Community Based Participatory Research to Reduce Oral Health Disparities in American Indian Children

Abstract

Community based participatory research is an approach aimed to equitably involve community members, representatives, and academic researchers in all aspects of the research process. Using this methodology can help integrate cultural knowledge into interventions, supporting researchers to effectively partner with communities in addressing health disparities. The Center for Native Oral Health Research (CNOHR) collaborates with two American Indian (AI) tribes to advance oral health knowledge and practice, including the conduct of randomized controlled clinical trials of culturally sensitive behavioral interventions for primary prevention of early childhood caries (ECC). This manuscript describes the development of researcher-community partnership, and the development and implementation of the two clinical trial in the community. It also gives a detailed account of the strategies developed through the community input in recruitment and retention of the study participants and finally the lessons learnt during the study implementation.

Keywords: American Indian; Center for native oral health research; Community advisory board; Community based participatory research; Early childhood caries.

Figure 1

Where did CNOHR I field staff recruit study participants. OB ward: Research staff recruited participants at the maternity ward at the Indian Health Services Hospital. Women, Infant and Child program (WIC): Research staff recruited participants at the WIC. Native Women’s Health (NWH): Research staff recruited participants at the NWH. Ongoing programs in the community: Research staff recruited participants from other programs in the community. Other –Random contact with staff in the community, recruitment at immunization clinic and walk-ins to the field office.

Figure 2

How were participants retained in CNOHR Study II. Letter sent home: personalized letters sent to each participant’s house. Email, Phone and texting: Phone calls, email, or text message from staff member asking participant to make an appointment. Home Visit: Unscheduled drop-in visit to participant home. Other: Includes participant remembering about the study from previous contact, hearing a radio ad, running into a staff member during another home visit, and word of mouth.