Farokhi Moshtagh R, Muck Andrew E, Nathan Hamsini, Yan James, Estacio Alvin, Su Ruoxuan, Stone Melanie, Mandlik Nandini, Worabo Heidi
Department of Comprehensive Dentistry, San Antonio Refugee Health Clinic, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States.
Department of Emergency Medicine, University of Virginia, Charlottesville, VA, United States.
Front Public Health. 2025 Aug 27;13:1594767. doi: 10.3389/fpubh.2025.1594767. eCollection 2025.
Ongoing socio-political instability has resulted in a growing influx of Afghan women with limited literacy skills resettling in the United States (U.S.). These women face considerable barriers in accessing oral and general healthcare services, exacerbated by limited literacy. This study aimed to explore Afghan women's challenges in accessing healthcare services and develop a technology-enabled intervention to enhance their health.
An interprofessional (IP) team of researchers collaborated with community advocates and leaders to gather participants' insights about preventive health. Participants identified as their preferred platform for receiving health information. Trained interpreters were employed to bridge cultural and linguistic gaps. The first phase involved conducting pre-intervention surveys to assess participants' experiences with the availability, accessibility, and affordability of healthcare services. Culturally tailored oral health messages were developed using the interactive platform. These videos incorporated messages in English, Pashto, and Farsi that were shared through , to accommodate varying literacy levels. The second phase emphasized hands-on demonstrations to illustrate oral hygiene techniques, and a customized rubric was used to assess participants' competency. Pre- and post-surveys for the pilot study assessed changes in knowledge and behavior, which helped refine the intervention protocol. Follow-up interviews were conducted six months post-intervention, assessing variations in outcome.
Forty-three Afghan women aged 19 to 57 participated in the study. Demographic data revealed that 58% identified Pashto as their primary language, 46% had received little to no formal education, and 77% were homemakers. Key barriers to healthcare access included financial constraints (91%), limited English proficiency (70%), low literacy levels (63%), and transportation challenges (56.3%). Post-intervention data revealed statistically significant improvements in participants' oral hygiene and dietary knowledge ( < 0.05). Assessment of brushing and flossing techniques indicated increased performance scores from pre-to post-intervention ( < 0.001). At the six-month post-intervention follow-up, 20 women participated. 80% ( = 16) reported reduced consumption of sugary beverages, while 95% ( = 19) indicated improved oral hygiene practices.
This study supports the effectiveness of a culturally responsive, technology-facilitated oral health intervention in enhancing self-care behaviors among Afghan refugee women. The findings suggest that healthcare providers should adopt patient-centered, community-engaged approaches to advance health outcomes. Technology-based interventions can effectively address constraints in health literacy.
持续的社会政治不稳定导致越来越多识字能力有限的阿富汗妇女在美国重新定居。这些妇女在获得口腔和一般医疗服务方面面临相当大的障碍,识字能力有限使情况更加恶化。本研究旨在探讨阿富汗妇女在获得医疗服务方面面临的挑战,并开发一种以技术为支撑的干预措施来改善她们的健康状况。
一个跨专业(IP)研究团队与社区倡导者和领导人合作,收集参与者对预防性健康的见解。参与者确定了他们接收健康信息的首选平台。聘请了经过培训的口译员来弥合文化和语言差距。第一阶段包括进行干预前调查,以评估参与者在医疗服务的可获得性、可及性和可承受性方面的经历。使用互动平台开发了符合文化背景的口腔健康信息。这些视频包含英语、普什图语和波斯语的信息,通过[具体平台名称]分享,以适应不同的识字水平。第二阶段强调实际操作演示,以说明口腔卫生技术,并使用定制的评分标准来评估参与者的能力。试点研究的干预前和干预后调查评估了知识和行为的变化,这有助于完善干预方案。在干预后六个月进行了随访访谈,评估结果的差异。
43名年龄在19至57岁之间的阿富汗妇女参与了该研究。人口统计数据显示,58%的人将普什图语作为主要语言,46%的人几乎没有接受过正规教育,77%的人是家庭主妇。获得医疗服务的主要障碍包括经济限制(91%)、英语水平有限(70%)、识字水平低(63%)和交通困难(56.3%)。干预后的数据显示,参与者的口腔卫生和饮食知识有统计学上显著的改善(P<0.05)。对刷牙和使用牙线技术的评估表明,从干预前到干预后,表现得分有所提高(P<0.001)。在干预后六个月的随访中,20名妇女参与。80%(n=16)报告含糖饮料的消费量减少,而95%(n=19)表示口腔卫生习惯有所改善。
本研究支持一种具有文化适应性、以技术促进的口腔健康干预措施在增强阿富汗难民妇女自我护理行为方面的有效性。研究结果表明,医疗服务提供者应采用以患者为中心、社区参与的方法来改善健康结果。基于技术的干预措施可以有效地解决健康素养方面的限制。