Jeffrey Gage

Epidemiology of dental caries among adolescents in Tamil Nadu, India

OBJECTIVE Economic and dietary changes in the Indian state of Tamil Nadu have led to compromised oral health status of the adolescent population. Adequate epidemiological data are not available to address the prevention or treatment needs in this region of India. The aim of this study was to measure the prevalence and severity of dental caries among adolescents of Tamil Nadu, a southern state of India. METHODS The study sample included 974 adolescent school students (12-15 years of age) from both rural and urban areas of Tamil Nadu, India. The decayed, missing and filled teeth (DMFT) index of these students was measured using the World Health Organization oral health survey method, in a quantitative cross-sectional study. RESULTS The oral health survey indicated that the prevalence of dental caries among adolescents in rural and urban areas of Tamil Nadu was 61.4%, with an average DMFT score of 2.03. Multiple regression analyses indicated factors such as gender, mothers education, type of school and caste as significant predictors of dental caries. CONCLUSION Female gender, Scheduled Caste and Tribes attending public schools in rural areas were identified as the more vulnerable populations to be affected by dental caries. Oral health policies should be targeted to these adolescent populations in the Tamil Nadu region.

Applying Community-Based Participatory Research to Create a Diabetes Prevention Documentary with New Zealand Māori

Background: Type 2 diabetes is almost three times more prevalent in the indigenous people of New Zealand (Māori) than non-Māori. Despite the high rate of diabetes in the Māori population, little is known about their personal understanding or experience of the disease. Objectives: To engage Māori in a participatory process to develop a culturally relevant diabetes prevention documentary. Methods: Principles of community-based participatory research (CBPR) were applied to a qualitative research design employing key informant interviews and focus groups to develop a diabetes prevention documentary. Conclusions: A CBPR approach provides an appropriate model for enacting local action-oriented approaches in the creation of a documentary that reflects Māori cultural beliefs and practices.

“I Want to Walk with My Moko.” The Application of Social Cognitive Theory in the Creation of a Diabetes Prevention Documentary with New Zealand Māori

Type 2 diabetes is almost three times more prevalent in the indigenous people of New Zealand (Māori) than non-Māori. Despite the high rate of diabetes there is a low level of diabetes knowledge and awareness in the Māori community. Several studies of Māori health identify a need for new health communication approaches to diabetes prevention in order to reduce the gap between Māori and non-Māori disease rates. We applied a Community-Based Participatory Research (CBPR) framework and behavioral theory to create a culturally appropriate documentary for Māori at risk for type 2 diabetes. We discuss how we utilized Bandura’s social cognitive theory to provide a culturally sensitive theoretical basis for behavior change messaging. We outline why social cognitive theory was a culturally appropriate foundation and describe the role of the community in shaping the documentary messaging. A culture-centered approach utilizing participatory methodologies and culturally sensitive behavioral change theory might serve as a model for creating health communication resources in collaboration with other indigenous communities.

Head Teachers' Views of Oral Health Education in Schools in Tamil Nadu, India.

Introduction: Children and young people in India have a high prevalence of dental decay. As part of a broader epidemiological study, we interviewed 10 head teachers to understand the status of, and challenges to, inclusion of oral health education in the curricula of public and private schools in Tamil Nadu, India. Objectives: The two main objectives of this study were (1) to describe the views of head teachers about the implementation of oral health education in school curricula and (2) to identify challenges to achieving oral health education in public and private schools in Tamil Nadu. Method: Qualitative descriptive design, with a purposive sample of 10 head teachers who participated in semi-structured interviews. Thematic coding was used to analyse and report on the data. Results: There is a lack of oral health education in public and private schools in Tamil Nadu, India. Four main types of barriers to the initiation and implementation of oral health education were lack of recognition, academic burden, prioritisation of other health needs and policy inequities. Head teachers acknowledged the lack of oral health education in their schools, yet also acknowledged the importance of oral health education in promoting students’ health. Conclusion: Health curricula in Tamil Nadu schools lack integration of oral health education. Limited access to the services, cultural factors, policy deficiencies, insufficient awareness among policy-makers, the nature of the education system and lack of research contribute to the current situation. Policy-makers should address these barriers to enable and promote oral health education strategies in both private and public schools of Tamil Nadu.