California Oral Health Education and Training Program: Knowledge and Behavior Change Among Parents Served at WIC and Head Start Programs

Listening to and learning from parents is an important aspect of providing services that can result in increased access and use of oral health services. First Smiles was a 4-year, $7 million oral health education and training initiative funded by First 5 California and implemented in 2004-2008 by California Dental Association and Dental Health Foundation. The program recognized the link between a child's oral health and their overall health—and the critical gap in access faced by many low-income families based in part on provider and parent knowledge, attitudes, barriers and behaviors. In addition to training 15,000 dental and primary care providers to serve children ages 0-5, including those with special needs, the initiative trained Head Start and WIC staff (primarily through train-the-trainer model) to deliver a consumer curriculum with 6 key messages. Data were collected from parent focus groups and staff and parent posttests/surveys (English and Spanish) uniquely developed for this program. The evaluation dataset includes 1,318 parents with half completing a 6-month follow-up survey. The sample is reflective of the demographics of families who access WIC and Head Start. Outcomes, which will be discussed in detail, include knowledge gain and retention; parental values about oral health; pre- and post-program utilization of dental services; barriers to service use (e.g., lack of knowledge about recommended age for first visit, misunderstanding about fluoride toothpaste); and adoption of positive behaviors at home after parent education. Additional findings and recommendations for community organizations and providers will be discussed.