Effectiveness of a community health worker program on oral health promotion.

OBJECTIVE To assess changes of knowledge and attitudes and health service access and utilization after the implementation of a community health worker program for oral health promotion. METHODS A capacity building project including learning, support, and supervision activities was developed between July 2003 and August 2004. A study to assess changes was conducted including 36 community health workers and a representative sample of homemaker literate women and mothers aged 25 to 39 years living in 3- to 6-room dwelling in the city of Rio Grande da Serra, Southeastern Brazil. Data on oral health knowledge, self-reported practices, and personal skills regarding self-examination, oral hygiene, number of people living in the same household, number of individual and collective toothbrushes, and dental service access and utilization were collected using structured interviews. Mean scores measured pre- and post-intervention program were compared for each group studied using Student's t-test. A 5% significance level was set for the analysis. RESULTS Statistically significant differences between pre- and post-intervention program were seen regarding oral health knowledge among both health workers and women (p<0.05). The number of shared toothbrushes per family decreased. Frequency of toothbrushing and flossing increased. Self-assessment of oral hygiene efficacy increased. Changes in practices and personal skills improved self-efficacy. Women had more access to services (p<0.000) and used them more regularly (p<0.000). CONCLUSIONS There were seen significant changes of perception regarding oral health, self-efficacy, and health service access and utilization. These changes may show that community health workers play a key role in oral health promotion.