Boca Sana, Cuerpo Sano/Healthy Mouth, Healthy Body: A community-based participatory research (CBPR) oral health project

Objective: To undertake a community-based participatory research (CBPR) approach to develop a Lideres-led (lay-community health worker) curriculum to increase oral health literacy and expand dental services for migrant Mexican families in North San Diego County, an underserved community.

Methods: Formative research activities were conducted over a one-year planning period (September 1, 2012-August 31, 2013). Existing community oral health assets, needs, and barriers were assessed. In November 2012, key informants (n=38; a 70% response rate) ranked program priorities via online survey. Input was obtained from three interviews and multiple community advisory board meetings. In February 2013, three focus groups were held with Lideres (n=22) and three with migrant families (n=30) inquiring about barriers to dental care and input on the educational program structure and content. Ten existing curricula were reviewed. Twelve Lideres reviewed draft curriculum materials and provided input during two focus groups in July 2013.

Results: The community elected to focus on adults and families for this project. A 5-week educational program with hands-on demonstrations and colorful accompanying visuals was developed, covering these topics: tooth decay, hygiene, nutrition, gum disease, and dental services. Lideres will also be trained to apply fluoride varnish, per California law.

Focus group findings reinforced known access problems and emphasized cultural competency issues. Most participants reported mistrust in local dental providers, years since last visit due to lack of insurance, low perceived quality of services, and transportation barriers.

 

Conclusions: The CBPR process engaged multiple community stakeholders in all aspects of planning and developing a tailored program.