The authors declare that they have no competing interests.
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.
U.S. Department of Health and Human Services, Oral health in America: a Report of the Surgeon General. Rockville, MD: National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000.
Kaste LM, Selwitz RH, Oldakowski RJ, Brunelle JA, Winn DM, Brown LJ. Coronal caries in the primary and permanent dentition of children and adolescents 1–17 years of age: United States, 1988–1991. J Dent Res. 1996;75(Spec No):631–41. PubMed
U.S. Census Bureau. State and County QuickFacts. California Population, 2014 estimate http://quickfacts.census.gov/qfd/states/06000.html. Accessed 2-21-15.
Demographic Profile of Hispanics in California. 2011. http://www.pewhispanic.org/states/state/ca/. Accessed 2-21-15
Horton LA, Parada H, Slymen DJ, Arredondo E, Ibarra L, Ayala GX. Targeting children’s dietary behaviors in a family intervention: ‘Entre familia: reflejos de salud’. Salud Publica Mex. 2013;55 Suppl 3:397–405. PubMed
Crespo NC, Elder JP, Ayala GX, Slymen DJ, Campbell NR, Sallis JF, et al. Results of a multi-level intervention to prevent and control childhood obesity among Latino children: the Aventuras Para Niños Study. Ann Behav Med. 2012;43(1):84–100. doi: 10.1007/s12160-011-9332-7. CrossRefPubMedPubMedCentral
Nuño T, Martinez ME, Harris R, García F. A Promotora-administered group education intervention to promote breast and cervical cancer screening in a rural community along the U.S.-Mexico border: a randomized controlled trial. Cancer Causes Control. 2011;22(3):367–74. doi: 10.1007/s10552-010-9705-4. Epub 2010 Dec 24. CrossRefPubMed
Stokols D. Translating social ecological theory into guidelines for community health promotion. Am J Health Prom. 1996;10:282–98. CrossRef
Bandura A. Social foundations of thought and action: a social cognitive theory. NJ.: Prentice Hall Englewood-Cliffs; 1986.
Charmaz K. Grounded Theory: Objectivist and Constructivist Methods. In: Denzin NK, Lincoln YS, editors. Handbook of qualitative research. Thousand Oaks, California: Sage; 2000. p. 509–35.
Bernard HR. Research methods in anthropology: qualitative and quantitative approaches. 4th ed. Lanham, Md.: AltaMira Press; 2005.
NVivo qualitative data analysis software; QSR International Pty Ltd. Version 10, 2012.
StataCorp. Stata Statistical Software: Release 13. College Station, TX: StataCorp LP; 2013.
Policy on Early Childhood Caries (ECC). Classifications, Consequences, and Preventive Strategies. American Academy of Pediatric Dentists. 2011. http://www.aapd.org/media/Policies_Guidelines/P_ECCClassifications.pdf. Accessed 19 Feb 2015.
Roppe B. Dental Program Brings Latino Values To California Community. 2001. http://minorityhealth.hhs.gov/assets/pdf/checked/Dental%20Program%20Brings%20Latino%20Values%20to%20California%20Community.pdf. Accessed 18 Feb 2015.
Oral Health Education. The Health Trust. http://healthtrust.org/services/oral-health-education-and-dental-services/ Accessed 19 Feb 2015.
Koniak-Griffin D, Brecht ML, Takayanagi S, Villegas J, Melendrez M, Balcázar H. A community health worker-led lifestyle behavior intervention for Latina (Hispanic) women: feasibility and outcomes of a randomized controlled trial. Int J Nurs Stud. 2015;52(1):75–87. doi: 10.1016/j.ijnurstu.2014.09.005. Epub 2014 Sep 22. CrossRefPubMed
- 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
Kristin S. Hoeft
Sarah M. Rios
Estela Pantoja Guzman
Judith C. Barker
- BioMed Central
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