A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries

BMC Public Health

Anthony Blinkhorn⁴  Andrew Martin⁶  Gerry Humphris¹  Ruth Freeman²  Ngiare Brown³  Fiona Blinkhorn⁵ 

[1] School of Medicine, University of St Andrews, Fife, Scotland, KY16 9TF, UK;Dental Health Services Research Unit, University of Dundee, Dundee, 2522, UK;Graduate School of Medicine, University of Wollongong, New South Wales, Australia;Population Oral Health, Faculty of Dentistry, University of Sydney, Sydney, New South Wales, 2006, Australia;School of Health Sciences, University of Newcastle, PO Box 127, Brush Road, Ourimbah, New South Wales, 2258, Australia;NHMRC Clinical Trials Centre, Sydney Medical School, University of Sydney, Sydney, New South Wales, 2006, Australia

关键词: Health promotion;    Aboriginal families;    Oral health;   

Others  :  1163243
DOI  :  10.1186/1471-2458-12-681

 received in 2012-06-26, accepted in 2012-08-14,  发布年份 2012

【 摘 要 】

Background

Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities.

Methods/Design

This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome.

Discussion

The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study.

Trial registration

ACTRN12612000712808

【 授权许可】

   
2012 Blinkhorn et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Australian Institute of Health and Welfare and Department of Health and Ageing: Progress of the Northern Territory Emergency Response Child Health Check Initiative: Update on results from the Child Health Check and follow-up data collections. Cat. no. IHW 28. Canberra: AIHW; 2009.
• [2]Tennant M, Namjoshi D, Silva D, Codde J: Oral health and hospitalization in Western Australian children. Aust Dent J 2000, 45:204-207.
• [3]Kruger E, Dyson K, Tennant M: Hospitalization of Western Australian children for oral health related conditions: a 5–8 year follow-up. Aust Dent J 2006, 51:231-236.
• [4]Jamieson L, Roberts-Thomson K: Dental general anaesthetic trends among Australian children. BMC Oral Health 2006., 6http://dx.doi.org/10.1186/1472-6831-6-16 webcite.
• [5]SCRGSP (Steering Committee for the Review of Government Service Provision), Overcoming Indigenous Disadvantage: Key Indicators 2009. Canberra: Productivity Commission; 2009.
• [6]Jamieson LM, Armfield J, Roberts-Thomson KF: Oral Health of Aboriginal and Torres Strait Islander children. Canberra: Australian Institute of Health and Welfare; 2007.
• [7]Brennan D, Carter KD: Adult access to dental care: Indigenous Australians. AIHW Dental Statistics and Research Series No. 16. Adelaide. South Australia: The University of Adelaide; 1988.
• [8]Schou L, Wight C, Wohlgemuth B: Deprivation and dental health. The benefits of a child dental health campaign in relation to deprivation as estimated by the uptake of free meals at school. Community Dental health 1991, 8:147-154.
• [9]Schou L, Wight C: Does dental health education affect inequalities in dental health? Community Dental Health 1994, 11:97-100.
• [10]Roberts-Thomson KF, Spencer AJ, Jamieson LM: Oral Health of Aboriginal and Torres Strait Islanders. The Med J Aust 2008, 188:592-593.
• [11]Kruger E, Dyson K, Tennant M: Preschool child oral health in rural Western Australia. Aust Dent J 2005, 50:258-262.
• [12]Smith K, Kruger E, Dyson K, Tennant M: Oral health in rural and remote Western Australian indigenous communities: a two-year retrospective analysis of 999 people. Int Dent J 2007, 57:93-9.
• [13]Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P: Framework for design and evaluation of complex interventions to improve health. BMJ 2000, 321(7262):694-6.
• [14]Parker E, Jamieson M: Associations between Indigenous Australian oral health literacy and self-reported oral health outcomes. BMC Oral Health 2010, 10:1-23. BioMed Central Full Text
• [15]Goodman RM, Steckler A, Kegler MC: Mobilizing organizations for health enhancement: Theories of organizational change. Health Behavior and Health Education: Theory, Research and Practice 1997, 24:287-312.
• [16]‘National Aboriginal Community Controlled Health Organisation Submission’ in Report On Public Dental Services. Commonwealth of Australia: Senate Community Affairs References Committee; 1998.
