This paper presented follow-up interview results with participants in an oral health education workshop developed for migrants and refugees. The interviews were designed to assess whether knowledge and behaviors previously shown to be increased during the workshop (5) were retained several months later. The results showed a fairly high degree of retention, in such areas as general oral health knowledge, and brushing/flossing frequency and techniques.
The results are encouraging since migrant workers, most of whom are Spanish-speaking workers, face many barriers to receiving health care in general and dental health care in particular, including lack of transportation, insurance, and sick leave; the threat of wage or job loss; language barriers; lack of regular dental practitioner; and limited clinic hours. In addition to these barriers in access, many migrant workers lack basic oral health knowledge, including the relationship between sweet foods and caries and the positive effects of good oral hygiene and fluoride on dental health and overall health (4).
Oral health training and education offers an important avenue to increasing knowledge about good oral health practices (7), and this was one of the first published evaluations we are aware of for education programs in migrant populations led by community health workers and promotoras de salud, rather than dental professionals (dentists or dental hygienists). During the last three years, CHWCMR conducted 32 oral workshops with a total of 697 participants living in rural and low-income communities in Washington State from 2017–2019. Overall, our positive findings for knowledge gain reported in a previous paper, and the retention of knowledge and behaviors reported here, support the idea that migrant populations may be better reached by education programs led by community health workers and promotoras de salud, especially those programs using an interactive approach (8).
There are several limitations that should be noted. The interviews were conducted with a relatively small sample of participants. There is likely social desirability reporting bias as participants attempt to demonstrate that they were good students and learned something in the workshops. All of the information about retention was self-reported since we had no way of observing oral health behaviors directly. Finally, this was a community-based study that relied on the lay leaders to do the data collection. All of the lay leaders received training in interviewing the participants, but there may have been inconsistencies in the way the interviews were done.
Despite the limitations, this study demonstrated that an interactive, lay-led oral health education program can be an effective way to promote sustained improvements in oral health knowledge and behavior in migrant populations.