Oral health literacy among migrant mothers in Sweden. A qualitative study

Authors

  • Elena Shmarina Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmö, Sweden; Kalmar County Council, Public Dental Service, Oskarshamn, Sweden https://orcid.org/0000-0003-4331-255X
  • Malin Stensson Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden; CHILD Research Group, SIDR, Jönköping University, Jönköping, Sweden
  • SANT-Network *see Acknowledgements for contributors
  • Brittmarie Jacobsson Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden; CHILD Research Group, SIDR, Jönköping University, Jönköping, Sweden https://orcid.org/0000-0003-0814-4706

DOI:

https://doi.org/10.1080/00016357.2023.2291206

Keywords:

Asylum seekers, dental health, information seeking behaviour, oral health information, refugees

Abstract

Objective: This interview study explored the oral health literacy of migrant mothers in Sweden, with special reference to where and why they access information about oral health and how they determine the credibility of such information.

Material and method: In-depth interviews were conducted with seven migrant mothers of children up to 10 years old. The mothers had entered Sweden from 2015 onwards and had been resettled in Kalmar County, Sweden. Their native language was Somalian, Dari or Arabic. The interview questions concerned the participants’ experiences of seeking oral health information, as well as oral health in general and dental health services. The interviews were analysed by qualitative content analysis.

Findings: The main findings indicate that migrant mothers used information sourcing as a pathway to solve oral health literacy tasks. Three main categories were identified, each with subcategories, describing the migrant mothers’ experiences of accessing and evaluating oral health information: ‘accessible source of information’, ‘needs-related purpose of seeking information’ and ‘trustworthiness assessment’. The migrant mothers reported that in case of a dental emergency or general queries, they sought oral health information from professionals and social sources. Moreover, they perceived oral health information to be most reliable when it was provided by dental professionals, was a recurring theme, or constituted majority opinion.

Conclusion: To improve oral health literacy in migrant mothers of young children, it is important not only to provide consistent and recurrent oral health information through accessible information channels, but also to adapt dental care to be more culturally appropriate. 

Downloads

Download data is not yet available.

References

Hewitt M. Oral health literacy: workshop summary. Washington,DC: National Academies Press; 2013.

Okan O, Bauer U, Levin-Zamir D, et al. International handbook of health literacy: research, practice and policy across the lifespan. Bristol: Policy Press; 2019. https://doi.org/10.56687/9781447344520

Reza M, Amin MS, Sgro A, et al. Oral health status of immigrant and refugee children in North America: a scoping review. J Can Dent Assoc. 2016;82:g3.

Christensen LB, Twetman S, Sundby A. Oral health in children and adolescents with different socio-cultural and socio-economic backgrounds. Acta Odontol Scand. 2010; 68(1):34-42. doi: 10.3109/00016350903301712. https://doi.org/10.3109/00016350903301712

André Kramer AC, Petzold M, Hakeberg M, et al. Multiple socioeconomic factors and dental caries in swedish children and adolescents. Caries Res. 2018;52(1-2):42-50. doi: 10.1159/000481411. https://doi.org/10.1159/000481411

Stecksén-Blicks C, Sunnegårdh K, Borssén E. Caries experience and background factors in 4-year-old children: time trends 1967-2002. Caries Res. 2004; 38(2):149-155. doi: 10.1159/000075939. https://doi.org/10.1159/000075939

Crespo E. The importance of oral health in immigrant and refugee children. Children. 2019;6(9):102. doi: 10.3390/children6090102. https://doi.org/10.3390/children6090102

Obeng CS. Culture and dental health among African immigrant school-aged children in the United States. Health Education. 2007;107(4):343-350. doi: 10.1108/09654280710759250. https://doi.org/10.1108/09654280710759250

Tiwari T, Albino J. Acculturation and pediatric minority oral health interventions. Dent Clin North Am. 2017; Jul61(3):549-563. doi:10.1016/j.cden.2017.02.006. https://doi.org/10.1016/j.cden.2017.02.006

Zdravkovic S, Grahn M, Björngren Cuadra C. Mapping the health of newly arrived migrants. (In Swedish: kartläggning av nyanländas hälsa). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM); 2016.

Firmino RT, Ferreira FM, Martins CC, et al. Is parental oral health literacy a predictor of children's oral health outcomes? Systematic review of the literature. Int J Paediatr Dent. 2018;28(5):459-471. https://doi.org/10.1111/ipd.12378

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-112. doi: 10.1016/j.nedt.2003.10.001. https://doi.org/10.1016/j.nedt.2003.10.001

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews andf ocus groups. Int J Qual Health Care. 2007;19(6):349-357. doi:10.1093/intqhc/mzm042. https://doi.org/10.1093/intqhc/mzm042

Patton MQ. Qualitative research & evaluation methods: integrating theory and practice. Thousand Oaks, CA: Sage Publications; 2014.

Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res. 2016;26(13):1753-1760. doi: 10.1177/1049732315617444. https://doi.org/10.1177/1049732315617444

Saunders B, Sim J, Kingstone T, et al. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant. 2018;52(4):1893-1907. doi: 10.1007/s11135-017-0574-8. https://doi.org/10.1007/s11135-017-0574-8

Krippendorff K. Content analysis: an introduction to its methodology. Thousand Oaks CA: Sage Publications; 2018.

Graneheim UH, Lindgren B-M, Lundman B. Methodological challenges in qualitative content analysis: a discussion paper. Nurse Educ Today. 2017;56:29-34. doi: 10.1016/j.nedt.2017.06.002. https://doi.org/10.1016/j.nedt.2017.06.002

Singh P, Hayden KA, Ens T, et al. Ethno-cultural preferences in receipt of heart health information. Am J Health Behav. 2017;41(2):114-126. Mar 1 doi: 10.5993/AJHB.41.2.2. https://doi.org/10.5993/AJHB.41.2.2

Cheney AM, Nieri T, Davis E, et al. The sociocultural factors underlying latina mothers' infant feeding practices. Glob Qual Nurs Res. 2019;6:2333393618825253. Jan-doi: 10.1177/2333393618825253. https://doi.org/10.1177/2333393618825253

Criss S, Woo Baidal JA, Goldman RE, et al. The role of health information sources in decision-making among hispanic mothers during their children's first 1000 days of life. Matern Child Health J. 2015;19(11):2536-2543. doi: 10.1007/s10995-015-1774-2. https://doi.org/10.1007/s10995-015-1774-2

Wandel M, Terragni L, Nguyen C, et al. Breastfeeding among Somali mothers living in Norway: attitudes, practices and challenges. Women Birth. 2016;29(6):487-493. doi: 10.1016/j.wombi.2016.04.006. https://doi.org/10.1016/j.wombi.2016.04.006

Riggs E, Gussy M, Gibbs L, et al. Hard to reach communities or hard to access services? Migrant mothers' experiences of dental services. Aust Dent J. 2014;59(2):201-207. doi: 10.1111/adj.12171. https://doi.org/10.1111/adj.12171

Socialdepartementet. National Dental Service Act [Tandvårdslag]. Stockholm 1985. p. 125.

Koch G, Poulsen S, Espelid I, et al. Pediatric dentistry: a clinical approach. Hoboken, NJ: John Wiley and Sons; 2017.

Mårtensson L, Lytsy P, Westerling R, et al. Experiences and needs concerning health related information for newly arrived refugees in Sweden. BMC Public Health. 2020;20(1):1044. doi: 10.1186/s12889-020-09163-w. https://doi.org/10.1186/s12889-020-09163-w

Mangrio E, Sjögren Forss K. Refugees' experiences of healthcare in the host country: a scoping review. BMC Health Serv Res. 2017;17(1):814. doi: 10.1186/s12913-017-2731-0. https://doi.org/10.1186/s12913-017-2731-0

Riggs E, Rajan S, Casey S, et al. Refugee child oral health. Oral Dis.2017;23(3):292-299. doi: 10.1111/odi.12530. https://doi.org/10.1111/odi.12530

Lee HY, Lee J, Kim NK. Gender differences in health literacy among korean adults: do women have a higher level of health literacy than men? Am J Mens Health. 2015;9(5):370-379. doi: 10.1177/1557988314545485. https://doi.org/10.1177/1557988314545485

Sørensen K, Pelikan JM, Röthlin F, et al. Health literacy in Europe: comparative results of the european health literacy survey (HLS-EU). Eur J Public Health. 2015;25(6):1053-1058. Dec doi: 10.1093/eurpub/ckv043. https://doi.org/10.1093/eurpub/ckv043

Berkman ND, Sheridan SL, Donahue KE, et al. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(2):97-107. Jul 19 doi: 10.7326/0003-4819-155-2-201107190-00005. https://doi.org/10.7326/0003-4819-155-2-201107190-00005

Clouston SAP, Manganello JA, Richards M. A life course approach to health literacy: the role of gender, educational attainment and lifetime cognitive capability. Age Ageing. 2017; May 146(3):493-499.doi: 10.1093/ageing/afw229. https://doi.org/10.1093/ageing/afw229

Thunberg G, Ferm U, Blom Å, et al. Implementation of pictorial support for communication with people who have been forced to flee: experiences from neonatal care. J Child Health Care. 2019;23(2):311-336. Jun doi: 10.1177/1367493518819210. https://doi.org/10.1177/1367493518819210

Brach C, Harris LM. Healthy people 2030 health literacy definition tells organizations: make information and services easy to find, understand, and use. J Gen Intern Med. 2021;36(4):1084-1085. doi:10.1007/s11606-020-06384-y. https://doi.org/10.1007/s11606-020-06384-y

Overview and statement of the problem. In: hewitt M, editor. Oral health literacy: workshop summary. Washington (DC): National Academies Press (US); 2013.

Downloads

Published

2024-03-26

Issue

Vol. 83: (2024) Acta Odontologica Scandinavica

Section

Original article

License

Copyright (c) 2024 Elena Shmarina, Malin Stensson, SANT-Network, Brittmarie Jacobsson

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.