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      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

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      , , ,
      BMC Oral Health
      BioMed Central

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          Abstract

          Background

          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.

          Methods

          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.

          Results

          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.

          Conclusions

          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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          Most cited references29

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          Translating social ecological theory into guidelines for community health promotion.

          D Stokols (2015)
          Health promotion programs often lack a clearly specified theoretical foundation or are based on narrowly conceived conceptual models. For example, lifestyle modification programs typically emphasize individually focused behavior change strategies, while neglecting the environmental underpinnings of health and illness. This article compares three distinct, yet complementary, theoretical perspectives on health promotion: behavioral change, environmental enhancement, and social ecological models. Key strengths and limitations of each perspective are examined, and core principles of social ecological theory are used to derive practical guidelines for designing and evaluating community health promotion programs. Directions for future health promotion research are discussed, including studies examining the role of intermediaries (e.g., corporate decision-makers, legislators) in promoting the well-being of others, and those evaluating the duration and scope of intervention outcomes.
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            Qualitative methods to ensure acceptability of behavioral and social interventions to the target population.

            This paper introduces qualitative methods for assessing the acceptability of an intervention.
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              Results of a multi-level intervention to prevent and control childhood obesity among Latino children: the Aventuras Para Niños Study.

              Community-based interventions are needed to reduce the burden of childhood obesity. To evaluate the impact of a multi-level promotora-based (Community Health Advisor) intervention to promote healthy eating and physical activity and prevent excess weight gain among Latino children. Thirteen elementary schools were randomized to one of four intervention conditions: individual/family level (Family-only), school/community level (Community-only), combined (Family + Community), or a measurement-only condition. Participants were 808 Latino parents and their children enrolled in kindergarten through 2(nd) grade. Measures included parent and child body mass index (BMI) and a self-administered parent survey that assessed several parent and child behaviors. There were no significant intervention effects on children's BMI z-score. The family intervention changed several obesity-related child behaviors (e.g., fruit/vegetable consumption) and these were mediated by changes in parenting variables (e.g., parent monitoring). A promotora-based behavioral intervention was efficacious at changing parental factors and child obesity-related health behaviors.
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                Author and article information

                Contributors
                Kristin.Hoeft@ucsf.edu
                s_rios@umail.ucsb.edu
                pantojaestela2012@gmail.com
                judith.barker@ucsf.edu
                Journal
                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central (London )
                1472-6831
                3 September 2015
                3 September 2015
                2015
                : 15
                : 103
                Affiliations
                [ ]Department of Epidemiology and Biostatistics, Center to Address Disparities in Children’s Oral Health (CAN DO), 3333 California Street, Suite 485, San Francisco, CA 94143 USA
                [ ]Department of Anthropology, History & Social Medicine, Center to Address Children’s Oral health Disparities (CAN DO), University of California San Francisco, 3333 California Street, Suite 485, San Francisco, CA 94143-0850 USA
                Article
                89
                10.1186/s12903-015-0089-4
                4558913
                26335081
                68d5e95c-3519-43a6-bb89-111c9661dd5a
                © Hoeft et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 February 2015
                : 25 August 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Dentistry
                Dentistry

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