A Promotora Program to Prevent Primary Tooth Decay in Low-income Latino Children

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DESCRIPTION (provided by applicant): KDH Research & Communication (KDHRC) proposes to develop and evaluate Dientes Fuertes, Vida Sana (DFVS), a culturally-competent program to prevent primary tooth decay in low-income Latino children ages zero to six. To effectively reach low-income Latino children, DFVS will train promotores de salud (PS) at Latino-serving community-based organizations (CBOs) to conduct outreach to Latino parents and guardians to build their knowledge and skills in 1) oral health literacy, including proper brushing, flossing, ad feeding practices to prevent primary tooth decay; and 2) oral healthcare system navigation, which includes when, where, and how to seek dental care and treatment and methods to overcome barriers to dental care. DFVS addresses a pressing public health need. Public health officials have called tooth decay a silent epidemic and the greatest unmet childhood health need. On an individual level, childhood tooth decay predicts lasting and substantive physical, psychosocial, and economic consequences. On a societal level, childhood tooth decay costs taxpayers hundreds of millions of dollars yearly, due mostly to emergency room care for preventable tooth pain. DFVS matches this pressing public health need with the PS intervention model, which has demonstrated effectiveness, culturally-competency, and cost-efficiency. DFVS is unique in the field. At the completion of this project, we will have the complete DFVS program, which will consist of four bilingual English/Spanish components: 1) a Training Guide (TG) for a CBO-based facilitator to conduct eight, two-hour sessions to prepare PS to conduct outreach to Latino guardians; 2) a multi-part training telenovela, or streaming video that dramatically illustrates Latino oral health challenges for PS learning and discussion; 3) an Implementation Guide (IG) to build CBOs' capacity to effectively use DFVS; and 4) a distribution website to host DFVS. What is more, we will have substantive data on DFVS's effectiveness as a culturally-competent program to prevent primary tooth decay in low-income Latino children ages zero to six. These data will stem from two sources. First, the feasibility evaluation will explore the extent to which DFVS is a useful, culturally- appropriate program that CBOs will adopt. It will also test how exposure to the DFVS prototype changes PS' knowledge, improve attitudes, and increase self-efficacy to conduct outreach to Latino guardians. Second, the outcome evaluation will test DFVS in a two group, multi-stage, controlled trial of DFVS's effectiveness when implemented by a group of CBOs. Taken together, DFVS and its evaluation results aim to reduce oral health disparities among low-income Latino children ages zero to six by creating an evidence-based, culturally- competent program to prevent primary tooth decay.