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Quality of Life Research

, Volume 26, Issue 10, pp 2607–2618 | Cite as

Enrollment in early head start and oral health-related quality of life

  • Jacqueline M. BurgetteEmail author
  • John S. Preisser
  • Morris Weinberger
  • Rebecca S. King
  • Jessica Y. Lee
  • R. Gary Rozier
Article

Abstract

Purpose

Dental problems in young children are widespread and can negatively impact quality of life. We examined the effect of enrollment in North Carolina Early Head Start (EHS)—a federally funded early education program for children under three years of age and their families—on oral health-related quality of life (OHRQoL).

Methods

In this quasi-experimental study, we interviewed 479 EHS and 699 Medicaid matched parent–child dyads at baseline (children’s average age 10 months) and 24 months later. Parents reported OHRQoL using the Early Childhood Oral Health Impact Scale (ECOHIS), a 0–52 point scale with higher scores representing more negative impacts. We used a marginalized semicontinuous two-part model to estimate: (1) the effect of EHS on the probability of reporting any follow-up impacts (ECOHIS ≥ 1), and (2) the difference in overall mean ECOHIS follow-up scores. We controlled for baseline ECOHIS, language, and EHS and non-EHS group imbalances using a propensity score.

Results

At follow-up, negative OHRQoL impacts were more often reported by parents of non-EHS than EHS children (45 versus 37%, P < .01). In the adjusted model, EHS parents reported a lower odds of negative OHRQoL impacts (OR 0.70; 95% CI 0.52, 0.94). Mean adjusted ECOHIS scores were not significantly different (EHS: 1.59 ± 3.34 versus non-EHS: 2.11 ± 3.85, P > 0.05).

Conclusions

This study is the first to demonstrate that families of young children enrolled in EHS report improved OHRQoL compared to their non-enrolled peers. These results highlight the potential effectiveness of improving the quality of life of low-resource families through early childhood education.

Keywords

Early intervention Quality of life Child health services Disparities Oral health Healthcare disparities 

Notes

Acknowledgements

This research is supported by a grant from the National Institute of Dental and Craniofacial Research, Prevention of Dental Caries in Early Head Start Children, #R01 DE018236. This research was partially supported by a National Research Service Award Post-Doctoral Traineeship from the Agency for HealthCare Research and Quality sponsored by The Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, #T32 HS000032.

Disclosures

None of the authors has any financial interest related to the article.

Disclaimers

The views expressed in the article are those of the authors and do not necessarily reflect the views of the National Institute of Dental and Craniofacial Research or the University of North Carolina at Chapel Hill.

