Culturally Appropriate Education for International Relief Workers: Can Education on Fluoride Varnish Help Sustain the Practice at Short-Term Medical Mission Sites?
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Purpose: Underserved populations at short-term medical mission (STMM) sites often experience little to no preventative oral health care. The lack of preventative oral care contributes to loss of tooth structure and function, chronic pain, impaired speech, local and systemic infections, medical complications, and poor nutrition. Application of fluoride varnish (FV) has shown to be effective in the prevention of dental caries because it promotes remineralization of tooth enamel, preserves teeth, and prevents systemic complications. International STMM relief workers are perfectly positioned to prevent oral health issues by providing FV to underserved populations. Objectives: To increase knowledge and understanding among international STMM relief workers regarding proper FV application and culturally appropriate oral health education for underserved populations experiencing poor oral health and complications related to the lack of preventative care in Haiti and Greece. Methods: FV educational intervention was implemented by two University at Buffalo, Doctor of Nursing Practice (DNP) Family Nurse Practitioner (FNP) students at two STMM sites in Haiti and Greece. International STMM relief workers who provided contact methods were asked to participate in an electronic survey at 3-months and 6-months post FV educational intervention. Participants were asked about the usefulness of the intervention and if they continued the FV education practice. Data analysis consisted of descriptive statistics. Results: The FV educational intervention contributed to the sustainability of oral care practice provided by STMM relief workers in rural and remote Haiti and refugee populations in Greece. Means and percentages showed meaningful results at three months with 89% of relief workers responding that FV application is a useful intervention and 78% willing to educate on FV to subsequent relief workers. A small subset had educated other relief workers on FV at the three-month survey evaluation. Six-month data revealed a smaller than expected sample size. Of the six-month participants, all found FV useful and applicable to their current practice, but none had further educated nor utilized the FV. Possible limitations for the project include time constraints, language barriers, lack of product distribution, personal beliefs, and issues with supply versus demand of FV. Conclusion: Study findings indicated that educating STMM relief workers on FV application for underserved populations in rural and remote Haiti and Greece showed potential for sustainability of practice. Challenges for continued education on FV application include availability of supplies, cultural barriers, access to target population, time constraints, and issues with supply of product versus demand. With continued research on sustainability of medical interventions in rural and remote areas, a greater impact on the oral health of these populations may be realized.