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Access/Utilization of Dental Care by Homeless Children
| Title: | Access/Utilization of Dental Care by Homeless Children |
| Author: | DiMarco, Marguerite Ann |
| Description: | Homelessness in the United States has significantly increased with homeless women and children representing the fastest growing group. The Surgeon General’s report, Oral Health in America, declared dental caries the “silent epidemic” with the worst oral health found among the poor of all ages. A prospective repeated measures study elucidated predictors of oral health access, utilization, and oral health status for children in female-headed homeless families, and determined whether shelter-based care increased utilization. A convenience sample of 120 mother-child dyads was recruited from an urban shelter. Measured predictors based on the Behavioral Model for Vulnerable Populations were age of mother/child, oral health beliefs, ethnicity, education, family size, number of times homeless, victimization, substance abuse, mental health concerns, and insurance status. Access barriers, utilization, and oral health status were tested on intake and one month follow-up. Level of health and oral health status of homeless children residing at the shelter were measured at intake. Each child (N=236) had an average of 2-3 health problems (only 24 children had no health problems). Thus, the level of health of the homeless child was fair- to- poor. Dental caries (n=98) was the number one health and oral health problem of homeless children. Ten independent variables explained 33% of the variance in Access Barriers to Care. The three most influential predictors of Access were Mental Health of Mother (B=-.43), Maternal Oral Health Beliefs (B=-.24), and Maternal Victimization (B=.19). Ten independent variables explained 24.3% of the variance of oral health status. Mother’s age (B=.35), number of children at the shelter (B=.34), and race (B=.15) had the most influence. Few families (n=9) actually utilized oral health services within one month. Nonetheless, shelter-based care was effective in improving access to dental care because 43% of families were able to secure dental appointments. Perceived access barriers decreased after Pediatric Nurse Practitioner care (p <.001). Predictors of access and oral health status in homeless children were identified and can guide nursing strategies to reduce health disparities among shelter-based homeless children. |
| Permanent Link: |
http://rave.ohiolink.edu/etdc/view?acc_num=case1184352136
http://hdl.handle.net/2374.OX/17644 |
| Date: | 2007 |
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