obesity and dental caries are increasing epidemics, especially among children who are living below the poverty level. This study was conducted to determine the relationship between body mass index (BMI) and caries in homeless children. METHODS: A secondary data analysis with a correlational design was used. A convenience sample of 157 children was recruited from a homeless shelter. RESULTS: Pearson's and partial correlations were used to explore the relationships among age, BMI, and caries. Most of the children were girls and were African American. Slightly more than half of the children were overweight (19.7%) or obese (30.6%) and had caries (50.3%). Significant positive correlations between age and BMI (p = .03) as well as between age and caries (p = .003) were found. As BMI increased, so did caries (p = .08). DISCUSSION: Consistent with reports from the Centers for Disease Control and Prevention, homeless children had higher BMI and caries rates than the national averages. Although a definitive conclusion between obesity and dental caries cannot be drawn, these two health issues are important areas for all pediatric health care providers to address at every visit.
Journal of Pediatric Health Care 01/2012; 27(4). DOI:10.1016/j.pedhc.2011.11.007 · 1.44 Impact Factor
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ABSTRACT: A qualitative study was conducted to identify psychosocial barriers to providing and obtaining preventive dental care for preschool children among African recent immigrants.
Seven focus groups were conducted with 48 mothers of 3- to 5-year-old children from Ethiopian, Eritrean, and Somali communities in Edmonton. Participants had lived in Canada for 5 years or less. Three debriefing interviews were conducted with the community health workers who facilitated the focus groups in participants' first languages. Data analysis consisted of assigning codes, grouping codes into existing or new categories of barriers, grouping identified categories into domains, and organizing categories and domains around a general perspective of psychosocial barriers to prevention of caries.
Barriers to prevention of early childhood caries (ECC) were associated with home-based prevention, early detection, and access to professional care. Barriers to parental prevention were related to health beliefs, knowledge, oral health approach, and skills. Barriers to early detection included perceived role of caregivers and dentists, perceived identity of ECC, ways of detecting cavities, and parental self-efficacy. Access barriers were related to parental knowledge of preventive services, attitudes toward dentists and dental services, English skills, and external constraints concerned dental insurance, social support, time, and transportation.
Preventive interventions should be aimed at assisting primary caregivers with providing and obtaining adequate dental care for their children through enhancing oral health literacy, developing new set of oral health–related skills, reducing environmental constraints, and strengthening their intention of obtaining professional preventive dental services.
Community Dentistry And Oral Epidemiology 04/2012; 40(6). DOI:10.1111/j.1600-0528.2012.00698.x · 2.03 Impact Factor
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ABSTRACT: : The purpose of the study was to determine the level of oral health care provided to hospitalized children on acute care units at a children's hospital in an academic medical center with a dental school.
: The research design was descriptive. Data were collected using a short written survey for parents and a brief online survey for nurses. A convenience sample of 49 pediatric nurses and 59 parents of hospitalized children participated.
: According to the parents, 17% of the hospitalized children brushed their teeth more than once a day, yet 60% of these same children brushed more than once a day when at home. According to the nurse respondents, their assessments, interventions, health teaching, and referrals related to oral care are done infrequently. Over 40% of the nurses responded that they do not educate patients about oral hygiene, and 61.2% provide no nutritional education in relation to oral health. The majority (65.3%) had never entered documentation related to broken teeth or cavities, and 85.7% had never advised patients to see a dentist.
: The findings of this study indicate a need for improved oral health care for hospitalized children. Pediatric nurses can contribute to the identification, care, and prevention of oral health problems in children. This begins by performing and documenting oral assessments, ensuring patients brush their teeth, including oral health promotion in parent-child education, and making needed oral health referrals.
MCN. The American journal of maternal child nursing 03/2013; 38(2):115-9. DOI:10.1097/NMC.0b013e318269daac · 0.90 Impact Factor
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