Abstract
OBJECTIVES: Through an analysis of postings to an online parenting forum, we aimed to explore the many ways in which parents orient to (i.e., take up, challenge, re-articulate) information about child dental health in the context of their online interactions. Our analysis is anchored in Nettleton’s theoretical work on dental authority and power, which we apply in a digital context.
METHODS: We examined discussion threads from the public online forums on BabyCenter Canada. We identified relevant threads using the site search function and keywords related to dental health, with a focus on dental caries (tooth decay), related care behaviours (e.g., toothbrushing), and the controversial issue of fluoride. Following descriptive content coding, we applied a critical lens to unpack themes related to expert knowledge, gender and parenting online cultures.
RESULTS: We analyzed 479 relevant threads. Our findings focus on two central themes: the tension between parents’ views and those of dental health professionals; and, the gendered, cultural roles and expectations that position mothers as primarily responsible for the care of children’s dental health. Though these themes are not new, our findings show that they persist in the digital context where social divisions (e.g., expert/non-expert) may be blurred.
CONCLUSIONS: Our analysis of online discussions provides an opportunity to think critically about ways in which parents engage with public health, in digital contexts. Although some mothers express disconnect when communicating with dental professionals, they are very engaged and concerned with dental health issues for their children. A challenge for dental public health is to find ways to shift perspective towards recognizing that the target population is empowered and already engaged in discussions of research evidence and clinical encounters on their own terms, facilitated by an online context.
Key Words: Dentistry, parents, public health, social media, sociology
Résumé
OBJECTIFS: Au moyen d’une analyse des publications sur un site parental en ligne, nous avons pour but d’examiner les façons multiples selon lesquelles les parents s’orientent (c.-à-d., s’approprier, défier, réarticuler) les informations sur la santé dentaire des enfants dans le contexte de leurs interactions en ligne. Notre analyse s’inscrit dans le travail théorique de Nettleton sur l’autorité et le pouvoir dentaires, que nous utilisons dans un contexte numérique.
MÉTHODES: Nous avons examiné les fils de discussion des forums en ligne sur BabyCenter Canada. Nous avons identifié des fils pertinents en utilisant une fonction de recherche ainsi que des mots-clés liés à la santé dentaire, et concentrés sur les caries dentaires, les comportements de soins dentaires (p.ex., se brosser les dents), ainsi que les controverses sur le fluorure. En utilisant un code de description du contenu, nous avons utilisé un regard critique afin de décortiquer les thèmes liés aux connaissances expertes, au genre, et aux sites sur lesquels on discute des enjeux parentaux.
RÉSULTATS: Nous avons analysé 479 fils pertinents. Nos conclusions sont centrées sur deux thèmes principaux: la tension entre les pointes de vue des parents et ceux des professionnels de la santé dentaire, d’une part; et, le rôle traditionnel qui veut que ce soit la mère qui agisse à titre de responsable principal de la santé dentaire des enfants. Même si ces thèmes ne présentent rien de neuf, nos données montrent qu’ils persistent dans un contexte numérique où l’on trouve des clivages sociaux (p. ex., expert / non-expert) peuvent devenir flous.
CONCLUSIONS: Notre analyse des discussions en ligne offre l’occasion de penser de manière critique au sujet des façons dont les parents s’intéressent à la santé publique dans un contexte numérique. Malgré le fait que certaines mères constatent une discontinuation lorsqu’elles communiquent avec les professionnels de la santé dentaire, elles sont très engagées et préoccupées quant aux enjeux de la santé dentaire de leurs enfants. Un des défis pour la santé dentaire publique sera de trouver des moyens de changer la perspective afin de reconnaître que la population cible est habiletée et déjà engagée dans des discussions au sujet des preuves scientifiques et des rencontres en clinique, selon leurs propres termes, facilité par un contexte numérique.
Mots Clés: dentisterie, parents, santé publique, médias sociaux, sociologie
Footnotes
Acknowledgements: Lindsay McLaren holds an Applied Public Health Chair funded by the Canadian Institutes of Health Research (Institute of Population & Public Health and Institute of Musculoskeletal Health & Arthritis), the Public Health Agency of Canada, and Alberta Innovates - Health Solutions.
Conflict of Interest: None to declare.
