•  Early childhood caries
•  Oral health promotion (families, children)
•  Disadvantaged populations (First Nations, immigrants, low income  
   families)
•  Access to care

 We have received funding from provincial, national and international agencies for demonstration projects and randomized trials to determine the best approach to improve oral health of children at high risk to dental caries.  Our projects have included new immigrant Vietnamese families in Vancouver, Sikh families in Surrey, B.C. and First Nations communities. Currently I’m collaborating with colleagues in northern Quebec on a five-year, CIHR-funded randomized control trial with Cree families.

"I wish my child would have beautiful teeth proiect"
(CIHR-funded 5-year RCT)
Early childhood caries (ECC), a severe form of dental caries affecting the primary teeth of young children, is a serious health problem for First Nations children. A 2001 dental health survey in Eeyou Istchee, the Cree territory of Northern Quebec revealed that 86% of 4-5 year old children had evidence of caries. Clearly, existing dental prevention initiatives have not met the needs of Cree families.

This trial, involving Cree mothers and children in Eeyou Istchee, is testing the effectiveness of an innovative, one-an-one counseling program called Motivational Interviewing (MI). In keeping with Cree philosophy and traditions, MI allows mothers to choose from a "menu" of preventive dental behaviours. The primary research question is whether there will be any difference in the dental health status of Cree children from communities where mothers have participated in MI interventions, compared to children from communities where mothers received information by more traditional means (pamphlets). This question will be answered by testing the hypothesis that the prevalence of caries among children 30 months of age will be lower in experimental "MI" communities than in control communities.

The secondary questions are whether Cree mothers' beliefs about child dental health, children's dental health practices, and the negative health outcomes of ECC will be altered in MI communities compared to control communities.

The design is single blind, with cluster randomization by community, and two treatment groups. The "experimental" treatment, MI, will assist mothers to choose from a menu of various age-appropriate, preventive options. The first intervention will occur during pregnancy, followed by regular MI sessions beginning at the child's two-month immunization until 24 months of age.

The primary statistical analysis will be a comparison of caries prevalence in intervention and control groups. For Eeyou Istchee, the long-term effects of this trial may go beyond improvements in child dental health. 

Recruitment of subjects is complete and an initial outcomes assessment will take place in the next year. Dr. Jacques Veronneau, McGill University Faculty of Dentistry is co-PI.

Early childhood caries among Filipino immigrant children to the Lower Mainland
(funded by S. Wah Leung Endowment Fund).
Filipinos are the third largest group of recent immigrants in B.C. Filipino immigrant children are reported by clinicians and public dental health staff to have high prevalence and severity of dental caries but this evidence is largely anecdotal and undocumented. The primary goal of this study is to document prevalence and treatment needs among Filipino immigrant children in British Columbia. Secondary goals are: (1) to assess the impact of socio-demographics, acculturation, and child-rearing practices on caries status, (2) to determine culturally-specific behaviors increasing caries-susceptibility, and (3) identify high caries risk children. These baseline data are essential to evaluate the need for a culturally-appropriate health promotion program to prevent and/or decrease caries levels among Filipino immigrants. The surveys are being conducted at church and community-based Filipino gatherings.

Although immigrant health research in Canada has grown exponentially, little has been conducted on the oral health of immigrants, as separate ethnic and cohort subgroups. The study consists of three phases: 

1. A dental survey to determine ECC levels among a convenience sample of 100 children ages 1½ to 5 year old children
2. A qualitative evaluation involving focus groups with a total 40 parents and caregivers to determine health behavior and child rearing practices.  This qualitative evaluation will inform the development of the next phase.
3. A questionnaire survey of primary caregivers using a semi-structured questionnaire to determine family demographics, dental services access & utilization, and child-rearing practices.

This project is being conducted by Dr. Khristine Carino, post-doctoral fellow.

Amin MS, Harrison RL.: Understanding parents' oral health behaviors for their young children. Qual Health Res 19: 116-27; 2009

Schroth RJ, Harrison RL, Lawrence HP, Peressini S. “Oral health and the Aboriginal child: A forum for community members, researchers and policy-makers. J Canadian Dental Assoc 74. 429-32, 2008

Harrison R, Benton TS, Everson-Stewart SP, Weinstein P.  “Effect of motivational interviewing on rates of early childhood caries:  a randomized trial”  Pediatr Dent 29: 16-22; 2007. 

Amin, M.S., Harrison, R.L.  “A conceptual model of parental behaviour change following a child’s dental general anesthesia.” Pediatr Dent 29: 278-86; 2007. 

Amin, M.S., Harrison, R.L.  “Change in parental oral health practices following a child’s dental treatment under general anesthesia.”  European Archives Pediatr Dent 7:116-20; 2006.

Amin, M.S., Harrison, R.L., Weinstein, P.  “A qualitative look at parents’ experience of their child’s dental general anesthesia.”  Int J Pediatr Dent 16:309-19; 2006.

Weinstein P, Harrison RL, Benton T. Motivating parents to prevent caries: confirmation of one-year findings. J Amer Dental Assoc 137:789-93; 2006.

Harrison, R.L., MacNab A., Benton, D., Duffy D.  “Brighter Smiles:  health promotion, service learning, and inter-professional collaboration in a First Nations community”, Can J Public Health 97:237-40; 2006.

Weinstein P, Harrison RL, Benton T. "Motivating parents to prevent caries: positive one year findings. J Amer Dental Assoc 135:731-38; 2004.
 
Amin MS, Harrison RL, Benton T, Roberts M, and Weinstein P. The effect of 10% Povidone-Iodine on S. mutans in young children with extensive dental caries. Pediatr Dentistrv 26:5-10; 2004.
 
Harrison RL, Wong T. An oral health promotion program for an urban minority population of preschool children. Comm Dent Oral Epidemiol 31:392-9; 2003.
 
Harrison RL, Pearce K, Li J, Wyman T. The Community Dental Facilitator Project: reducing barriers to dental care." J Public Health Dent 63:2(Spring), 126-28; 2003.

YWCA Women of Distinction Awards:  Nominee, Health and Active Living, Vancouver 2007
American Academy of Pediatric Dentistry Foundation Research Award, 2006
Honorary Membership, British Columbia Dental Association 2006
Vancouver Coastal Health Research Institute Affiliated Investigator – 2005
Canadian Dental Association Oral Health Promotion Award – 2004
Faculty Travel Award, Educational Research, International Association of Dental Research – 2001
UBC Teaching Excellence Award – 1995

Dr. Khristine Carino – Postdoctoral fellow
Dr. Claudia Marano – MSc Candidate
Dr. Jana Sabo - MSc Candidate