Dental hesitancy: a qualitative study of culturally and linguistically diverse mothers

Kanchan Marcus; Madhan Balasubramanian; Stephanie D Short; Woosung Sohn

doi:10.1186/s12889-022-14513-x

Dental hesitancy: a qualitative study of culturally and linguistically diverse mothers

BMC Public Health. 2022 Nov 28;22(1):2199. doi: 10.1186/s12889-022-14513-x.

Authors

Kanchan Marcus^{1

2}, Madhan Balasubramanian^{3

4}, Stephanie D Short⁴, Woosung Sohn^{5

4}

Affiliations

¹ Population Oral Health, Faculty of Medicine and Health, The University of Sydney School of Dentistry, Surry Hills, NSW, Australia. kver2593@uni.sydney.edu.au.
² Menzies Centre for Health Policy and Economics, School of Public Health, The University of Sydney, Camperdown, NSW, Australia. kver2593@uni.sydney.edu.au.
³ Health Care Management, College of Business, Government and Law, Flinders University, Adelaide, Australia.
⁴ Menzies Centre for Health Policy and Economics, School of Public Health, The University of Sydney, Camperdown, NSW, Australia.
⁵ Population Oral Health, Faculty of Medicine and Health, The University of Sydney School of Dentistry, Surry Hills, NSW, Australia.

Abstract

Background: Oral healthcare is paramount and inextricably linked to well-being. Yet, the evidence indicates that culturally and linguistically diverse (CALD) migrant communities have unequal access to mainstream dental services due to several barriers. The purpose of this study was to investigate the oral healthcare experiences, attitudes and barriers to oral healthcare utilisation in CALD mothers.

Methods: A qualitative study with semi-structured interviews was conducted within a social constructivism epistemology. CALD mothers who identified as non-English speaking, foreign country born, with a child under 12, were recruited though purposive snowball sampling. Questions probed oral healthcare experiences, barriers, enablers, and attitudes. Verbatim typed transcripts were thematically analysed using grounded methodology.

Results: Thirty-three CALD mothers participated; twenty from India, five from Fiji, four from China, two from Nepal and one each from Israel and Macedonia. Languages included Cantonese, Fiji-Hindi, Gujrati, Hebrew, Hindi, Kannada, Mandarin, Maharashtrian, Macedonian, Nepalese, Punjabi, Sanskrit, Telegu and Urdu. Cost was the foremost barrier to oral healthcare services, followed by Confidence in quality care for the provision of services and treatment. Confusion in navigating a public and private healthcare system was highlighted and Competing priorities took precedence. Complacency referred to 'no need' or lack of urgency in dental care. Subsequently, dental hesitancy (superordinate theme) described the patterning of data as comprising the five 'C' factors and was theorised as the dental hesitancy phenomenon to explain the occurrence of delay or avoidance in utilising dental care.

Conclusion: Findings highlight the utility of the dental hesitancy phenomenon unearthed within this study. CALD mothers explained five 'C' dimensions: cost, confidence, confusion, competing priorities and complacency as barriers to accessing timely dental care. Multisectoral collaboration between healthcare systems, universal health coverage and primary sector support is required to address dental hesitancy in CALD mothers. Further, this study contributes to the field of behavioural and social sciences in oral health and augments the literature on dental avoidance.

Keywords: Access; CALD; Dental hesitancy; Healthcare disparities; Oral health; Qualitative.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Female
Health Facilities*
Humans
Language
Mothers*
Parturition
Pregnancy
Qualitative Research