Maternal Health| Volume 29, ISSUE 6, P522-528, November 2019

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“I Didn't Know”: Pregnant Women's Oral Health Literacy Experiences and Future Intervention Preferences



      This study explored women's 1) experiences in accessing, understanding, appraising, and applying oral health information and services, and 2) preferences regarding oral health promotion during pregnancy.


      Pregnant women ages 18 to 45 were recruited from an obstetrics and gynecology clinic at a large university hospital. Focus groups were conducted using the four domains of the integrated model of health literacy (access, understand, appraise, apply) and were audio-recorded and professionally transcribed. Thematic analysis was employed using Atlas.ti.


      Participants (n = 17) were Hispanic (53%), married (67%), college educated (87%), employed (80%), and insured (100%). Most participants reported not accessing or receiving oral health information during pregnancy, with limited information received from less trustworthy sources (Internet; friends/family) and focusing on symptoms or myths. Participants revealed gaps in basic oral health understanding and demonstrated limited ability to evaluate or apply information, such as engaging in positive oral health behaviors, according to their needs and personal health status. Participants strongly desired that oral health promotion be integrated into prenatal care.


      Participants described missed opportunities to improve oral health literacy and desire future health messages that facilitate patient–provider communication on oral health during prenatal care visits. Future health interventions should convey the importance and associated risks, be time efficient and patient centered, and include patient activation to prompt oral health–seeking behaviors during pregnancy.
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      Cheryl A. Vamos, PhD, MPH, is an assistant professor at the University of South Florida's College of Public Health and Fellow in the Chiles Center. Her specialization includes reproductive health, family planning, and health literacy.


      Laura Merrell, PhD, MPH, CPH, is an assistant professor at James Madison University's Department of Health Sciences. Her research areas include health literacy, oral health, sexual and reproductive health, and health behaviors.


      Taylor A. Livingston, PhD, IBCLC, is a postdoctoral scholar within the Center of Excellence in MCH Education, Science, and Practice, University of South Florida, College of Public Health. Her specializations include breastfeeding and its intersections with current political, economic, and cultural realms.


      Emanuelle Dias, BA, is a Master of Public Health Candidate and graduate research assistant at the University of South Florida's College of Public Health. Her research interests include minority health and implementation science/quality improvement efforts.


      Linda Detman, PhD, is a research associate, an assistant director for the Chiles Center, and program manager for the Florida Perinatal Quality Collaborative at the University of South Florida's College of Public Health. Her specialization includes health services research evaluation.


      Judette Louis, MD, MPH, is associate professor and interim chair, Obstetrics and Gynecology, University of South Florida's College of Medicine and College of Public Health. Her research interests include maternal morbidity/mortality, pregnancy as a window to cardiovascular health, and obstructive sleep apnea.


      Ellen Daley, PhD, MPH, is professor and associate dean, research, practice, and doctoral training, and senior fellow, Chiles Center, University of South Florida's College of Public Health. Her specialization includes women's health, sexuality education, sexually transmitted disease prevention, and contraceptive use.