Using focus groups to design systems science models that promote oral health equity
Authored by Mary E Northridge, Sara S Metcalf, Susan S Kum
Date Published: 2018
DOI: 10.1186/s12903-018-0560-0
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Abstract
Background: While the US population overall has experienced improvements
in oral health over the past 60 years, oral diseases remain among the
most common chronic conditions across the life course. Further, lack of
access to oral health care contributes to profound and enduring oral
health inequities worldwide. Vulnerable and underserved populations who
commonly lack access to oral health care include racial/ethnic minority
older adults living in urban environments. The aim of this study was to
use a systematic approach to explicate cause and effect relationships in
creating a causal map, a type of concept map in which the links between
nodes represent causality or influence.
Methods: To improve our mental models of the real world and devise
strategies to promote oral health equity, methods including system
dynamics, agent-based modeling, geographic information science, and
social network simulation have been leveraged by the research team. The
practice of systems science modeling is situated amidst an ongoing
modeling process of observing the real world, formulating mental models
of how it works, setting decision rules to guide behavior, and from
these heuristics, making decisions that in turn affect the state of the
real world. Qualitative data were obtained from focus groups conducted
with community-dwelling older adults who self-identify as African
American, Dominican, or Puerto Rican to elicit their lived experiences
in accessing oral health care in their northern Manhattan neighborhoods.
Results: The findings of this study support the multi-dimensional and
multi-level perspective of access to oral health care and affirm a
theorized discrepancy in fit between available dental providers and
patients. The lack of information about oral health at the community
level may be compromising the use and quality of oral health care among
racial/ethnic minority older adults.
Conclusions: Well-informed community members may fill critical roles in
oral health promotion, as they are viewed as highly credible sources of
information and recommendations for dental providers. The next phase of
this research will involve incorporating the knowledge gained from this
study into simulation models that will be used to explore alternative
paths toward improving oral health and health care for racial/ethnic
minority older adults.
Tags
Agent-based modeling
Dynamics
networks
Policy
Public-health
Life
Geography
Older-adults
Thinking
Disparities
Access
Oral public health
Dental public health
Oral health equity
Systems
science
Qualitative analysis
Focus group
analysis
Racial/ethnic minorities
Older adults
Community-based oral
health care
Chronic disease epidemiology
Disparities
research