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      Nivel de Conocimiento sobre Pasta Dental Fluorada en Padres y Profesores de Preescolares Translated title: Level of Knowledge about Fluoride Toothpaste in Parents and Teachers from Preschool Children

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          Abstract

          : El objetivo del estudio fue determinar el nivel de conocimiento sobre pasta dental fluorada según la fuente de información sobre flúor en padres y profesores de preescolares. Se aplicó un cuestionario a una muestra representativa de padres y a todos los profesores de preescolares de instituciones educativas iniciales estatales del distrito de la Molina, Lima, Perú. El nivel de conocimiento se categorizó en tres niveles: bajo (0-2 puntos), medio (3-5 puntos) y alto (67 puntos). Se utilizó tablas de distribución de frecuencias para el análisis univariado y las pruebas chi cuadrado y exacta de Fisher para el análisis bivariado. El nivel de conocimiento sobre pasta dental fluorada más frecuente fue el nivel medio tanto en los padres (n=68, 45 %) como en los profesores (n=52, 58,4 %). El ítem: el cepillado de dientes con pasta dental con flúor puede curar la caries inicial, presentó el menor número de aciertos en su respuesta con 50 (33,1 %) y 19 (21,4 %) padres y profesores respectivamente. Cuando se relacionó el nivel de conocimiento con las fuentes de información sobre flúor se encontró que en el caso de los padres, la charla educativa (p=0,014) y el dentista (p=0,003) estaban asociados, mientras que en el caso de los profesores, solo se halló asociación estadísticamente significativa con la charla educativa (p=0,013). El nivel predominante de conocimientos sobre pasta fluorada en los padres y profesores fue el nivel medio y estuvo asociada al dentista y la charla educativa como fuentes principales de información.

          Translated abstract

          The study aimed to determine the level of knowledge about fluoride toothpaste based on the fluoride source for parents and teachers from preschool children. A questionnaire was applied in a representative sample of parents and all teachers working at preschool educational state institutions in the Molina district, Lima, Perú. The level of knowledge was classified into three levels: low (0-2 points), medium (3-5 points) and high (6-7 points). We used frequency distribution tables for the univariate analisys, the chi square test and Fisher exact test for the bivariate analisys. The most frequent level of knowledge about fluoride toothpaste was medium level in both, parents (n = 68, 45%) and teachers (n = 52, 58.4%). The item: brushing teeth with fluoride toothpaste can cure the initial decay, obtained (had) the lowest number of correct response 50 (33.1%) and 19 (21.4%) parents and teachers respectively. It was found that the level of knowledge related to sources of information about fluoride is in the case of parents, educational talk (p = 0.014) and the dentist (p = 0.003) were associated, whereas in the case of teachers, only statistically significant association was found with the educational talk (p = 0.013). The higher level of knowledge about fluoride toothpaste on parents and teachers was the middle level and was associated with the dentist and educational talk as major sources of information.

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          Parental knowledge, beliefs and behaviours for oral health of toddlers residing in rural Victoria.

          Little is known about the oral health of children under the age of four years. The determinants of early childhood caries (ECC) in this young age group are also not well understood despite a growing recognition that early interventions may deliver the greatest benefits. The aim of this study was to examine the oral health-related knowledge, attitudes and reported behaviours of parents of children aged 12-24 months living in rural areas of Victoria, Australia. A robust theoretical model was utilized to identify oral health-related behaviours and their antecedent and reinforcing conditions within the context of this specific population group. Two hundred and ninety-four parent/child dyads were recruited through their maternal and child health nurses as part of a larger intervention trial. Parents completed a self-report questionnaire. Knowledge regarding risk and protective factors amongst parents was variable and sometimes at odds with contemporary evidence. Knowledge of the role of early infection with S. mutans was very low, with high levels of behaviours that may promote early transmission reported. Tooth cleaning was reported by most parents at least sometimes, however a large proportion lacked confidence and this was significantly related to the frequency of the cleaning. Parents were confused about the fluoride status of their water supplies. Most parents believed fluoride toothpaste reduced the risk of ECC but did not know whether it should be used with toddlers. The results of this study have implications for efforts to prevent dental decay in this very young age group. Health care professionals other than dentists need support to provide information and promote confidence with regard to optimal fluoride exposure. Attention should also be given to the contribution of early contact with particular bacteria in oral health education and promotion programmes.
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            From concept to application: the impact of a community-wide intervention to improve the delivery of preventive services to children.

