Midwestern Latino caregivers\u2019 knowledge, attitudes and sense making of the oral health etiology, prevention and barriers that inhibit their children\u2019s oral health: a CBPR approach

Kimberly K Walker,Lorena C Galvez,Armando E Soto-Rojas,Gabriela J Smith,Dulce Vega,Miriam Acevedo,Laura Dandelet,Richard D Jackson,E Angeles Martínez-Mier,Sarah M Stelzner

doi:10.1186/s12903-017-0354-9

Abstract

BackgroundUsing community-based participatory research, the Health Protection Model was used to understand the cultural experiences, attitudes, knowledge and behaviors surrounding caries etiology, its prevention and barriers to accessing oral health care for children of Latino parents residing in Central Indiana.MethodsA community reference group (CBPR) was established and bi-lingual community research associates were used to conduct focus groups comprised of Latino caregivers. Transcripts were analyzed for thematic content using inductive thematic analysis.ResultsResults indicated significant gaps in parental knowledge regarding caries etiology and prevention, with cultural underlays. Most parents believed the etiology of caries was related to the child’s ingestion of certain foods containing high amounts of carbohydrates. Fewer parents believed either genetics/biological inheritance or bacteria was the primary causative factor. Fatalism negatively impacted preventive practices, and a clear separation existed concerning the perceived responsibilities of mothers and fathers to provide for the oral needs of their children. Females were more likely to report they were primarily responsible for brushing their children’s teeth, overseeing the child’s diet and seeking dental care for the child. Fathers believed they were primarily responsible for providing the means to pay for professional care. Perceived barriers to care were related to finances and communication difficulties, especially communicating with providers and completing insurance forms.ConclusionThe main study implication is the demonstration of how the CBPR model provided enhanced understanding of Latino caregivers’ experiences to inform improvements in oral prevention and treatment of their children. Current efforts continue to employ CBPR to implement programs to address the needs of this vulnerable population.

Highlights

Using community-based participatory research, the Health Protection Model was used to understand the cultural experiences, attitudes, knowledge and behaviors surrounding caries etiology, its prevention and barriers to accessing oral health care for children of Latino parents residing in Central Indiana
Children immigrating from Mexico and those of Mexican descent born in the United States have higher dental caries rates and lower utilization of dental services than other American children of differing race and ethnicity [2]
The research team consisted of faculty and staff from the Indiana University School of Dentistry (IUSD) and the La Plaza Latino Community Organization (LCO), both located in Indianapolis IN, USA

Summary

Introduction

Using community-based participatory research, the Health Protection Model was used to understand the cultural experiences, attitudes, knowledge and behaviors surrounding caries etiology, its prevention and barriers to accessing oral health care for children of Latino parents residing in Central Indiana. With the growing Latino population, there is a need to better understand the personal, provider and system barriers that result in oral health disparities, especially in children [1]. Research on the oral healthcare needs of Latinos in the Midwest is limited, and further investigation of the way in which system barriers interact with an individual’s attitudes, knowledge and cultural beliefs to affect oral health care has been recommended [4, 6, 7]

Methods

Results

Discussion

Conclusion