Perceptions of Oral Health in Appalachian Kentucky: Implications for Message Design

Abstract

We conducted three studies to investigate Appalachian college students’ perceptions and behavior concerning oral health for the purpose of identifying salient factors to consider in designing persuasive messages to promote oral health. In Study 1, we conducted seven focus groups with 67 college students at a state university in Appalachian Kentucky. Using thematic analysis, we found that students based their oral health behavior on the perception that people living in Appalachia have poor oral health and that students denied, confirmed, reframed, or fulfilled this “misconception.” In Study 2, quantitative results from a representative survey of students (N = 587) at the same university indicated that the barriers to enacting good oral health behavior were primarily logistical in nature, whereas the facilitators of good oral health behavior were largely social. In Study 3, results from dental screenings (N = 364) of students at the university demonstrated that about one in five students presented with active, visible decay. We discuss how these results inform our understanding of oral health behavior in Appalachia and the implications of these results for designing messages to promote oral health in the region.

Notes

¹ Cody and others sometimes mentioned 60 Minutes, which has presented stories of Appalachian health disparities, but without explicit focus on oral health disparities. Diane Sawyer was commonly referred to for her 20/20 special, “A Hidden America: Children of the Mountains.” Sawyer’s (2009) documentary followed four Appalachian youth who faced struggles due to poverty, often focusing on poor oral health in the region.