Enrollment in early head start and oral health-related quality of life
- 374 Downloads
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).
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.
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).
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.
KeywordsEarly intervention Quality of life Child health services Disparities Oral health Healthcare disparities
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.
None of the authors has any financial interest related to the article.
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.
- 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.World Health Organization (2003). World health organization definition of health. http://www.who.int/about/definition/en/print.html. Accessed 3 June 2016.
- 4.Sheiham, A. (2005). Oral health, general health and quality of life. Bulletin of the World Health Organization, 83(9), 641.Google Scholar
- 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.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
- 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
- 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.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.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
- 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.
- 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
- 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
- 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