References

  1. 1.
    Locker, D., & Allen, F. (2007). What do measures of ‘oral health-related quality of life’ measure? Community Dentistry and Oral Epidemiology, 35(6), 401–411.CrossRefPubMedGoogle Scholar
  2. 2.
    Slade, G. (2002). Assessment of oral health-related quality of life. In M. Inglehart & R. Magramain (Eds.), oral health-related quality of life (p. 29). Carol Stream: Quintessence.Google Scholar
  3. 3.
    World Health Organization (2003). World health organization definition of health. http://www.who.int/about/definition/en/print.html. Accessed 3 June 2016.
  4. 4.
    Sheiham, A. (2005). Oral health, general health and quality of life. Bulletin of the World Health Organization, 83(9), 641.Google Scholar
  5. 5.
    Oral Health in America: A report of the Surgeon General (2000). Rockville, MD: U.S Department of Health and Human Services.Google Scholar
  6. 6.
    Locker, D. (1997). Concepts of oral health, disease and the quality of life. In G. Slade (Ed.), Measuring oral health and quality of life. Chapel Hill: University of North Carolina, Dental Ecology.Google Scholar
  7. 7.
    Barbosa, T. S., & Gaviao, M. B. (2008). Oral health-related quality of life in children: part II. Effects of clinical oral health status. A systematic review. International Journal of Dental Hygine, 6(2), 100–107.CrossRefGoogle Scholar
  8. 8.
    Onoriobe, U., Rozier, R. G., Cantrell, J., & King, R. S. (2014). Effects of enamel fluorosis and dental caries on quality of life. Journal of Dental Research, 93(10), 972–979.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Abanto, J., Tello, G., Bonini, G. C., Oliveira, L. B., Murakami, C., & Bonecker, M. (2015). Impact of traumatic dental injuries and malocclusions on quality of life of preschool children: A population-based study. International Journal of Paediatric Dentistry, 25(1), 18–28.CrossRefPubMedGoogle Scholar
  10. 10.
    Kramer, P. F., Feldens, C. A., Ferreira, S. H., Bervian, J., Rodrigues, P. H., & Peres, M. A. (2013). Exploring the impact of oral diseases and disorders on quality of life of preschool children. Community Dentistry and Oral Epidemiology, 41(4), 327–335.CrossRefPubMedGoogle Scholar
  11. 11.
    Scarpelli, A. C., Paiva, S. M., Viegas, C. M., Carvalho, A. C., Ferreira, F. M., & Pordeus, I. A. (2013). Oral health-related quality of life among Brazilian preschool children. Community Dentistry and Oral Epidemiology, 41(4), 336–344.CrossRefPubMedGoogle Scholar
  12. 12.
    Wong, H. M., McGrath, C. P., King, N. M., & Lo, E. C. (2011). Oral health-related quality of life in Hong Kong preschool children. Caries Research, 45(4), 370–376.CrossRefPubMedGoogle Scholar
  13. 13.
    Almaz, M. E., Sonmez, I. S., Oba, A. A., & Alp, S. (2014). Assessing changes in oral health-related quality of life following dental rehabilitation under general anesthesia. Journal of Clinical Pediatric Dentistry, 38(3), 263–267.CrossRefPubMedGoogle Scholar
  14. 14.
    Jankauskiene, B., Virtanen, J. I., Kubilius, R., & Narbutaite, J. (2014). Oral health-related quality of life after dental general anaesthesia treatment among children: A follow-up study. BMC Oral Health, 14, 81.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Cantekin, K., Yildirim, M. D., & Cantekin, I. (2014). Assessing change in quality of life and dental anxiety in young children following dental rehabilitation under general anesthesia. Pediatric Dentistry, 36(1), 12E–17E.PubMedGoogle Scholar
  16. 16.
    Klaassen, M. A., Veerkamp, J. S., & Hoogstraten, J. (2009). Young children’s oral health-related quality of life and dental fear after treatment under general anaesthesia: A randomized controlled trial. European Journal of Oral Sciences, 117(3), 273–278.CrossRefPubMedGoogle Scholar
  17. 17.
    Divaris, K., Lee, J. Y., Baker, A. D., & Vann, W. F. J. (2012). Caregivers’ oral health literacy and their young children’s oral health-related quality-of-life. Acta Odontologica Scandinavica, 70(5), 390–397.CrossRefPubMedGoogle Scholar
  18. 18.
