Provider perspectives on cultural adaptation of oral health interventions and the impact of COVID-19 on oral care among American Indian children

Thomas, Heather Rae (2023) Provider perspectives on cultural adaptation of oral health interventions and the impact of COVID-19 on oral care among American Indian children. Doctoral thesis, Northern Arizona University.

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Abstract

Early childhood caries (ECC) is a chronic childhood disease that is most prevalent among American Indian and Alaska Native (AI/AN) populations. Despite recent declines in ECC rates nationally and among other high-risk groups, the rates of ECC among AI/AN populations persist at greater levels. The implications of ECC are far-reaching, affecting the overall physical and mental wellbeing, social and functional development of the individual, as well as contributing to economic loss. Interventions utilizing a variety of approaches to address ECC among AI/AN populations have shown mixed results, but few have explored the possibility of creative cultural adaptation of oral health education materials to improve the oral health of AI/AN children. The use of Entertainment Education (E-E) and specific cultural adaptation of intervention materials have shown success in improving health behaviors of marginalized and disadvantaged populations and may be successfully utilized to reduce ECC in AI/AN populations. Access to oral care has been a longstanding barrier for AI/AN populations which has recently worsened due to the effects of COVID-19. This dissertation had three Specific Aims: 1. Develop an entertaining and culturally and contextually adapted children’s book with infused oral health education that is perceived by Tribal members and local oral health care providers as acceptable, understandable, and culturally relevant. 2. Assess the differences of access to and quality of dental care for young AI children before and during COVID-19. 3. Determine perceived barriers to oral healthcare for young AI children and the strategies dental professionals recommend to overcome them.

Item Type:	Thesis (Doctoral)
Publisher’s Statement:	© Copyright is held by the author. Digital access to this material is made possible by the Cline Library, Northern Arizona University. Further transmission, reproduction or presentation of protected items is prohibited except with permission of the author.
Keywords:	Dental caries; American Indian children; Alaka Native children
Subjects:	R Medicine > RK Dentistry
MeSH Subjects:	N Health Care > N06 Environment and Public Health
NAU Depositing Author Academic Status:	Student
Department/Unit:	Graduate College > Theses and Dissertations College of Health and Human Services > Dental Hygiene
Date Deposited:	20 Oct 2025 17:42
Last Modified:	20 Oct 2025 17:42
URI:	https://openknowledge.nau.edu/id/eprint/6219

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