References
- 1.Nettleton S. Wisdom, diligence and teeth: Discursive practices and the creation of mothers. Sociol Health Illn. 1991;13(1):98–111. doi: 10.1111/1467-9566.ep11340329. [DOI] [Google Scholar]
- 2.Nettleton S. Power, Pain and Dentistry. Buckingham, UK: Open University Press; 1992. [Google Scholar]
- 3.Calnan M, Williams S. Style of life and the salience of health: An exploratory study of health related practices in households from differing socio-economic circumstances. Sociol Health Illn. 1991;13(4):506–29. doi: 10.1111/j.1467-9566.1991.tb00525.x. [DOI] [Google Scholar]
- 4.Katainen A. Social class differences in the accounts of smoking - striving for distinction? Sociol Health Illn. 2010;32(7):1087–101. doi: 10.1111/j.1467-9566.2010.01267.x. [DOI] [PubMed] [Google Scholar]
- 5.Canadian Internet Registration Authority. Canadian Internet Registration Authority Factbook 2014. 2014. [Google Scholar]
- 6.Statistics Canada. The Daily — Canadian Internet Use Survey, 2012. 2013. [Google Scholar]
- 7.Lupton D. Health promotion in the digital era: A critical commentary. Health Promot Int. 2014;30(1):174–83. doi: 10.1093/heapro/dau091. [DOI] [PubMed] [Google Scholar]
- 8.Porter N, Ispa JM. Mothers’ online message board questions about parenting infants and toddlers. J Adv Nurs. 2013;69(3):559–68. doi: 10.1111/j.1365-2648.2012.06030.x. [DOI] [PubMed] [Google Scholar]
- 9.Madge C, O’Connor H. Parenting gone wired: Empowerment of new mothers on the internet? Soc Cult Geogr. 2006;7(2):199–220. doi: 10.1080/14649360600600528. [DOI] [Google Scholar]
- 10.Drentea P, Moren-Cross JL. Social capital and social support on the web: The case of an internet mother site. Sociol Health Illn. 2005;27(7):920–43. doi: 10.1111/j.1467-9566.2005.00464.x. [DOI] [PubMed] [Google Scholar]
- 11.Zaslow E. Revalorizing feminine ways of knowing. Inform Commun Soc. 2012;15(9):1352–72. doi: 10.1080/1369118X.2011.638653. [DOI] [Google Scholar]
- 12.Canadian Institute for Health Information. Treatment of Preventable Dental Cavities in Preschoolers: A Focus on Day Surgery Under General Anesthesia. Ottawa, ON: CIHI; 2013. [Google Scholar]
- 13.BabyCenter Canada. Who We Are. 2012. [Google Scholar]
- 14.BabyCenter Network. Traffic. 2017. [Google Scholar]
- 15.BabyCenter Canada. What’s Inside BabyCenter. 2008. [Google Scholar]
- 16.Martin B. Scientific Knowledge in Controversy: The Social Dynamics of the Fluoridation Debate. Albany, NY: State University of New York Press; 1991. [Google Scholar]
- 17.Peckham S. Slaying sacred cows: Is it time to pull the plug on water fluoridation? Crit Public Health. 2012;22(2):159–77. doi: 10.1080/09581596.2011.596818. [DOI] [Google Scholar]
- 18.Noble H, Smith J. Issues of validity and reliability in qualitative research. Evid Based Nurs. 2015;18(2):34–35. doi: 10.1136/eb-2015-102054. [DOI] [PubMed] [Google Scholar]
- 19.Eakin J, Robertson A, Poland B, Coburn D, Edwards R. Towards a critical social science perspective on health promotion research. Health Promot Int. 1996;11(2):157–65. doi: 10.1093/heapro/11.2.157. [DOI] [Google Scholar]
- 20.Singh A, Purohit B. Tooth brushing, oil pulling and tissue regeneration: A review of holistic approaches to oral health. J Ayurveda Integr Med. 2011;2(2):64–68. doi: 10.4103/0975-9476.82525. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Sarkadi A, Bremberg S. Socially unbiased parenting support on the Internet: A cross-sectional study of users of a large Swedish parenting website. Child Care Health Dev. 2005;31(1):43–52. doi: 10.1111/j.1365-2214.2005.00475.x. [DOI] [PubMed] [Google Scholar]
- 22.Plantin L, Daneback K. Parenthood, information and support on the internet. A literature review of research on parents and professionals online. BMC Fam Pract. 2009;10:34. doi: 10.1186/1471-2296-10-34. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23.Khalid A, Quirlonez C. Straight, white teeth as a social prerogative. Sociol Health Illn. 2015;37(5):782–96. doi: 10.1111/1467-9566.12238. [DOI] [PubMed] [Google Scholar]