American Indian community engagement to promote oral health behavior changes: A pilot study

Oral health is one determinant of overall health status in children and adults. The prevalence of oral disease is disproportionately high in individuals of low income and in American Indian populations. Indian Health Service data (1999) shows American Indian and Alaska Native children have nearly three times the number of untreated lesions as children in the general U. S. population. In an unpublished study from the Northern Plains (2010) 88% of children have untreated lesions. Our University partnership with a Northern Plains Tribe led to development of a community based intervention focused on oral health promotion. Six hundred families will receive enhanced community services and three hundred of those families will receive four motivational interviewing (MI) intervention sessions focused on pediatric oral health. The goal is to elicit oral health behavior changes in the mother on behalf of her child. Fifteen mothers participated in the pilot of the motivational interviewing materials and process. The interventionist engaged the mother in dialogue about daily routines with her child. Each mother identified supports and challenges to making oral health behavior changes. An independent interviewer audio recorded the participant's answers to a set of questions to ascertain the usability of motivational interviewing in this American Indian population. Analysis of the post MI-session interviews revealed the mothers unanimously favored the motivational interviewing format. Mothers found oral health and early childhood caries information useful and stated they felt motivated to make changes. Mothers emphasized the importance of all mothers learning about early childhood caries prevention.