This R21 application is to support pilot work examining the acceptability and feasibility of a culturally-appropriate, rigorously designed, implemented and evaluated, trained community-based Latino lay health worker (promotora) educational intervention. This intervention aims to reduce oral health disparities due to prevalence of early childhood caries (ECC) in children in rural, Latino families. ECC, (baby bottle tooth decay or cavities) the most common infectious disease of childhood (Surgeon General 2000) and a major unmet health care need (Newacheck et al 2000), is highly prevalent among low- income, rural preschool aged children, especially those of Mexican-origin. The proposed study will occur in two stages. Stage 1 addresses development, refinement and acceptability of the program and evaluation methods to promotoras, participants and the community using focus groups and other qualitative research methods. The curriculum is guided by Social Cognitive Theory. Stage 2 addresses feasibility and fidelity issues by implementing and evaluating the promotora training and pilot interactive oral health education program for 100 parents of children aged 1 to 5 years in Salinas, CA, a predominantly Latino agricultural community.
We aim to assess, via pre-test post-test changes (at completion of program and 3-months after completion), whether the proposed intervention program: 1) Increases parental understanding of the mechanism and consequences of caries, knowledge of effective preventive activities including the role of fluoride, and understanding and knowledge about oral health generally including access to and use of oral health professionals, 2) Increases parental knowledge, skills and sense of self-efficacy with respect to their role in affecting their children's oral health care at home, including where, when and how to enroll children for oral services. The direction and amount of change in parental knowledge, attitude, practices and self- efficacy will be assessed. Rigorous process and outcome evaluation strategies will be used. If, in addition to meeting the stated objectives, the program is acceptable to the community and its delivery feasible, then an RO1 will be written in the future to support the program with a larger sample of Latino families in a rural location as a randomized rigorously designed, controlled intervention study.
The proposed research involves a culturally-appropriate educational intervention focused on parents of Latino children living in a rural area. It addresses Early Childhood Caries (ECC), a major oral health disparity experienced by children under five years of age. The intervention aims to reduce the number of children with ECC through improving parental understanding of its causes, mechanisms, and preventive activities - particularly improved oral hygiene (tooth brushing). The intervention enhances parents'ability to assist and better manage children's oral health care behaviors.
| Hoeft, K S; Barker, J C; Shiboski, S et al. (2016) Effectiveness evaluation of Contra Caries Oral Health Education Program for improving Spanish-speaking parents' preventive oral health knowledge and behaviors for their young children. Community Dent Oral Epidemiol 44:564-576 |
| Hoeft, Kristin S; Rios, Sarah M; Pantoja Guzman, Estela et al. (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 15:103 |
