Akintobi Tabia Henry, Hoffman LaShawn M, McAllister Calvin, Goodin Lisa, Hernandez Natalie D, Rollins Latrice, Miller Assia
1 Morehouse School of Medicine, Atlanta, GA, USA.
2 Pittsburgh Community Improvement Association, Atlanta, GA, USA.
Am J Mens Health. 2018 Mar;12(2):326-337. doi: 10.1177/1557988316639912. Epub 2016 Mar 23.
Despite improvements in oral health status in the United States, pronounced racial/ethnic disparities exist. Black men are less likely to visit the dentist, are twice as likely to experience tooth decay, and have a significantly lower 5-year oral cancer survival rate when compared to White men. The Minority Men's Oral Health Dental Access Program employed a community-based participatory research approach to examine the oral health barriers and opportunities for intervention among Black men in a low-income, urban neighborhood. A cross-sectional study design was implemented through a self-administered survey completed among 154 Black males. The majority reported not having dental insurance (68.8%). Most frequently cited oral health care barriers were lack of dental insurance and not being able to afford dental care. Attitudes related to the significance of dental care centered on cancer prevention and feeling comfortable with one's smile. The impact of oral health on daily life centered on social interaction, with men citing insecurities associated with eating, talking, and smiling due to embarrassment with how their teeth/mouth looked to others. Multivariate logistic regression revealed that those who had difficulty finding dental care were 4.81 times (odds ratio = 4.65, 95% confidence interval [1.80, 12.85]) more likely to report no dental insurance, and 2.73 times (odds ratio = 3.72; 95% confidence interval [1.12, 6.70]) more likely to report poor oral health. Community-based participatory approaches include assessment of neighborhood residents affected by the health issue to frame interventions that resonate and are more effective. Social, physical, and infrastructural factors may emerge, requiring a multilevel approach.
尽管美国的口腔健康状况有所改善,但明显的种族/族裔差异依然存在。与白人男性相比,黑人男性看牙医的可能性较小,患龋齿的可能性是白人男性的两倍,且口腔癌5年生存率显著更低。少数族裔男性口腔健康牙科服务项目采用基于社区的参与性研究方法,来调查低收入城市社区中黑人男性的口腔健康障碍及干预机会。通过对154名黑人男性进行的自填式调查实施了一项横断面研究设计。大多数人报告没有牙科保险(68.8%)。最常被提及的口腔保健障碍是缺乏牙科保险和负担不起牙科护理费用。与牙科护理重要性相关的态度集中在癌症预防以及对自己笑容感到满意上。口腔健康对日常生活的影响集中在社交互动方面,男性提到由于担心自己牙齿/嘴巴在他人眼中的样子而在饮食、交谈和微笑时感到不自在。多变量逻辑回归显示,那些难以获得牙科护理的人报告没有牙科保险的可能性高4.81倍(比值比 = 4.65,95%置信区间[1.80, 12.85]),报告口腔健康状况差的可能性高2.73倍(比值比 = 3.72;95%置信区间[1.12, 6.70])。基于社区的参与性方法包括评估受健康问题影响的社区居民,以制定能引起共鸣且更有效的干预措施。可能会出现社会、物理和基础设施方面的因素,这就需要采取多层次方法。