Recruiting rural dentally-avoidant adolescents into an intervention study

Abstract

Aim: To carry out a study designed to test an intervention to increase dental attendance in rural dentally-avoidant adolescents, to identify and recruit eligible adolescents.

Study design and methods: This study used a cross-sectional design to identify eligible adolescents. A total of 2,762 adolescents (60% of the enrolled students) from junior high and senior high schools in a rural county in Washington State (USA) were given a dental examination with a light and mirror by calibrated dental examiners using WHO criteria. Parents of children with serious dental needs were urged to seek dental care for their adolescent children. They were offered the chance to enroll their child in a study comparing two programs designed to help the adolescent decide whether to seek out dental care. A second group of emancipated adolescents and young adults (aged < 26 years) receiving services at the local college and health department was also screened, and eligible individuals were also offered the chance to enroll.

Results and statistics: Only 23 (6%) of 357 eligible junior and senior high school adolescents enrolled, compared with 24 (67%) of the 36 eligible emancipated adolescents and young adults. A second follow-up letter was sent to the 85 parents of un-enrolled adolescents with the most severe caries, offering direct assistance in obtaining dental care for their children; only 3 families responded.

Conclusions: This study illustrates the difficulty in engaging adolescents in their oral health and utilization of oral health interventions. The results also suggest that slightly older rural individuals are more interested in and/or able to overcome barriers to seeking out dental care. Alternative strategies are suggested for recruiting avoidant adolescents.