180581 Evaluation of the effectiveness of promotoras in oral health promotion for preschool children

Monday, October 27, 2008

Nancy M. Reifel, DDS, MPH , School of Dentistry, University of California, Los Angeles, Los Angeles, CA
Erika Gomez , School of Dentistry, University of California, Los Angeles, Los Angeles, CA
Lilian Lopez , School of Dentistry, University of California, Los Angeles, Los Angeles, CA
A 1994 study of California preschoolers found that 27% had untreated dental caries, twice the national average. California's Head Start children had caries rates that were 19% to 30% higher than other pre-school settings, with Latino children having a prevalence of 66% with untreated decay. The Intervention: UCLA collaborated with Head Start and School Readiness Programs in a Latino community of Los Angeles. Trained bi-lingual Promotoras provided caries prevention education and services individually to families of preschool children. Services included an annual screening and oral inspection, referral for dental treatment, quarterly topical fluoride varnish, distribution of oral hygiene supplies, and targeted glass ionomer sealants, individualized oral hygiene instruction and toothbrush prophylaxis and diet counseling. Evaluation Methods: 4700 services records of 1500 children were inspected to determine the scope and amount of services provided. Pre and post evaluations of oral health status for 305 children were assessed to determine the oral health impact of the program. Thirty parents were interviewed to evaluate the behavioral and social impact of the program. Results: Oral inspection and topical fluoride application services were delivered to a greater percentage of children than individualized oral hygiene instruction with toothbrush prophylaxis and diet modification. The treatment records and parent reports are in agreement on this. For parents, oral hygiene instruction was the most important component of the program. Overall, children's oral hygiene improved. Conclusion: Promotoras are effective agents to change oral hygiene behavior of preschool children's parents through the clinical services including individualized oral hygiene instruction.

Learning Objectives:
1. Identify clinical dental procedures that can be effectively provided by Promotoras. 2. Recognize the impact of comprehensive, individualized oral hygiene instruction. 3. Analyze program data to determine the health impact of a community oral health promotion program.

Keywords: Oral Health, Community Health Promoters

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the director of the program and prepared the evaluation report.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.