Villalta Jennifer, Askaryar Hamida, Verzemnieks Inese, Kinsler Janni, Kropenske Vickie, Ramos-Gomez Francisco
School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States.
School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States.
Front Public Health. 2019 Jul 3;7:175. doi: 10.3389/fpubh.2019.00175. eCollection 2019.
To determine the effectiveness of a train-the-trainer program for Community Oral Health Workers (COHWs) with the goal of reducing Early Childhood Caries (ECC). Thirteen Latina caregivers from a local Early Head Start program participated in an 8 h bilingual oral health training program that provided information and hands-on experiences pertaining to prenatal and children's oral health. Once trained, the 13 COHWs conducted a series of bilingual interactive oral health promotion workshops at local community sites. Pre/post-tests were conducted after each workshop with a total of 157 caregivers of young children. Bivariate analyses were used to assess changes in knowledge, attitudes, and practices of the COHWs and caregivers regarding children's oral health. Significant positive changes ( < 0.05) in COHWs' knowledge were observed for age a child can brush his/her teeth alone and what a pregnant woman with morning sickness can do to protect her teeth. Positive trends were observed for knowing that tap water with fluoride prevents cavities and that poor oral health of parents affects their children's dental health. While community caregivers in the workshops reported a high consumption of sweet snacks and beverages, there was a significant positive increase ( < 0.05) in knowledge and attitudes regarding oral health care. Significant increases in knowledge were obtained regarding: when a child can brush his/her teeth well alone, the age when fluoridated toothpaste can be used, ways tooth decay can be prevented, when a child's first dental visit should be, and what a pregnant woman with morning sickness can do to protect her teeth. Significant positive improvements were found regarding caregiver's favorable attitude that fluoridated water can help prevent cavities, disagreeing that tap water is dangerous, and agreeing that a parent's dental health affects their children's dental health. The study showed a targeted and culturally competent oral health program can significantly improve knowledge, attitudes, and self-reported practices of COHWs and the caregivers they trained. Although longitudinal studies are needed to determine if a COHW model can help reduce ECC in underserved communities, preliminary results support the utilization of this model as a viable option that should be expanded.
为确定以减少幼儿龋齿（ECC）为目标的社区口腔卫生工作者（COHWs）培训师培训项目的有效性。来自当地一个早期开端计划的13名拉丁裔照顾者参加了一个8小时的双语口腔健康培训项目，该项目提供了与产前和儿童口腔健康相关的信息和实践经验。一旦接受培训，这13名COHWs在当地社区场所开展了一系列双语互动口腔健康促进工作坊。在每个工作坊结束后，对总共157名幼儿照顾者进行了前后测试。采用双变量分析来评估COHWs和照顾者在儿童口腔健康方面的知识、态度和行为的变化。观察到COHWs在孩子能够独自刷牙的年龄以及晨吐的孕妇可以采取什么措施保护牙齿方面的知识有显著的积极变化（<0.05）。在知晓含氟自来水可预防龋齿以及父母口腔健康不佳会影响孩子的牙齿健康方面观察到了积极趋势。虽然工作坊中的社区照顾者报告说甜零食和饮料的摄入量很高，但在口腔保健的知识和态度方面有显著的积极增长（<0.05）。在以下方面获得了显著的知识增长：孩子能够独自很好地刷牙的时间、可以使用含氟牙膏的年龄、预防龋齿的方法、孩子第一次看牙医的时间以及晨吐的孕妇可以采取什么措施保护牙齿。在照顾者对含氟水有助于预防龋齿的积极态度、不同意自来水有害以及同意父母的牙齿健康会影响孩子的牙齿健康方面发现了显著的积极改善。该研究表明，一个有针对性且具备文化能力的口腔健康项目可以显著改善COHWs以及他们培训的照顾者的知识、态度和自我报告的行为。尽管需要进行纵向研究来确定COHW模式是否有助于减少服务不足社区的ECC，但初步结果支持将该模式作为一个可行的选择加以推广。
