# Immigrant parents' perspectives on children's oral health and barriers to a culturally adapted intervention in Norway

## TL;DR

The study explores why a culturally adapted oral health intervention failed to improve immigrant parents' knowledge and attitudes in Norway, highlighting cultural and systemic barriers.

## Contribution

The study provides new insights into barriers immigrant parents face in adopting oral health practices and offers recommendations for culturally sensitive interventions.

## Key findings

- Parents appreciated multilingual pamphlets but preferred receiving information from local health nurses.
- Cultural practices around sugar intake made it difficult for parents to control children's diets.
- Parents recommended earlier dental follow-ups and culturally competent dental services.

## Abstract

A previous culturally adapted oral health intervention was deemed ineffective in improving immigrant parents' oral health-related knowledge and attitudes. This qualitative study aimed to explore the perceived barriers to benefiting from the intervention and the perspectives of immigrant parents regarding their children's oral health behaviors, and use of dental health services.

Forty-five immigrant parents who previously received the intervention were invited; 12 consented to participate and were interviewed using semi-structured individual interviews. The interviews were recorded and transcribed verbatim. Data was analyzed using thematic analysis.

The participants were all women aged 28–44, from Africa, Asia, Eastern Europe and South America. Most were college or university-educated and were employed. Four main themes were identified: Intervention Implementation: Parents appreciated the use of pamphlets in their native languages, but highlighted the need to receive dental information from the public health nurses at the local health centers. Parental perspectives on children's oral hygiene habits: Parents demonstrated high oral health knowledge and highlighted the differences in oral hygiene habits between their home countries and Norway. Parental perspectives on children's feeding practices: Participants noted that sugar intake is deeply rooted in cultural and social practices, making it difficult for them to control their children's sugar intake. Dental Health Systems for Children: Parents expressed the need for more frequent follow-ups starting earlier than 3 years of age. They also emphasized the importance of cultural and linguistic competence and sensitivity during dental appointments.

This study highlights the influence of immigrant parents' cultural backgrounds, daily challenges, and interactions with the Norwegian dental health system on their children's oral health practices and perceptions of the oral health intervention. The findings suggest that oral health interventions should be comprehensive, easy to remember, and delivered by credible professionals. Furthermore, to promote positive behavioral change, it is advisable to provide continuous support, repeat oral health care guidance, provide clear communication, and utilize native languages.

ClinicalTrials.gov Identifier: [NCT05758454].