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.
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.
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. Kristin.Hoeft@ucsf.edu.
Kristin S
KS
Hoeft
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. s_rios@umail.ucsb.edu.
Sarah M
SM
Rios
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. pantojaestela2012@gmail.com.
Estela
E
Pantoja Guzman
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. judith.barker@ucsf.edu.
Judith C
JC
Barker
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002140:California; D000067576:Child Health; D002675:Child, Preschool; D003150:Community Health Workers; D003256:Community Participation; D065246:Culturally Competent Care; D003731:Dental Caries / Q000517:prevention & control*; D017144:Focus Groups; D006267:Health Education, Dental / Q000379:methods*; D006801:Humans; D007223:Infant; D017058:Mexican Americans / Q000523:psychology; D008875:Middle Aged; D009909:Oral Health; D009910:Oral Hygiene; D010287:Parent-Child Relations; D010290:Parents / Q000193:education*; D011203:Poverty; D016730:Program Development; D036301:Qualitative Research; D012423:Rural Health; D035862:Vulnerable Populations; D055815:Young Adult