Evaluating An Intervention to Address Early Childhood Caries in Aboriginal Children

Objectives: In 2004, through the joint effort of Health Canada and First Nations and Inuit (FN/I) communities, a community-based preventive program, the Children’s Oral Health Initiative (COHI), was introduced to reduce the high prevalence early childhood caries in Aboriginal children. The program’s objective is to increase access to preventive oral health services (counselling, fluoride varnish, sealants, ART) provided to FN/I children and caregivers living on federal reserves and in remote communities. Communities must request the program and agree to support the training of a lay community health worker known as the COHI Aide. COHI targets preschool children; 5-7 year olds; pregnant women; and parents/caregivers. The aim of the study was to evaluate the effectiveness of COHI in improving access to preventive dental services for FN/I children.

Methods: Federal data from 2006 – 2013 was collected. Improvement in access to care was evaluated by quantifying the number of eligible communities enrolled in COHI and assessing changes in the number over time. Measures of improved access to care were also evaluated with descriptive statistics giving counts and percentages of preventive procedures (counselling, fluoride varnish, sealants, ART) performed for the eligible population.

Results: COHI was piloted in 41 communities in 2004. By 2014, the program had expanded to 320 FN/I communities, which represents 55% of all eligible FN/I communities across Canada. By 2012, 23,085 FN/I children (50% of the eligible population) had received COHI preventive oral health services.
Conclusions: The results demonstrate COHI’s success as a preventive oral health care delivery model in remote communities. It has also demonstrated the successful development of a sustained preventive dental presence in FN/I communities, the COHI Aide.