Applying Community-Based Participatory Research Principles to Global Oral Health: A Case Study from Costa Rica

ABSTRACT

Background

Resource-limited communities across the globe face dramatic health disparities augmented by the shortcomings of translating research into practice. Community-based participatory research (CBPR) empowers communities through research and engagement to generate knowledge and improve global oral health. This case study presents findings and methods from a CBPR oral health project with an Indigenous Community in Costa Rica (La Casona).

Methods

Interviews were conducted with public health dentists, community stakeholders, and community health leaders. Qualitative content and direct coding analysis of 8 interview transcripts was used to develop initial themes. Initial themes were grouped into final themes with representative quotations with framework analysis.

Results

Final themes identified included health education, financial status, structural influences on health, diet and nutrition, sociocultural characteristics, and environmental factors. Community partners guided development of a conceptual framework identifying common protective factors and common risk factors for oral health in La Casona.

Conclusion

This study is an example of CBPR that explores interconnected determinants of oral health in La Casona and uniquely identifies common protective factors in addition to common risk factors for oral health.

Practical Implications

Dental practitioners can apply the CBPR principles applied for this study in other clinical and research initiatives to better align with the WHO Strategic Objectives.

KEYWORDS:

• Global health
• community-based participatory research
• oral health
• community health
• indigenous health

Acknowledgments

Thank you to our partners and community members of Coto Brus and La Casona as teachers, colleagues, and friends, for whom this project exists. Gratitude to Dr. Christine Riedy for her guidance in data analysis. Special thanks to the Abundance Foundation, HSDM Office of Global and Community Health and Associate Dean Jane Barrow, and Dogon Fund for supporting travel to Costa Rica for DOD and RL.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Funding

The work was supported by the Abundance Foundation Harvard School of Dental Medicine [Office of Global and Community Health, Dogon Fund].

Supplementary Data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/19424396.2024.2330558.

Additional information

Notes on contributors

David O. Danesh

David O. Danesh, DMD, MPH, MS, is a pediatric dentist, Adjunct Clinical Assistant Professor at The Ohio State University and a pediatric dental attending at Nationwide Children’s Hospital, Columbus, Ohio, USA.

Ryan Lisann

Ryan Lisann, DMD, EdM, is a pediatric dentist and lecturer at Harvard School of Dental Medicine, Boston, Massachusetts, USA.

Carlos A. Faerron-Guzman

Carlos A. Faerron-Guzman, MD, MSC, is director of the Centro Interamericano para la Salud Global (CISG) in Costa Rica and Associate Professor, Graduate School, University of Maryland, Baltimore, Baltimore, Maryland, USA.

Gustavo A. Bermúdez Mora

Gustavo A. Bermúdez Mora, DDS, is a public health dentist and Regional Supervisor of Dentistry in the Directorate of Integrated Health Service Delivery Network of the Brunca Region at the Costa Rican Social Security Fund (CCSS). Dr. Bermúdez Mora is a member of the Collective Oral Health Commission at the Colegio de Cirujanos Dentistas de Costa Rica.

Dominga Bejarano-Palacios

Dominga Bejarano-Palacios is a former Local Indigenous Midwife and an Indigenous Leader of the Elderly Women Group in La Casona Indigenous Territory of Coto Brus, Costa Rica.

Mérita Bejarano-Bejarano

Merita Bejarano-Bejarano is a Local Indigenous Cultural Advisor in La Casona Indigenous Territory of Coto Brus, Costa Rica.