Dimensional Analysis of Barriers to Prevention of Early Childhood Caries

Objective: A qualitative study was conducted to explore dimensions underlying psychosocial barriers to prevention of early childhood caries among recent immigrants in Edmonton, Canada.

Method: Eleven focus groups were completed with 65 mothers of 3-5 year old children from African and South Asian communities. Participants had lived in Canada for five years or less. Four debriefing interviews were conducted with the community workers who facilitated the focus groups in participants’ first languages. A dimensional analysis was used for data analysis.   

Result: Type, level, nature, awareness, controllability, influence, objectiveness, and interdependence were the most salient dimensions underlying barriers to home-based and professional-based preventions.  Type refers to a barrier itself while level refers to where the barrier was located (individual, family, community, or systemic level). Nature expresses the inherent character of identified barriers which were related to knowledge, skills, perceptions, attitude, or environmental constraints. Awareness concerns the participants’ level of consciousness about existing barriers. Controllability speaks to perceived control over identified barriers, while influence describes the preventive action(s) affected by each barrier. The extent to which perceptions reflect reality is conceptualized as objectiveness. Misperceptions, for instance, fell under the category of dimension.  Interdependency indicates the connection among the barriers specifically how one barrier led to or is conditioned by other barriers.  

Conclusion: Identified dimentions allow to better understand and describe the barriers as well as the way that they need to be addressed. Therefore, dimensions should be considered when developing intervention strategies directed at removing or reducing the impact of barriers to prevention of ECC. Further examination is needed to determine the usefulness of each dimension in barrier management.