Access to oral health services for urban low-income Latino children: social ecological influences.
OBJECTIVE
Using an ecological conceptual model, this study examined the social context, structural, and behavioral factors within an immigrant community that contribute to increased access and use of oral health services by Latino children. The predictors of health service use at the level of the individual, the family, the provider, and the health service system were studied for their effects on the initiation of care, continuity of care, and frequency of planned visits.


METHODS
In-depth face-to-face interviews were conducted with 320 Latino mothers regarding their use of oral health services for 4-8-year-old children [Mexican (n = 221), Puerto Rican (n = 69), and Central and South American (n = 30)]. Outcome measures of dental care utilization were early age at initiation of care, continuity of care, and frequency of planned dental visits.


RESULTS
Regular planned dental visits were significantly related to the structural variables of household income and provider availability. The initiation of dental care was related to the mother's beliefs about the value of early preventive dental care. Mothers were more likely to continue care if they believed that the purpose was to keep the child's teeth healthy and had satisfactory communication with the dentist.


CONCLUSIONS
Identifying the structural and behavioral factors that increase the likelihood of the use of oral health services can provide the basis for developing effective interventions specific to Latino children at the neighborhood level. The study findings can be also used for designing culturally appropriate oral health promotion programs and provider coordination of care.
School of Public Health, University of Illinois, Chicago, IL, USA. telleen@uic.edu
Sharon
S
Telleen
Young O
YO
Rhee Kim
Noel
N
Chavez
Richard E
RE
Barrett
William
W
Hall
Sangeeta
S
Gajendra
D000367:Age Factors; D001294:Attitude to Health; D002641:Chicago; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data; D002675:Child, Preschool; D003266:Continuity of Patient Care; D003752:Dental Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D007347:Insurance, Dental; D007407:Interviews as Topic; D008960:Models, Psychological; D055361:Multilevel Analysis; D010342:Patient Acceptance of Health Care; D012044:Regression Analysis; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires