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Dental Public Health Activities: Descriptive Summaries

Partnerships and Cultural Relevancy: Changing Perceptions of Oral Health within a Native American Tribe

Practice Number: 04008
Submitted By: Partnerships and Cultural Relevancy: Changing Perceptions of Oral Health within a Native American Tribe
Submission Date: March 2019
Last Reviewed: March 2019
Last Updated: March 2019
Best Practice Approach Example Partnerships and Cultural Relevancy: Changing Perceptions of Oral Health within a Native American Tribe
 

Native American children have some of the highest dental caries rates in the United States; estimated to be four times higher than the national average. Project Zero—Women & Infants (PZWI), a Perinatal Infant Oral Health Quality Improvement (PIOHQI) grant embarked on a partnership with a Native American Tribe located in northern Arizona to address this preventable disease.

The Tribal Department of Health and Human Services, Women Infants and Children (WIC), Community Health Representatives (CHR), Head Start, judicial system; local Indian Health Services (IHS) Dental and Nutrition Departments; Northern Arizona University, Department of Dental Hygiene and Arizona American Indian Oral Health Coalition supported by PZWI set-out to improve oral health on their Reservation. Initially, PZWI’s goal was to assist the Tribe in making a systemic change as they integrated oral health into their primary care.

Though regular facilitated discussions centered on the oral health needs of the population, this project matured organically leading to 1) Continuous Quality Improvement (QI) training, 2) fluoride varnish application training, 3) culturally relevant oral health education and awareness campaign, 4) warm hand-off referral to the IHS Dental Department and 5) judicial system changes.

The inclusion of the Tribal judicial system and the broad awareness and educational campaign caused us to recognize that the Tribe was engaged in making a cultural shift in how their people viewed oral health. PZWI was instrumental in this shift by facilitating in-person and web communication between agencies and offices; organizing and facilitating meetings; providing training and presentations; and developing culturally relevant educational materials. PZWI is a PIOHQI project funded by the U.S. Department of Health, Health Resources and Services Administration Grant #H47MC2918.

Lessons Learned:

Clearly, the most significant lesson learned is to respect Tribal wisdom and not assert traditional Western culture into their way of life. PZWI was fortunate to have a well-respected and connected Tribal member as part of our team. She assisted with understanding and navigating the culture, teaching us about their holistic view of health and helping us embrace their way of seeing health and wellness. The success of this project is due largely to the fact that she is a trusted Tribal member who focused on what was best for the health of her people.

Also related was the relationship the principal investigator had with the Tribe and the IHS Dental Department prior to this project. In 2002, the principal investigator initiated a grant- funded dental hygiene clinical rotation to the IHS Dental Department in which all NAU dental hygiene students stay on the reservation for a given period of time to provide oral health services. This existing relationship added to the veracity of PZWI’s work.

We encountered two main challenges in supporting the oral health integration on this Reservation. The first was the geographic distance between our home-base and the Reservation. Another challenge was finding a time when everyone on the Tribal team was available to meet. Many of the members were clinicians with full patient loads.

Contact Person(s) for Inquiries:

Denise Muesch Helm, Professor, Northern Arizona University Department of Dental Hygiene, P.O. Box 15065, Flagstaff, AZ, 86325, Phone: 928-607-2309, Email: denise.helm@nau.edu

Alejandra Figueroa, Evaluator, Northern Arizona University Department of Dental Hygiene, P.O. Box 15065, Flagstaff, AZ, 86325, Email: Alejandra.figueroa@nau.edu

Marissa Leslie Adams, Manager, Northern Arizona University Department of Dental Hygiene, P.O. Box 15065, Flagstaff, AZ, 86325, Phone: 928-523-9449, Email: Marissa.adams@nau.edu

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