• [17]Australian Dental Association Incorporated: National Dental Update April 2004. Delivery of Oral Health Care to Indigenous Australians: ADA; 2004. Viewed 9th April 2008 http://www.ada.org.au/app_cmslib/media/lib/0702/m44890_v1_delivery%20of%20oral%20health%20care%20to%20Indigenous%20AustraliansAPR2004.pdf webcite.
• [18]Mouths H, Lives H: Australia’s National Oral Health Plan 2004–2013. South Australia Department of Health: Australian Health Minister Conference; 2004.
• [19]Aboriginal N, Workshop TSIOH: Workshop report and action plan. Canberra: Commonwealth Department of Health and Ageing; 2003.
• [20]Walker D, Tennant M, Short SD: Listening to indigenous health workers. Helping to explain the disconnect between policy and practice in oral health role development in remote Australia. Heal Educ J 2011, 70:400-406.
• [21]Blinkhorn AS: Influence of social norms on toothbrushing behaviour of preschool children. Comm Dent and Oral Epidemiol 1978, 6:222-6.
• [22]Ferrer R, Palmer R, Burge S: The family contribution to health status: a population level- estimate. Annals of Family Medicine 2005, 3:102-108.
• [23]Tickle M, Milsom KM, Humphris GM, Blinkhorn AS: Parental attitudes to the care of the carious primary dentition. British Dent J 2003, 195:451-455.
• [24]Leventhal H, Brisette I, Leventhal EA: The common sense model of self regulation of health and illness. In TheSelf Regulation of Health and Illness Behaviour. Edited by Cameron LD, Leventhal H. London: Routledge; 2003:42-65.
• [25]Milsom KM, Blinkhorn AS, Tickle M: The incidence of dental caries in primary molar teeth of young children receiving NHS funded dental care in practices in the NW of England. British Dent J 2008, 205:E14.
• [26]Kruger E, Tennant M, Lowe A: Knowledge and perceptions of oral health in a rural Community. CCROH: A report to the Health Department of Western Australia; 2003.
• [27]National Rural Health Alliance: Position Paper: Public dental services in Australia: whose responsibility?. Canberra, Australia: National Rural Health Alliance; 2005.
• [28]Jamieson L, Bailie R, Beneforti M, Koster C, Spencer A: Dental self-care and dietary characteristics of remote living Indigenous children. Rural Remote Heal 2006, 6:503.
• [29]Gussy MG, Waters EG, Walsh O, Kilpatrick NM: Early childhood caries: Current evidence for aetiology and prevention. J Paediatric and Child Health 2006, 42:37-43.
• [30]Marinho VCC, Higgins JPT, Logan S, Sheiham A: Fluoride toothpaste for preventing caries in children and adolescents. The Cochrane Database of Systematic Reviews 2003, (1):CD002278.
• [31]Wanyonyi KL, et al.: A systematic review and meta-analysis of face-to-face communication of tailored health messages: Implications for practice. Patient EducCouns 2011.
• [32]Davies GM, Worthington HV, Ellwood RP, Bently EM, Taylor GO, Blinkhorn AS, Davies RM: A randomised controlled trial of the effectiveness of providing free fluoride toothpaste from the age of 12 months on reducing caries in 5–6 year old children. Community Dental Health 2002, 19:131-36.
• [33]Martin-Iverson N, Pacza T, Phatouros A, Tennant M: Indigenous Australian dental health: a brief review of caries experience. Aust Dent J 2000, 45(1):17-20.
• [34]Hallett K, O’Rourke P: Social and behavioural determinants of early childhood caries. Aust Dent J 2003, 48(1):27-33.
• [35]Blinkhorn F, Phelan C: Lifting the Lip. Paediatrics and Child Health in General Practice Australia 2009, 6:20.
• [36]Versloot J: Dental Discomfort Scale. Community Dentistry and Oral Epidemiology 2006, 34(1):47-52.
• [37]Matthey S: Assessing the experience of motherhood: the Being a Mother Scale – BaM13. Journal of Effective Disorders 2011, 128(1–2):142-52.
• [38]Ritchie J, Spencer L: Qualitative data analysis for applied policy research. In Analysing Qualitative Data. Edited by Bryman A, Burgess R. London: Routledge & Co; 1994:173-94.
• [39]Cole DA, Maxwell S: Testing meditational models with longitudinal data: Questions and Tips in the use of Structural Equation Modelling. J Abnorm Psychol 2003, 112:558-577.
• [40]MacKinnon DP: Introduction to Statistical Mediation Analysis. New York: Taylor & Francis Group; 2008.
• [41]Collins LM, Graham JW, Flaherty BP: An alternative framework for defining mediation. Multivar Behav Res 1998, 33:295-312.
• [42]Browne NW, Cudeck R: Alternative ways of assessing model fit. In Testing structural equation models. Edited by Bollen KA, Long JS. Newbury Park, CA: Sage; 1993:136-162.