Using Community-Based Participatory Research to address oral health disparities

Objectives: Community-Based Participatory Research (CBPR) has been viewed as an effective approach in bridging the existing divide between the knowledge gained from research and the reduction of existing health disparities in local communities. A trans-disciplinary approach grounded in the principles of CPBR was used in the development of MySmileBuddy, an interactive mobile computer tablet application that seeks to increase the capacity of community health workers (CHWs) in pediatric oral health promotion through linguistically and culturally relevant 1) Early Childhood Caries (ECC) risk assessment, 2) family oriented oral health education, and 3) tailored goal setting. Methods: Seven focus groups with local parents of young children, Head Start staff, CHWs, and dental safety net providers and staff were held over a period of 20 months. Five sessions were conducted during the community assessment and development phase and two during the evaluation phase of the MySmileBuddy prototype. Identified themes were categorized into three domains: 1) development of community strengths and resources, 2) co-learning and capacity building, and 3) balancing data collection and intervention effectiveness. Results: CHWs initially perceived their responsibility as connecting families to dental offices and that all services including prevention, oral health promotion, management and repair fell upon the responsibility of the dentist. Interestingly, parents reported being more comfortable discussing oral health issues and solutions with CHWs than dentists. Ten of the original 26 variables were included in the final MySmileBuddy model in order to increase local relevancy and provide additional time and flexibility for the conversational style used by CHWs in family assessments. Conclusion: CBPR requires significant investment and attention but this applied approach is successful in validating the role of CHWs in MySmileBuddy and increasing their capacity in pediatric oral health. CBPR assists in targeting community specific ECC risk factors, creating sustainable partnerships, and reducing oral health disparities.