UNDERSTANDING THE PHENOMENON OF EARLY CHILDHOOD CARIES IN RURAL AND REMOTE CHILDREN IN NORTHERN SASKATCHEWAN: A REALIST SYNTHESIS
Date
2023-11-27
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
0000-0003-0199-3705
Type
Thesis
Degree Level
Masters
Abstract
Early childhood caries in preschool children is a growing public health concern in Canada. Children in Northern Saskatchewan experience poor oral health outcomes compared to those in the southern regions of the province (Inam, 2021; Saskatchewan Health Authority Oral Health Program, n.d.). Despite various efforts by the government and non-governmental organizations to address this problem, the situation is still a major public health concern. This study aims to understand the phenomenon of early childhood caries in rural and remote children in Northern Saskatchewan. While initially appearing as a straightforward phenomenon, it is, in fact, a complex systemic phenomenon. Therefore, this study employs a systems approach to realism to understand its complexity. Based on realist philosophy, I used realist synthesis, a theory-driven process that synthesizes evidence and aims to create a generative explanation for causation ‐ that is, an outcome (O) of interest was generated by relevant mechanism(s) (M) being triggered in various contexts (C). This study followed six iterative steps, including 1. initial program theory, 2. search strategy, 3. the selection and appraisal of documents, 4. data extraction, 5. analysis and synthesis of data, and 6. the dissemination of results. Through the iterative process of searching and data analysis, this realist synthesis developed an initial program theory, identified some potential mechanisms (parents' perceived values, prioritization and beliefs, self-efficacy, stress, depression, trust, anxiety, fear of being judged, and losing their child to social service, perceived food value, effects of colonialism in their beliefs, confidence, and empowerment) at the individual and community levels, and designed a multilayer conceptual map showing a hierarchy of different level mechanisms, and their interactions with each other in influencing the existence of early childhood caries in rural and remote children in Northern Saskatchewan based on available data. The mechanisms identified and hypothesized in this realist synthesis are based on secondary data that will need to be tested with the community in future research aimed to refine or refute this initial program theory.
Description
Keywords
Early childhood caries, rural and remote children, Northern Saskatchewan, realist synthesis.
Citation
Degree
Master of Science (M.Sc.)
Department
Community Health and Epidemiology
Program
Community and Population Health Science