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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Oral Health 1/2015

Using community participation to assess acceptability of “Contra Caries”, a theory-based, promotora-led oral health education program for rural Latino parents: a mixed methods study

BMC Oral Health > Ausgabe 1/2015
Kristin S. Hoeft, Sarah M. Rios, Estela Pantoja Guzman, Judith C. Barker
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

KSH helped conceptualize and obtain funding for the study, design and carry out data collection, designed curriculum, conducted data analysis, and was the primary author for the manuscript. SMR helped design, recruit participants for, and carry out the qualitative data collection, designed curriculum, and was involved in qualitative data analysis and provided feedback on the manuscript. EPG, the field coordinator overseeing the implementation of the intervention, helped design curriculum, recruit participants and collect the survey data, and provided feedback on the manuscript. JCB helped conceptualize and obtain funding for the study, and was the senior advisor for every stage of the research process, especially involved in research design, data analysis, curriculum revision, conceptualizing the scope of the manuscript, and providing feedback on the manuscript. All four authors have read and approved the final manuscript.



Latino children experience more prevalent and severe tooth decay than non-Hispanic white and non-Hispanic black children. Few theory-based, evaluated and culturally appropriate interventions target parents of this vulnerable population. To fill this gap, the Contra Caries Oral Health Education Program, a theory-based, promotora-led education program for low-income, Spanish-speaking parents of children aged 1–5 years, was developed. This article describes qualitative findings of the acceptability of curriculum content and activities, presents the process of refinement of the curriculum through engaging the target population and promotoras, and presents results from the evaluation assessing the acceptability of the curriculum once implemented.


Focus groups were conducted with low-income Spanish-speaking parents of children 1–5 years living in a city in an agricultural area of California. Interviews were digitally recorded, translated and transcribed, checked for accuracy and the resulting data was thematically coded and analyzed using a social constructionist approach. The Contra Caries Oral Health Education Program was then implemented with a separate but similar sample, and after completing the program, participants were administered surveys asking about acceptability and favorite activities of the education program. Data were entered into a database, checked for accuracy, open-ended questions were categorized, and responses to close-ended questions counted.


Twelve focus groups were conducted (N = 51), 105 parents attended the Contra Caries Oral Health Education Program, and 83 parents filled out surveys. Complete attendance and retention was high (89 % and 90 %, respectively). This study found that their children’s oral health is a high priority. Parents were not only interested in, but actually attended classes focused on increasing their knowledge and skills with respect to early childhood oral health. The Contra Caries content and format was perceived as acceptable by parents. Strong opinions about curriculum content were expressed for including information on how caries starts and progresses, weaning from the bottle, oral health care for children and adults, motivational strategies for children’s tooth brushing, dental visits and cavity restorations.


The Contra Caries Oral Health Education Program was acceptable to low-income, Spanish-speaking parents of children 1–5 years. Participating in the curriculum development and revision process likely played an important role in the parents’ high acceptability of the program.
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