Impact of an Oral Health Education Program on the Oral Health Literacy of Refugees

Romana Muller; Lisa Bilich; Merri Jones

doi:10.1007/s10903-024-01594-6

Impact of an Oral Health Education Program on the Oral Health Literacy of Refugees

J Immigr Minor Health. 2024 Apr 8. doi: 10.1007/s10903-024-01594-6. Online ahead of print.

Authors

Romana Muller¹, Lisa Bilich², Merri Jones²

Affiliations

¹ Missouri School of Dentistry & Oral Health, St. Louis Dental Center, A.T. Still University1500 Park Ave, St. Louis, MO, 63104, USA. rmuller@atsu.edu.
² Eastern Washington University, 310 N. Riverpoint Blvd. Box E, Spokane, WA, 99202, USA.

PMID: 38589753
DOI: 10.1007/s10903-024-01594-6

Abstract

Inadequate comprehension of healthcare information contributes to poor health outcomes. Ethnic minorities are one of the populations most affected by low health and oral health literacy (OHL). The hypothesis of the current study was that an oral health education program (OHEP) can improve the OHL, oral health awareness and behaviors of refugees. We also hypothesized that there will be a difference between OHL in English and native language in the Pre-intervention phase. Fifty-two adult refugees participated in an educational program that included a comprehensive and culturally sensitive PowerPoint presentation and hands-on learning activities on oral health topics. The study used a cross-sectional pre-post study design. Before the program (Pre-intervention group), participants completed 2 surveys: Sociodemographic Survey and Oral Health Perceptions of Refugees in a bilingual format, and the Estimate of Oral Health Literacy-Bilingual40 (EOHL-BL40) in English, and in the participants' native language. Immediately after an OHEP (Post-intervention group), participants completed the EOHL-BL40 survey in English only. Two weeks after OHEP (Follow-up intervention), participants completed again the Sociodemographic Survey and Oral Health Perceptions of Refugees and the Estimate of Oral Health Literacy-Bilingual40 (EOHL-BL40) in English only. The mean percentage of words understood on Pre-intervention EOHL-BL40 survey were significantly higher in native languages (47.3% ±3.7%) compared with survey in English (15.3% ±1.2%, P < 0.001). Post-intervention scores, immediately after educational program, were higher (28.6% ±2.4%), P < 0.001) for survey in English compared with the Pre-intervention (15.3% ±1.2%). The follow-up (2 weeks later) scores (25.5% ±2.4) were slightly lower than Post-intervention but still significantly higher (P < 0.001) than Pre-intervention. Results for both Sociodemographic Survey and Oral Health Perceptions of Refugees surveys were similar: the OHEP positively affected oral health awareness and oral health behaviors. Results of the study suggested that OHEP may improve oral health literacy, oral health awareness, and personal oral hygiene practices of refugees.

Keywords: Communication barriers; Limited English proficiency; Oral health education; Oral health literacy; Oral health literacy assessment; Refugees and immigrants.