            To improve health outcomes of children, the US Maternal and Child Health Bureau has recommended more effective organization of preventive services within primary care practices and more coordination between practices and community-based agencies. However, applying these recommendations in communities is challenging because they require both more complex systems of care delivery within organizations and more complex interactions between them. To improve the way that preventive health care services are organized and delivered in 1 community, we designed, implemented, and assessed the impact of a health care system-level approach, which involved addressing multiple care delivery processes, at multiple levels in the community, the practice, and the family. Our objective was to improve the processes of preventive services delivery to all children in a defined geographic community, with particular attention to health outcomes for low-income mothers and infants. Observational intervention study in 1 North Carolina county (population 182 000) involving low- income pregnant mothers and their infants, primary care practices, and departments of health and mental health. An interrupted time-series design was used to assess rates of preventive services in office practices before and after the intervention, and a historical cohort design was used to compare maternal and child health outcomes for women enrolled in an intensive home visiting program with women who sought prenatal care during the 9 months before the program's initiation. Outcomes were assessed when the infants reached 12 months of age. Our primary objective was to achieve changes in the process of care delivery at the level of the clinical interaction between care providers and patients that would lead to improved health and developmental outcomes for families. We selected interventions that were directed toward major risk factors (eg, poverty, ineffective care systems for preventive care in office practices) and for which there was existing evidence of efficacy. The interventions involved community-, practice-, and family-level strategies to improve processes of care delivery to families and children. The objectives of the community-level intervention were: 1) to achieve policy level changes that would result in changes in resources available at the level of clinical care, 2) to engage multiple practice organizations in the intervention to achieve an effect on most, if not all, families in the community, and 3) to enhance communication between, among, and within public and private practice organizations to improve coordination and avoid duplication of services. The objective of the practice-level interventions was to overcome specific barriers in the process of care delivery so that preventive services could be effectively delivered. To assist the health department in implementing the family-level intervention, we provided assistance in hiring and training staff and ongoing consultation on staff supervision, including the use of structured protocols for care delivery, and regular feedback data about implementation of the program. Interventions with primary care practices focused on the design of the delivery system within the office and the use of teamwork and data in an "office systems" approach to improving clinical preventive care. All practices (N = 8) that enrolled at least 5 infants/month received help in assessing performance and developing systems (eg, preventive services flow sheets) for preventive services delivery. Family-level interventions addressed the process of care delivery to high-risk pregnant women (<100% poverty) and their infants. Mothers were recruited for the home visiting intervention when they first sought prenatal care at the community health center, the county's largest provider of prenatal care to underserved women. The home visiting intervention involved teams of nurses and educators and involved 2 to 4 visits per month through the infant's first year of life to provide parental education on fetal and infant health and development, enhance parents' informal support systems, and link parents with needed health and human services. We included training in injury prevention and discipline, and home visitors assisted mothers in obtaining care from one of the primary care offices. There were high levels of participation, changes in the organization of the delivery system, and improvements in preventive health outcomes. Agencies cooperated in joint contracting, staff training, and defining program eligibility. All 8 eligible practices agreed to participate and 7/8 implemented at least 1 new office system element. Of eligible women, 89% agreed to participate, and outcome data were available on 80% (180/225). After adjusting for differences in baseline characteristics, intervention group women were significantly more likely than comparison group women to use contraceptives (69% vs 47%), not smoke tobacco (27% vs 54%) and have a safe and stimulating home environment for their children. Intervention group children were more likely to have had an appropriate number of well-child care visits (57% vs 37%) and less likely to be injured (2% vs 7%). Intervention mothers also received Aid to Families with Dependent Children for fewer months after the birth of their child (7.7 months vs 11.3 months). We observed a number of positive effects at all 3 levels of intervention. Policy-level changes at the state and community led to lasting changes in the organization and financing of care, which enabled changes in clinical services to take place. These changes have now been expanded beyond this community to other communities in the state. We were also able to engage multiple practice organizations, reduce duplication, and improve the coordination of care. Changes in the process of preventive services delivery were noted in participating practices. Finally, the outcomes of the family-level intervention were comparable in direction and magnitude to the outcomes of previous randomized trials of the intervention. All the changes were achieved over a relatively brief 3-year study period, and many have been sustained since the project was completed. Tiered, interrelated interventions directed at an entire population of mothers and children hold promise to improve the effectiveness and outcomes of health care for families and children.
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              A systematic review of the effectiveness of health service interventions aimed at reducing inequalities in health.

              To review the available evidence in order to identify effective interventions which health services alone or in collaboration with other agencies could use to reduce inequalities in health. A search of the literature was undertaken using a number of databases including Medline (from 1990), Applied Social Science Index and Abstracts (1987-1994), and the System for Information on Grey Literature in Europe (1984-1994), on a large range of key words. Studies were included if they assessed interventions designed to reduce inequalities in health or improve the health of a population group relevant to the review, and could be carried out by a health service alone or in collaboration with other agencies. Only studies evaluating interventions using an experimental design were included. Papers in any language were considered. In addition, systematic reviews of the research on the effectiveness of health promotion and the treatment of conditions where there are significant health inequalities were identified in order to illustrate the potential for reducing inequalities in health. 94 studies were identified which satisfied all the inclusion criteria and 21 reviews were included. A number of interventions have been shown to improve the health of groups who are disadvantaged by socio-economic class, ethnicity or age and, if properly targeted, could be expected to reduce health inequalities. If a health intervention is being used, there should be evidence that it has an impact on health status. Attention should then be given to the way in which the intervention is delivered and the characteristics of a programme to promote implementation. Characteristics of successful interventions specifically aimed at reducing health differentials include: systematic and intensive approaches to delivering effective health care; improvement in access and prompts to encourage the use of services; strategies employing a combination of interventions and those involving a multi-disciplinary approach; ensuring interventions address the expressed or identified needs of the target population; and the involvement of peers in the delivery of interventions. However, these characteristics alone are not sufficient for success, nor are they universally necessary. Although it is likely that the most significant contributions to reducing health inequalities will be in improving economic and social conditions and the physical environment, there are interventions which health services, either alone or in collaboration with other agencies, can use to reduce inequalities in health.
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                Author and article information

                Journal
                ijodontos
                International journal of odontostomatology
                Int. J. Odontostomat.
                Universidad de La Frontera. Facultad de Medicina (Temuco, , Chile )
                0718-381X
                2013
                : 7
                : 1
                : 17-24
                Affiliations
                [01] Lima orgnameUniversidad de San Martín de Porres orgdiv1Facultad de Odontología Perú
                Article
                S0718-381X2013000100003 S0718-381X(13)00700100003
                9a5f6a69-efd5-407b-ba64-a68eb04ba85f

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 15 November 2012
                : 22 June 2012
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 14, Pages: 8
                Product

                SciELO Chile


                salud bucal,fluoruros,dentífricos,oral health,fluorides,dentifrices

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