Chauhan Amrit, Staples Annalea, Forshaw Eleanor, Zoltie Timothy, Nasser Riffat, Gray-Burrows Kara A, Day Peter F
School of Dentistry, University of Leeds, Leeds, United Kingdom.
Better Start Bradford, Bradford, United Kingdom.
Front Oral Health. 2024 Nov 4;5:1392388. doi: 10.3389/froh.2024.1392388. eCollection 2024.
Within the city of Bradford in West Yorkshire, South Asian and Eastern European communities have an increased risk of childhood tooth decay, especially among families with Limited English Proficiency. Tooth decay is preventable, with national guidelines advocating home-based behaviours (toothbrushing with fluoride toothpaste and reducing sugar intake). In England, Health Visitors have opportunities to undertake oral health conversations during universal visits for children aged 0-24 months. The HABIT (Health visitors delivering Advice in Britain on Infant Toothbrushing) intervention provides structured oral health conversations, underpinned by complex intervention methodology. A feasibility study found HABIT acceptable to parents, feasible to deliver and led to improvements in home-based behaviours. However, the reach of this original study was limited to those proficient in English. This new study focused on exploring and enhancing the accessibility of the HABIT intervention to parents with Limited English Proficiency.
Twenty-four parents participated in interviews and focus groups, with 21 requesting support from interpreters. Community centres and WhatsApp were used to maximise inclusivity. Interviews and focus groups, followed a topic guide and the "Think Aloud" technique, were professionally transcribed, managed in NVivo, and thematically analysed. Team discussions facilitated analytical rigour. Recruitment continued until data saturation.
Three themes were developed: (1) Navigating linguistic barriers; (2) Engagement through visuals; and (3) Addressing oral health challenges. Parents employed diverse strategies to interpret resources, including Google Translate, as well as family and wider community members. Consequently, the HABIT resources were modified to include simple text, subtitles, and translation tools. Parents highlighted the benefits of shorter oral health messages with clear visuals to help understanding, and this strategy was applied across all resources. Challenges surrounding children's resistance to toothbrushing, high sugar intake within their wider families and communities, and limited dental access were all raised. The HABIT resources were updated to address these challenges.
Collaborative community engagement has enhanced the HABIT resources, enabling access for high-risk communities to preventive oral-health programmes thereby promoting health equity.
在西约克郡的布拉德福德市，南亚和东欧社区儿童患龋齿的风险增加，尤其是在英语水平有限的家庭中。龋齿是可以预防的，国家指南提倡家庭行为（使用含氟牙膏刷牙和减少糖摄入量）。在英国，健康访视员有机会在对0至24个月儿童的常规访视期间进行口腔健康交流。HABIT（英国健康访视员提供婴儿刷牙建议）干预提供了结构化的口腔健康交流，并以复杂的干预方法为基础。一项可行性研究发现，HABIT干预为家长所接受，实施可行，并能改善家庭行为。然而，这项原始研究的范围仅限于英语熟练的人群。这项新研究的重点是探索并提高HABIT干预对英语水平有限的家长的可及性。
24名家长参与了访谈和焦点小组，其中21人要求使用口译员提供支持。利用社区中心和WhatsApp来最大限度地实现包容性。访谈和焦点小组遵循主题指南和“边想边说”技巧，进行专业转录，在NVivo中管理，并进行主题分析。团队讨论促进了分析的严谨性。招募工作持续进行，直至数据饱和。
形成了三个主题：（1）克服语言障碍；（2）通过视觉手段促进参与；（3）应对口腔健康挑战。家长们采用了多种策略来解读资料，包括使用谷歌翻译以及求助于家人和更广泛的社区成员。因此，HABIT资料进行了修改，包括简单的文本、字幕和翻译工具。家长们强调了简短的口腔健康信息并配以清晰视觉效果有助于理解的好处，这一策略应用于所有资料中。还提出了围绕儿童抗拒刷牙、其家庭和社区内高糖摄入量以及牙科就诊机会有限等挑战。HABIT资料进行了更新以应对这些挑战。
社区合作参与增强了HABIT资料，使高风险社区能够获得预防性口腔健康项目，从而促进了健康公平。
