Symptom Interpretation &Oral Health among Harlem Adults

DESCRIPTION (provided by applicant): Although the oral health of the US population has greatly improved over the last three decades, significant disparities continue to exist among different subpopulations. The Surgeon General's report "Oral Health in America" published in 2000 revealed a hidden epidemic of oral diseases that is largely borne by these disadvantaged social groups. In the Harlem Household Survey, from among 50 health complaints about which respondents were questioned, problems with teeth or gums were the most frequently cited problem (30 percent). What remedial actions, if any, do disadvantaged individuals take when they experience oral symptoms or problems? While access to care is undoubtedly a critical determinant of the actions they will take, other factors much less well investigated or understood such as lay beliefs, attitudes and emotions (e.g., fear and threat) are also important. For example, the casual attributions they assign to their oral symptom/problems, will guide their coping responses including whether to seek formal dental care, attempt self care (including self-medication and treatment), or do nothing for now (i.e., delay action). To gain better understanding of these issues, we propose to study the symptom appraisal processes and coping responses of non-Hispanic Black/African Americans residing in Central Harlem who have experienced an oral symptom within the last six months. Of particular interest, are the self-care behaviors used in response to oral problems. In the field of dental research, self-care has been looked at almost exclusively in terms of behaviors enacted by the individuals to prevent dental problems (i.e. oral health behaviors). Particularly brushing, flossing, use of interdental devices, use of mouthwashes, and regular dental visits. There is on the other hand, a dearth of research data self-care behavior in response to dental or oral symptom and problems (i.e., illness behavior), which is our focus in the proposed study. In depth face-to-face, focused interviews will be conducted with 120 adults. As in several of the principal Investigator's previous federally funded investigations, qualitative research methods will be employed.