Parental Ethnic Identity and Its Influence on Children's Oral Health in American Indian Families.

Anne R Wilson,Rachel L Johnson,Sarah J Schmiege,Luohua Jiang,Angela G Brega,Judith Albino

doi:10.3390/ijerph18084130

Abstract

Objectives: To examine the relationship between ethnic identity and oral health knowledge, beliefs, behavior, and outcomes in American Indian families. Methods: Secondary data were analyzed for 579 parent–child dyads in a randomized controlled trial aimed at reducing early childhood caries in a Northern Plains tribal community. Data included demographic characteristics; parental ethnic identity; oral health knowledge, beliefs, and behavior; and parental/pediatric oral health outcomes. Ethnic identity was assessed using two measures: perceived importance of tribal identity and tribal language proficiency. We examined the association of baseline ethnic identity with baseline and longitudinal oral health measures. Results: At baseline, importance of tribal identity was significantly associated with several oral health beliefs, and one’s locus of control measure (external-chance). Baseline scores on importance of tribal identity were also associated with one’s oral heath belief (perceived severity), the same locus of control measure, and oral health knowledge and behavior over the three years of study follow up. Tribal language proficiency was not associated with any study measures at baseline, although it was associated with parental oral health status over the three years. Conclusions: Ethnic identity was associated with a range of oral health constructs expected to influence American Indian children’s oral health.

Highlights

In the United States, American Indian and Alaska Native groups are disproportionately affected by persistent oral health disparities
To determine whether baseline ethnic identity was associated with oral health over time, we examined the associations of baseline ethnic identity with the oral health constructs at three follow-up time points (12, 24, and 36 months)
The importance of maintaining tribal identity was not significantly associated with oral health knowledge, perceived susceptibility and self-efficacy, internal Locus of Control (LOC), powerful others

Summary

Introduction

In the United States, American Indian and Alaska Native groups are disproportionately affected by persistent oral health disparities. Childhood caries is nearly three times higher for Native children than for non-Hispanic white children [2]. These findings highlight the need for greater understanding of social determinants specific to Native populations as an underpinning of oral health promotion initiatives. The literature suggests that ethnic identity may be associated with health-related outcomes among Native groups. Ethnic identity has been described as the subjective identification with and sense of belonging to one’s ethnic group, or for Native people, one’s tribe of origin [7]. Indicators of ethnic identity include use of the language of one’s ethnic group, perceived importance of ethnic group membership in relation to one’s self concept, Int. J.

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