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Enrollment in early head start and oral health-related quality of life

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Abstract

Purpose

Dental problems in young children are widespread and can negatively impact quality of life. We examined the effect of enrollment in North Carolina Early Head Start (EHS)—a federally funded early education program for children under three years of age and their families—on oral health-related quality of life (OHRQoL).

Methods

In this quasi-experimental study, we interviewed 479 EHS and 699 Medicaid matched parent–child dyads at baseline (children’s average age 10 months) and 24 months later. Parents reported OHRQoL using the Early Childhood Oral Health Impact Scale (ECOHIS), a 0–52 point scale with higher scores representing more negative impacts. We used a marginalized semicontinuous two-part model to estimate: (1) the effect of EHS on the probability of reporting any follow-up impacts (ECOHIS ≥ 1), and (2) the difference in overall mean ECOHIS follow-up scores. We controlled for baseline ECOHIS, language, and EHS and non-EHS group imbalances using a propensity score.

Results

At follow-up, negative OHRQoL impacts were more often reported by parents of non-EHS than EHS children (45 versus 37%, P < .01). In the adjusted model, EHS parents reported a lower odds of negative OHRQoL impacts (OR 0.70; 95% CI 0.52, 0.94). Mean adjusted ECOHIS scores were not significantly different (EHS: 1.59 ± 3.34 versus non-EHS: 2.11 ± 3.85, P > 0.05).

Conclusions

This study is the first to demonstrate that families of young children enrolled in EHS report improved OHRQoL compared to their non-enrolled peers. These results highlight the potential effectiveness of improving the quality of life of low-resource families through early childhood education.

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Acknowledgements

This research is supported by a grant from the National Institute of Dental and Craniofacial Research, Prevention of Dental Caries in Early Head Start Children, #R01 DE018236. This research was partially supported by a National Research Service Award Post-Doctoral Traineeship from the Agency for HealthCare Research and Quality sponsored by The Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, #T32 HS000032.

Disclosures

None of the authors has any financial interest related to the article.

Disclaimers

The views expressed in the article are those of the authors and do not necessarily reflect the views of the National Institute of Dental and Craniofacial Research or the University of North Carolina at Chapel Hill.

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Authors and Affiliations

  1. Department of Pediatric Dentistry, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Jacqueline M. Burgette & Jessica Y. Lee

  2. Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Jacqueline M. Burgette, Morris Weinberger, Rebecca S. King, Jessica Y. Lee & R. Gary Rozier

  3. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Jacqueline M. Burgette

  4. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    John S. Preisser

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  1. Jacqueline M. Burgette
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Correspondence to Jacqueline M. Burgette.

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Burgette, J.M., Preisser, J.S., Weinberger, M. et al. Enrollment in early head start and oral health-related quality of life. Qual Life Res 26, 2607–2618 (2017). https://doi.org/10.1007/s11136-017-1584-7

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