Reciprocal Innovation – Dental Caries Prevention Program Tailored to Rural Indigenous Communities in Mexico2020-08-12T13:53:19-04:00

Dental Caries Prevention Program Tailored to Rural Indigenous Communities in Mexico

Principal Investigator Dr. Esperanza Angeles Martinez-Mier
International Collaborator(s)
Project Title Dental Caries Prevention Program Tailored to Rural Indigenous Communities in Mexico
Priority Area Prevention
The Intervention This project plans to learn from the experiences with promotora-led education in the US and train community oral health promotoras in indigenous rural communities in Yucatan, Mexico. These promotores, i.e. trained lay health educators from the local community, will be immersed in the sociocultural context of the population, which will enhance the actions and strategies developed by our research team. These health educators from the local community, is a culturally appropriate approach to delivery of health interventions, and has been shown to be effective at creating behavior change for other (non-dental) health conditions.
Key Facilitators This intervention is being piloted in Yucatan rural towns in Mexico. The Indiana CTSI is developing a program focused on reciprocal innovation that seeks to support the indentification, adaptation, implementation, and evaluation of promising interventions developed at LMIC partner sites for use in Indiana. This infrastructure provides funding and other resoruces to adapt interventions to a US context. Additional partners include international partnership between the UADY and the Bionational/cross-Cultural Health Enhancement Center at IUPUI.
Target Population Children and parents will be invited to participate in the study until we reach 40 pairs. The number is based on budgetary constraints and number of children per class in our target school (20 to children per class for 4 grades for a 30% participation rate – which we have obtained in the past). In order to participate children must: a) Have signed an informed consent (parent) and the authorization for the release of health information for research and provide medical and dental history information prior to their participation; b) Be between 6-10 years old and in general good health; c) Be willing and capable of receiving a dental exam; and, d) Agree to comply with all subjects responsibilities as stated in the protocol (e.g. attendance at appointments, etc).The “promotores” in this project, will be mainly parents of a student in first grade.
Process to Implementation This intervention has not yet been implemented in Indiana but is being piloted in Mexico. If the pilot findings show positive outcomes, potential exists to apply this intervention to low resourced clinical settings in Indiana and the US. Following identification of potential pilot sites in Indiana, this intervention could be adapted and piloted for use in the US clinical context using support from the Indiana CTSI and other health partners in Indiana, e.g. dental programs, State Department of Health, IU Health, Eskenazi, and other public health and dental centers.
Key Stakeholders Stakeholders include adolescent patients, their caregivers, and dental partners. We anticipate in transferring to the US that there would need to be similar stakeholders that would need to be engaged within the dental health systems.
Scaled or Transferred? The aim is to work toward scaling this process into the US setting.
Type of Research This project aims to utilize a combination of approaches that include intervention strategies, education, and services targeted to the specific community needs. Fluoride applications are key components of oral health programs; and there is sufficient evidence supporting their effectiveness. When fluoride is used as a preventive measure, the threshold below which sugar can be used safely increases. They are an intervention particularly suitable for use in remote rural populations, since they are low-cost, easily transportable, included in many countries’ basic oral health schemes and can be applied by non-dental personnel after the appropriate training. Additoinally, training health educators from the local community, is a culturally appropriate approach to delivery of health interventions, and has been shown to be effective at creating behavior change for other (non-dental) health conditions.
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