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Volume 2: No. 2, April 2005
SPECIAL TOPICS
ORIGINAL RESEARCH: FEATURED
ABSTRACT FROM THE 19TH NATIONAL CONFERENCE ON CHRONIC DISEASE
PREVENTION AND CONTROL
Reducing Dental Sealant Disparities in School-aged Children
Through Better Targeting of Informational Campaigns
Kari Jones, Susan Griffin, Ramal Moonesinghe, Freder Jaramillo, Claudia
Vousden
Suggested citation for this article: Jones K, Griffin
S, Moonesinghe R, Jaramillo F, Vousden C. Reducing dental sealant disparities
in school-aged children through better targeting of informational
campaigns [abstract]. Prev Chronic Dis [serial online]
2005 Apr [date cited]. Available from: URL: http://www.cdc.gov/pcd/issues/2005/
apr/04_0142p.htm.
PEER REVIEWED
Track: Communications and Technology
The objective of this study was to investigate whether
disparities in receipt of dental sealants among school-aged
children are linked to caregivers’ knowledge of the
preventive purpose of sealants. These findings may be used to
better target oral health education campaigns.
Using data from the National Health and Nutrition Examination Survey
(NHANES) 1999–2000, we estimated sealant prevalence among children aged six to 17
years who had at least one tooth eligible for a sealant. We then identified the
explanatory factors (main effects model) associated with knowledge of sealants
among caregivers of children aged less than 18 years using data
from the 2003 ConsumerStyles, HealthStyles, and Recontact
marketing surveys and logistic regression. We stratified the data
from the marketing surveys on sealant knowledge and the NHANES data on
sealant prevalence by race/ethnicity and income (whether ≥
or < 200% of the 2003 federal poverty guidelines), the two significant
explanatory factors common to both data sets (P < .001 for race/ethnicity
and P = .01 for income).
Over the full study sample, sealant knowledge was 62.5%, and
sealant prevalence was 31%. Caregivers’ race/ethnicity,
age, marital status, education, income, and sex were
significant predictors of sealant knowledge. Both sealant
knowledge and prevalence were positively associated with income
level. Among higher-income families, 71% of caregivers exhibited
sealant knowledge compared with 47% of their low-income
counterparts; 42% of higher-income children had sealants compared
with 22% of their low-income counterparts. Among higher-income
families, sealant prevalence among children was positively
associated with caregiver knowledge (r = 0.973).
Non-Hispanic whites had the highest caregiver knowledge (78%) and
highest sealant prevalence (49%) in this group; non-Hispanic
blacks had the lowest caregiver knowledge (41%) and sealant
prevalence (22%). Among low-income families, there was no
association between caregiver knowledge and sealant
prevalence.
Current sealant prevalence is well below the Healthy People
2010 objective of 50%. We found disparities in both knowledge
and prevalence of sealants by race/ethnicity and income. The
positive association between sealant knowledge and prevalence for
higher-income families is consistent with the economic principle
that demand for sealants increases with knowledge of their
benefit. The lack of an association between sealant prevalence
and knowledge among low-income families may reflect higher levels
of public provision of sealants to this group. This suggests that
informational campaigns could increase demand for sealants in
both income groups. Additionally, efficient
targeting — targeting groups with the lowest demonstrated
knowledge — should also help eliminate disparities. This
information is useful to oral health coalitions funded by the Centers for
Disease Control and Prevention in
many states to promote oral health and eliminate
oral health disparities.
Corresponding Author: Kari A. Jones, PhD, Research Economist,
Centers for Disease Control and Prevention, Division of Public
Private Partnerships, 4770 Buford Hwy NE, MS K-39, Atlanta, GA 30341-3724. Telephone: 770-488-2404. E-mail: cqo3@cdc.gov.
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