Understanding behavioural changes through community-based participatory research to promote oral health in socially disadvantaged neighbourhoods in Southern Sweden

BMJ Open. 2020 Apr 6;10(4):e035732. doi: 10.1136/bmjopen-2019-035732.


Objectives: Inequalities in oral health have been on the rise globally. In Sweden, these differences exist not between regions, but among subgroups living in vulnerable situations. This study aims at understanding behavioural change after taking part in participatory oral health promotional activity among families living in socially disadvantaged neighbourhoods in Southern Sweden.

Setting: The current study involved citizens from a socially disadvantaged neighbourhood in Malmö, together with actors from the academic, public and private sectors. These neighbourhoods were characterised by high rates of unemployment, crime, low education levels and, most importantly, poor health.

Participants: Families with children aged 7-14 years from the neighbourhood were invited to participate in the health promotional activities by a community representative, known as a health promoter, using snowball sampling. Between 8 and 12 families participated in the multistage focus groups over 6 months. Data were analysed using qualitative content analysis.

Results: Three main themes emerged from the analysis, providing an understanding of the determinants for behavioural change, including meaningful social interactions, family dynamics and health trajectories. The mothers in the study valued the social aspects of their participation; however, they believed that gaining knowledge in combination with social interaction made their presence also meaningful. Further, the participants recognised the role of family dynamics primarily the interactions within the family, family structure and traditional practices as influencing oral health-related behaviour among children. Participants reported having experienced a change in general health owing to changed behaviour. They started to understand the association between general health and oral health that further motivated them to follow healthier behavioural routines.

Conclusions: The results from this study show that oral health promotion through reflection and dialogue with the communities, together with other stakeholders, may have the potential to influence behavioural change and empower participants to be future ambassadors for change.

Keywords: community child health; public health; qualitative research; social medicine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Community-Based Participatory Research*
  • Health Promotion
  • Humans
  • Oral Health
  • Sweden
  • Vulnerable Populations