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Head Start Oral Health Initiative

Parent Focus Group Discussion Guide

INTRODUCTION (10 minutes)

Thank you very much for agreeing to participate in this discussion. Your participation is very important to the study. I’m __________ and I work for [MATHEMATICA POLICY RESEARCH/HEALTH SYSTEMS RESEARCH], an independent research firm/organization.

We are conducting a study for the federal Administration for Children and Families to learn about the Head Start Oral Health Initiative. As part of the study, we want to learn the oral health care services that children and families are receiving through Head Start and about your opinions about the services.

• I am going to moderate the discussion. It is really important for everyone to speak up so we can have a lively and informative discussion.

• We ask that you respect each other’s point of view. There are no right or wrong answers. You are the experts – we want to learn from you.

• It will be helpful if you speak one at a time, so everyone has a chance to talk.

• We have many topics to cover during the discussion. At times, I may need to move the conversation along to be sure we cover everything.

• We also ask that you not repeat any of the discussion you’ve heard after you leave today.

• We also want you to know that being part of this discussion is up to you, and you can choose to not answer a question if you wish. Being part of this discussion will also not affect the services you receive from Head Start.

• I would like to tape-record our discussion. I am taping our discussion so I can listen to it later when I write up my notes. No one besides our research team will listen to the tape. Everything you say here is private. When we write our report, we will include a summary of people’s opinions, but no one will be quoted by name.

• If you want to say anything that you don’t want taped, please let me know and I will be glad to pause the tape recorder. Does anybody have any objections to being part of this focus group or to my taping our discussion?

• The discussion will last about 1½ hours, and we will not take any formal breaks. But please feel free to get up at any time if you need to.

Once again, thank you for coming today. Are there any questions before we get started?

1. Let’s go around the room and introduce ourselves. Please tell us:

• Your first name

• The name of age of your child who is enrolled in Head Start or Early Head Start

ACCESS TO SERVICES IN THE COMMUNITY (20 minutes)

To begin, I’d like to ask some questions about how easy or difficult it is for you get oral health care and other services you need in the community.

2. In your experience, how easy or difficult is it to find dentists or other dental providers who are willing to treat children under the age of 5? Under the age of 3?

3. Overall, what are the main problems you face in arranging dental services for your children? PROBES: Finding dentists? Waiting lists for appointments? Transportation to dentists’ offices? Few dentists located near where you live? Paying for dental care? Finding dentists who speak your language? Other problems?

4. Can I see a show of hands, how many of you have dental insurance coverage to pay for dental care, such as Medicaid or SCHIP? If you don’t have dental insurance, do you have another way to pay for dental services? For example, will Head Start pay for dental services? Are dentists available who provide free or low-cost dental care?

5. Can I see a show of hands, how many of you have a single place you can go to get dental treatment for your children? For those who have a single dental provider, how did you find this provider? Did Head Start help you find this dentist? How do you pay for the services? Are there services that your child needs that this dentist will not provide? About how often does you child visit this dentist?

6. Do you go to the dentist? Do you have a single place you can go to get dental treatment for yourself? If so, how did you find this provider? Did Head Start help you?

7. How easy or difficult is it for you to find other health services your children need, such as medical care? IF DIFFICULT: What are the main problems you have trying to find doctors and other medical providers? Overall, would you say it is easier or more difficult to arrange medical or dental services for your children? Why?

PARENTS’ ATTITUDES AND BELIEFS ABOUT ORAL HEALTH CARE (15 minutes)

Now I’d like to talk about your views on the dental services that you and your children need.

8. How important do you think children’s dental health is for their overall healthy growth and development? Is it important, somewhat important, or not related to their physical health and growth? Why do you think this?

9. Ideally, at what age do you think a child should receive his or her first dental exam? Why? After the first exam, how often do you think children under age 5 should see a dentist?

10. Assuming the services are available, how often to you think adults should see a dentist? Why?

11. Tell me about how you take care of your children’s teeth at home. Between birth and age 1? At age 1? At age 3? At age 5? At what age do you think it is important to begin brushing children’s teeth?

12. Do you look at your children’s teeth at home? If so, tell me how you do this. About how often do you do this?

13. Has your child’s doctor ever talked to you about how to take care of your child’s teeth, or about when your child should begin seeing a dentist? If so, please tell me what advice the doctor gave you.