    Kumar, S., Kroon, J., & Lalloo, R. (2014). A systematic review of the impact of parental socio-economic status and home environment characteristics on children’s oral health related quality of life. Health and Quality of Life Outcomes, 12, 41.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Mofidi, M., Rozier, R. G., & King, R. S. (2002). Problems with access to dental care for Medicaid-insured children: What caregivers think. American Journal of Public Health, 92(1), 53–58.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Mofidi, M., Zeldin, L. P., & Rozier, R. G. (2009). Oral health of Early Head Start children: A qualitative study of staff, parents, and pregnant women. American Journal of Public Health, 99(2), 245–251.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    The Early Head Start National Resource Center, Office of Head Start, Administration for Children and Families, U. S. Department of Health and Human Services (2016). About Early Head Start. http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/ehsnrc/about-ehs/about.html#about. Accessed 3 June 2016.
  22. 22.
    The Early Head Start National Resource Center, Office of Head Start, Administration for Children and Families, U. S. Department of Health and Human Services (2014). Early Head Start program facts for fiscal year 2012. https://www.acf.hhs.gov/sites/default/files/occ/ehs_program_fact_sheet_fy_2012.pdf?nocache=1365609925. Accessed 3 June 2016.
  23. 23.
    Love, J. M., & Brooks-Gunn, J. (2010). Getting the most out of early head start: What has been accomplished and what needs to be done. In R. Haskins & W. S. Barnett (Eds.), Investing in young children: New directions in federal preschool and early childhood policy (pp. 29–37). Rutgers: Brookings and National Institute for Early Education Research.Google Scholar
  24. 24.
    Love, J. M., Chazan-Cohen, R., Raikes, H., & Brooks-Gunn, J. (2013). What makes a difference: Early Head Start evaluation findings in a developmental context. Monographs of the Society for Research in Child Development, 78(1), 1–173.CrossRefGoogle Scholar
  25. 25.
    Love, J. M., Kisker, E. E., Ross, C., et al. (2005). The effectiveness of Early Head Start for 3-year-old children and their parents: Lessons for policy and programs. Developmental Psychology, 41(6), 885–901.CrossRefPubMedGoogle Scholar
  26. 26.
    Kranz, A. M., Rozier, R. G., Zeldin, L. P., & Preisser, J. S. (2011). Oral health activities of Early Head Start teachers directed toward children and parents. Journal of Public Health Dentistry, 71(2), 161–169.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Head Start Bureau, Administration on Children, Youth and Families, U.S. Department of Health and Human Services (2006). Oral health—RevisionACF-PI-HS-06-03. http://eclkc.ohs.acf.hhs.gov/hslc/standards/PIs/2006/resour_pri_00109_122006.html. Accessed 3 June 2016.
  28. 28.
    Born, C. D., Divaris, K., Zeldin, L. P., & Rozier, R. G. (2016). Influences on preschool children’s oral health-related quality of life as reported by English and Spanish-speaking parents and caregivers. Journal of Public Health Dentistry. doi: 10.1111/jphd.12152.PubMedGoogle Scholar
  29. 29.
    Ferrans, C. E., Zerwic, J. J., Wilbur, J. E., & Larson, J. L. (2005). Conceptual model of health-related quality of life. Journal of Nursing Scholarship, 37(4), 336–342.CrossRefPubMedGoogle Scholar
  30. 30.
    Friedman-Krauss, A., & Barnett, W.S. (2013). Early childhood education: Pathways to better health. National Institute for Early Education Research Policy Brief, Tech. Rep. Issue 25. New Brunswick, NJ: National Institute for Early Education Research.Google Scholar
  31. 31.
    Bronfenbrenner, Urie. (1977). Toward an experimental ecology of human development. American Psychologist, 32(7), 513–531.CrossRefGoogle Scholar
  32. 32.
    Pahel, B. T., Rozier, R. G., & Slade, G. D. (2007). Parental perceptions of children’s oral health: The early childhood oral health impact scale (ECOHIS). Health and Quality of Life Outcomes, 5, 6.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Gherunpong, S., Tsakos, G., & Sheiham, A. (2004). The prevalence and severity of oral impacts on daily performances in Thai primary school children. Health and Quality of Life Outcomes, 2, 57.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Kida, I. A., Astrom, A. N., Strand, G. V., Masalu, J. R., & Tsakos, G. (2006). Psychometric properties and the prevalence, intensity and causes of oral impacts on daily performance (OIDP) in a population of older Tanzanians. Health and Quality of Life Outcomes, 4, 56.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Slade, G. D., Nuttall, N., Sanders, A. E., Steele, J. G., Allen, P. F., & Lahti, S. (2005). Impacts of oral disorders in the United Kingdom and Australia. British Dental Journal, 198(8), 489–493.CrossRefPubMedGoogle Scholar
