“More than Just a Tooth Problem”: A Theory-Based Qualitative Study Exploring Dental Perceptions at a FQHC Público
Kashfipour, Yasmin (Spring 2019)
Abstract
Introduction: Oral health remains a critical problem in public health, especially in low income or impoverished populations. Research has proven that there is a direct link between oral health and one’s systemic health and well-being. Health seeking behavior and the anxiety related to visiting the dentist remains an enigmatic topic in health care. In addition, the rising cost of health care adds another dynamic that affects how people seek oral health care. Research shows that health seeking behavior has direct effect on health outcomes. Although there are community health centers known as FQHC’s (federally qualified health care centers) that were created to help address the financial barrier to health care, there are little resources available that address the factors that contribute to oral health-seeking behavior. The HEALing Community Center was established in 2015 to help address some of these issues and aid people seeking comprehensive care, in overcoming some of the psychosocial and financial barriers that some may face when seeking dental treatment.
Objective: This study explores the dental health perceptions of low-income women of the HEALing Community Center through the application of Theory of Planned Behavior. Furthermore, this study aims to understand the motivations along with socio-contextual factors that determine health seeking behavior of receiving dental care, specifically at HEALing Community Center. Lastly, the study examines the dental habits of women and how this can lead to overall better health of their families.
Methods: Qualitative methods were used to collect primary data through semi-structured, one-on-one interviews with women who seek oral health care at the HEALing Community Center. Interview questions addressed the constructs of Theory of Planned Behavior. Thematic analysis was carried out utilizing MAXQDA software in which codes would be used to create a comprehensive codebook for analysis purposes.
Results: Five themes emerged regarding determinants that influence women to seek care at the HEALing Community Center, women’s perceptions of dental care, and the socio-contextual factors that influence individuals to seek care at HEALing Community Center, including: Dental Anxiety, Friends and Family Influence, Aesthetics, Quality of Services, and Lessons Learned
Conclusions: Based on these findings, it is essential to understand that friends and family influence, quality of services, aesthetics, and lessons learned are factors that play a role in dental health seeking behavior amongst low-income women. This suggests that it may be best to provide more effective health promotion methods, locate FQHCs in disproportionately affected areas of Atlanta, and provide educational services and better access to care.
Table of Contents
Chapter 1: Introduction…………………………………………………………………8
Problem Definition………………………………………………………….......8
Scope of the Problem…………………………………………………………...8
Theory of Planned Behavior as a Theoretical Framework……………………..9
Statement of Problem………………………………………………………….10
Research Aim………………………………………………………………….11
Chapter 2: Review of the Literature…………………………………………………..12
The Evolution of Oral Health…………………………………………………12
Diseases of Oral Cavity……………………………………………………….13
Dental Health Behavior……………………………………………………….15
US Healthcare System and Dental Care………………………………………16
Status of Oral Health in the United States…………………………………….18
State of Georgia’s Oral Health………………………………………………..19
Public Health Significance of FQHCs………………………………………...20
Building Bright Smiles through Oral Health Education………………………21
Public Health Significance……………………………………………………22
Chapter 3: Research Methods…………………………………………………………24
Study Design…………………………………………………………………..24
Sampling & Recruitment……………………………………………………...24
Data Collection & Measures………………………………………………….25
Confidentiality………………………………………………………………..26
Potential Risks/Discomforts to Study Participants…………………………...26
Benefits………………………………………………………………………26
Compensation………………………………………………………………...27
Data Analysis: Data Management and Monitoring…………………………..27
Analysis/Statistical Plans……………………………………………………..27
Student Contribution…………………………………………………………28
Chapter 4: Thesis Manuscript…………………………………………………………29
Chapter 5: Public Health Implications………………………………………………..51
Recommendations……………………………………………………………52
Limitations…………………………………………………………………....53
References……………………………………………………………………………….54
Appendices……………………………………………………………………………....58
Appendix A. Eligibility Survey………………………………………………58
Appendix B. Interview Guide………………………………………………...60
Appendix C. Codebook……………………………………………………....63
About this Master's Thesis
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