Addressing Oral Health Literacy among Mexican Immigrants

描述(申请人提供)：拉美裔移民是美国增长最快和最大的少数群体，2010年占全国人口的16%，预计到2050年将占全国人口的30%。2 5岁或以下的拉美裔儿童，以及那些墨西哥裔、低收入家庭或农村地区的儿童，在任何种族/民族群体中，儿童早期龋齿的发生率最高，仅次于美洲原住民。3-7拉美裔儿童是所有种族/种族群体中牙齿利用率最低的群体之一，墨西哥裔美国人的使用率是所有拉丁裔群体中最低的。8-10维持口腔健康需要理解健康信息、对健康信息采取行动以及导航牙科保健的能力；换言之，适当水平的口腔健康素养(OHL)。11，12在墨西哥移民家庭中，在他们感到安全和受到尊重的环境下进行适当的口腔健康素养教育，如英语作为第二语言(ESL)课程，是一个新兴的牙科公共卫生优先事项。13，14个ESL课程提供了一个理想的环境，向新到的移民父母和患龋齿风险较高的家庭推广OHL，特别是考虑到ESL课堂环境公认的安全和信任的声誉。16-18在制定OHL课程以供拉美裔学生使用之前，首先必须了解这些人口中OHL的确切构成。目前对口腔疾病预防的理解、口腔健康信息的来源和获取、利用口腔健康信息获得专业牙科保健的经验和能力以及对口腔健康服务的理解和看法是什么？我们建议进行人种学研究来调查这些问题，这些问题是墨西哥移民家庭口腔健康差异的基础。这项拟议的研究是一项专注于口腔健康差异和口腔扁平苔藓的研究计划的第一个也是至关重要的形成阶段。它将为制定适当框架的OHL核心课程奠定基础，旨在帮助墨西哥移民更好地驾驭牙科保健系统。我们将在ESL课堂上评估本课程的基础项目，以便为下一阶段的研究进行提炼。目前拟议的形成性研究的总体目标是为加强拉美裔移民父母和家庭对牙科系统的了解和导航(OHL)技能的干预奠定基础。其具体目标是1)为SF Bay地区的墨西哥移民定义OHL的维度(即进行人种学研究-观察、个人和小组访谈-以描述口腔健康差异、现有的口腔健康理解和系统导航的经历)；以及2)为OHL课程制定基础项目，以便在ESL地区和环境中提供(目前为墨西哥移民服务的十(10)个ESL课程的基础项目；观察他们对未来课程的这些基础方面的参与，并对成年ESL学生进行10次小组访谈，了解他们对每个项目的看法)。

DESCRIPTION (provided by applicant): The fastest-growing and largest minority group in the United States, Latino immigrants accounted for 16% of the nation's population in 2010 and are projected to represent 30% by 2050.1,2 Latino children age 5 or under, and those of Mexican origin, in low-income families or in rural locations, have the highest rates of early childhood caries of any racial/ethnic groups, second only to Native Americans.3-7 Latinos have one of the lowest dental utilization rates of all ethnic/racial groups, with Mexican-Americans having the lowest utilization rate of all Latino groups.8-10 Maintaining oral health requires the ability to understand and act on health information and to navigate dental healthcare; in other words, an adequate level of Oral Health Literacy (OHL).11,12 Addressing OHL in Mexican immigrant families with appropriately framed education in contexts where they feel safe and respected, such as English as a Second Language (ESL) classes, is an emerging dental public health priority.13,14 ESL classes present an ideal environment to promote OHL to newly arrived immigrant parents and families at high risk for dental caries, particularly due to the well-established safe and trusting reputation of ESL classroom environments.16-18 Prior to developing OHL curriculum for use in ESL classes serving Latinos, it is first necessary to understand what exactly constitutes OHL in this population. What are current understandings of oral disease prevention, sources of and access to oral health information, experiences with and ability to use oral health information to access professional dental care, and understandings and perceptions of dental health services? We propose to conduct ethnographic research to investigate these questions which underpin oral health disparities among Mexican immigrant families. The proposed study is the first and vital formative stage of a research program focused on oral health disparities and OHL. It will provide the foundation for the development of appropriately framed core OHL curriculum aimed at assisting Mexican immigrants to better navigate the dental care system. We will evaluate foundational items of this curriculum in ESL classes in order to refine it for the next stage of research. The overall goal of the currently proposed formative study is to establish the foundation for an intervention to enhance dental system understanding and navigational (OHL) skills among Latino immigrant parents and families. The Specific Aims are to 1) Define the dimensions of OHL for SF Bay Area Mexican immigrants (i.e. conduct ethnographic research - observations, individual and group interviews - to describe experiences of oral health disparities, existing oral health understandings and system navigation); and 2) Develop foundational items for an OHL curriculum for delivery in ESL catchment areas and settings (present foundational items in ten (10) ESL classes serving Mexican immigrants; observe their engagement with these foundational aspects of a future curriculum and conduct 10 group interviews with adult ESL students for their views about each item).