RECEIPT OF ORAL HEALTH SERVICES (25 minutes)

At this point I’d like to hear about the dental services you and your children are receiving.

14. Can I see a show of hands, has someone examined your Head Start child’s mouth at least once? Who did the exam? A dentist? A dental hygienist? A pediatrician or doctor? Someone who works for Head Start?

15. Where did this dental exam happen? At a dentist’s office or clinic? At a pediatrician or doctor’s office? At Head Start? At another location? Were you able to be present, or did you receive information from the exam about your child’s dental health?

16. Did any of your children need follow-up services or treatment? If so, what did they need? How easy or difficult was it for you to arrange these services for your child? Did Head Start help you, for example, by helping you find a dentist, make an appointment, get to the dentist’s office, or pay for the services?

17. Can I see a show of hands, has your Head Start child seen a dentist or another dental provider in the past six months? For what reason—an exam, a cleaning, for treatment? If it was for treatment, what kind of treatment did your child receive?

18. At this point, are you able to arrange the dental services you think your child needs? Regular check-ups and cleanings? Treatments?

19. Can I see of show of hands, how many of you have seen a dentist in the past six months? What was your reason for seeing a dentist? Check-up and cleaning? Treatment? How easy or difficult was it to find a dentist? Did Head Start help you?

20. How often do you usually go to the dentist? Do you get regular check-ups, or do you see a dentist only when you have problems with your teeth? Where do you usually go for dental services? How do you pay for the services?

21. What are the primary reasons you do not go to the dentist? PROBES: Is it because you don’t have dental insurance, you can’t take time off from work, you don’t have transportation, you’ve had bad experiences with dentists in the past, or you are afraid to go to the dentist?

22. Has Head Start ever helped you with the following for your child? For you or other family members? If so, please tell me what they did to help.

• Find a dentist or other dental provider

• Make an appointment with a dentist or dental provider

• Provide transportation to a dental appointment

• Provide translation services during a dental appointment

• Help you pay for dental services

23. Overall, how satisfied are you with the help you received from Head Start to arrange dental services for your Head Start child? For yourself? For other family members?

24. Do you have suggestions for how Head Start could improve these services? Are there other things Head Start could do to help you get the dental services you and your family need?

ORAL HEALTH EDUCATION (20 minutes)

Now I’d like to talk about the information you and your child have received about how to take care of your teeth.

25. In the past year, have you gone to any workshops or parent trainings about oral health? If so, what did you talk about during that event? Who provided the information? Did you receive any information in writing about oral health at that event?

26. Have you received information about oral health in any other way, such as during a home visit or during a visit to a dentist’s office? If so, what did you talk about and who provided the information?

27. Have you received any written information such as pamphlets or handouts, or videos about how to take care of your own or your children’s teeth? What did you learn from these materials? IF SOME FAMILIES DO NOT SPEAK ENGLISH AS A FIRST LANGUAGE: Did you receive these materials in English, or another language?

28. IF NOT ALREADY MENTIONED: Did any of the educational activities and materials provide you with instruction on how to examine your child’s teeth and mouth at home, and what to look for? If so, tell me about what you learned.

29. In the past year, do you know if your Head Start children received any education or training on how to take care of their teeth, such as learning how to brush, from Head Start? Did this happen in a Head Start classroom, during a home visit, or during a visit to a dentist? Tell me about what your child learned.

30. Can I see a show of hands, have you ever received supplies from Head Start for taking care of your children’s teeth (such a toothbrush, toothpaste, other)? Do you receive these supplies regularly, occasionally, or just once? Did you receive any instruction about how to use the supplies? Who provided the instruction?

31. Overall, how helpful has the education and training on oral health you have received from Head Start been for you? Did you learn anything new from this information? If so, what did you learn? How helpful do you think the education and training has been for your children?

32. Is there anything you would change about the oral health education and training that Head Start provides? Do you have any suggestions for improving this component of the program?

CONCLUSION

Those are all of the questions I had for you today. Is there anything else about dental services provided by Head Start that you think I should know about? Anything else you would like to mention before we end?

Thank you for taking the time to share your thoughts and experiences. Our discussion has been very useful for helping me learn more about the Head Start Oral Health Initiative.

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