  36. 36.
    Soe, K. K., Gelbier, S., & Robinson, P. G. (2004). Reliability and validity of two oral health related quality of life measures in Myanmar adolescents. Community Dental Health, 21(4), 306–311.PubMedGoogle Scholar
  37. 37.
    Tsakos, G., Allen, P. F., Steele, J. G., & Locker, D. (2012). Interpreting oral health-related quality of life data. Community Dentistry and Oral Epidemiology, 40(3), 193–200.CrossRefPubMedGoogle Scholar
  38. 38.
    Batista, M. J., Lawrence, H. P., & de Sousa Mda, L. (2014). Impact of tooth loss related to number and position on oral health quality of life among adults. Health and Quality of Life Outcomes, 12, 165.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Lu, H. X., Xu, W., Wong, M. C., Wei, T. Y., & Feng, X. P. (2015). Impact of periodontal conditions on the quality of life of pregnant women: A cross-sectional study. Health and Quality of Life Outcomes, 13, 67.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Truong, A., Higgs, P., Cogger, S., Jamieson, L., Burns, L., & Dietze, P. (2015). Oral health-related quality of life among an Australian sample of people who inject drugs. Journal of Public Health Dentistry, 75(3), 218–224.CrossRefPubMedGoogle Scholar
  41. 41.
    Talekar, B., Rozier, R., & Zeldin, L. (2005). Spanish version of the early childhood oral health impact scale. Journal of Dentistry Research, 84, 2653.Google Scholar
  42. 42.
    Burgette, J. M., Preisser, J. S., & Rozier, R. G. (2016). Propensity score weighting: an application to an early head start dental study. Journal of Public Health Dentistry, 76(1), 17–29.CrossRefPubMedGoogle Scholar
  43. 43.
    Smith, V. A., Neelon, B., Preisser, J. S., & Maciejewski, M. L. (2015). A marginalized two-part model for longitudinal semicontinuous data. Statistical Methods in Medical Research. doi: 10.1177/0962280215592908.Google Scholar
  44. 44.
    Smith, V. A., Preisser, J. S., Neelon, B., & Maciejewski, M. L. (2014). A marginalized two-part model for semicontinuous data. Statistics in Medicine, 33(28), 4891–4903.CrossRefPubMedGoogle Scholar
  45. 45.
    Smith, V. A., & Preisser, J. S. (2015). Direct and flexible marginal inference for semicontinuous data. Statistical Methods in Medical Research. doi: 10.1177/0962280215602290.Google Scholar
  46. 46.
    Olsen, M. K., & Schafer, J. L. (2001). A two-part random-effects model for semicontinuous longitudinal data. Journal of the American Statistical Association, 96(454), 730–745.CrossRefGoogle Scholar
  47. 47.
    Goettems, M. L., Ardenghi, T. M., Romano, A. R., Demarco, F. F., & Torriani, D. D. (2011). Influence of maternal dental anxiety on oral health-related quality of life of preschool children. Quality of Life Research, 20(6), 951–959.CrossRefPubMedGoogle Scholar
  48. 48.
    Arrow, P. (2016). Responsiveness and sensitivity of the early childhood oral health impact scale to primary dental care for early childhood caries. Community Dentistry and Oral Epidemiology, 44(1), 1–10.CrossRefPubMedGoogle Scholar
  49. 49.
    Arrow, P., & Klobas, E. (2016). Child oral health-related quality of life and early childhood caries: A non-inferiority randomised control trial. Australian Dental Journal, 61(2), 227–235.CrossRefPubMedGoogle Scholar
  50. 50.
    Campbell, P., Conti, G., Heckman, J. J., Moon, S. H., Pinto, R., Pungello, E., et al. (2014). Early childhood investments substantially boost adult health. Science, 343(6178), 1478–1485.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Jacqueline M. Burgette
    • 1
    • 2
    • 3
    Email author
  • John S. Preisser
    • 4
  • Morris Weinberger
    • 2
  • Rebecca S. King
    • 2
  • Jessica Y. Lee
    • 1
    • 2
  • R. Gary Rozier
    • 2
  1. 1.Department of Pediatric Dentistry, School of DentistryUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Department of Health Policy and Management, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Cecil G. Sheps Center for Health Services ResearchUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Department of Biostatistics, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA

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