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case1184352136.pdf (641.04 KB)
ETD Abstract Container
Abstract Header
Access/Utilization of Dental Care by Homeless Children
Author Info
DiMarco, Marguerite Ann
Permalink:
http://rave.ohiolink.edu/etdc/view?acc_num=case1184352136
Abstract Details
Year and Degree
2007, Doctor of Philosophy, Case Western Reserve University, Nursing.
Abstract
Homelessness in the United States has significantly increased with homeless women and children representing the fastest growing group. The Surgeon General’s report, Oral Health in America, declared dental caries the “silent epidemic” with the worst oral health found among the poor of all ages. A prospective repeated measures study elucidated predictors of oral health access, utilization, and oral health status for children in female-headed homeless families, and determined whether shelter-based care increased utilization. A convenience sample of 120 mother-child dyads was recruited from an urban shelter. Measured predictors based on the Behavioral Model for Vulnerable Populations were age of mother/child, oral health beliefs, ethnicity, education, family size, number of times homeless, victimization, substance abuse, mental health concerns, and insurance status. Access barriers, utilization, and oral health status were tested on intake and one month follow-up. Level of health and oral health status of homeless children residing at the shelter were measured at intake. Each child (N=236) had an average of 2-3 health problems (only 24 children had no health problems). Thus, the level of health of the homeless child was fair- to- poor. Dental caries (n=98) was the number one health and oral health problem of homeless children. Ten independent variables explained 33% of the variance in Access Barriers to Care. The three most influential predictors of Access were Mental Health of Mother (B=-.43), Maternal Oral Health Beliefs (B=-.24), and Maternal Victimization (B=.19). Ten independent variables explained 24.3% of the variance of oral health status. Mother’s age (B=.35), number of children at the shelter (B=.34), and race (B=.15) had the most influence. Few families (n=9) actually utilized oral health services within one month. Nonetheless, shelter-based care was effective in improving access to dental care because 43% of families were able to secure dental appointments. Perceived access barriers decreased after Pediatric Nurse Practitioner care (p <.001). Predictors of access and oral health status in homeless children were identified and can guide nursing strategies to reduce health disparities among shelter-based homeless children.
Committee
Susan Ludington (Advisor)
Subject Headings
Health Sciences, Nursing
Keywords
Oral Health
;
HOMELESS
;
Oral Health Status
;
DENTAL CARE
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Citations
DiMarco, M. A. (2007).
Access/Utilization of Dental Care by Homeless Children
[Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1184352136
APA Style (7th edition)
DiMarco, Marguerite.
Access/Utilization of Dental Care by Homeless Children.
2007. Case Western Reserve University, Doctoral dissertation.
OhioLINK Electronic Theses and Dissertations Center
, http://rave.ohiolink.edu/etdc/view?acc_num=case1184352136.
MLA Style (8th edition)
DiMarco, Marguerite. "Access/Utilization of Dental Care by Homeless Children." Doctoral dissertation, Case Western Reserve University, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=case1184352136
Chicago Manual of Style (17th edition)
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Document number:
case1184352136
Download Count:
1,712
Copyright Info
© 2007, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.