Em 2004, mais de 176 mil Agentes Comunitários de Saúde (ACS) estavam atuando no Brasil com a finalidade de colaborar nas ações de promoção da saúde e na prevenção das doenças; e de contribuir para fortalecer a capacidade da população no enfrentamento dos problemas de saúde. O propósito deste estudo foi descrever o efeito da atuação dos ACS na percepção de saúde bucal em mulheres e mães (M&M). Realizou-se uma pesquisa social do tipo antes-depois e a população compreendeu os ACS de Rio Grande da Serra (SP) e uma amostra representativa de M&M. Para avaliar a mudança de percepção da população foi aplicado antes e depois da capacitação dos ACS um formulário contendo questões fechadas. As respostas foram analisadas separadamente. Foi empregado o teste do Qui-quadrado de McNemar, adotando-se um nível de significância de 5% para rejeição da hipótese de nulidade. Os resultados mostraram que as diferenças observadas entre os ACS após sua capacitação foram estatisticamente significativas (p<0,05) para todas as 14 questões. Entre as mulheres, não foram observadas diferenças estatisticamente significativas (p>0,05) em somente duas questões. Foram captadas mudanças nos conhecimentos de saúde bucal apresentados pelas M&M, efeito que pode ser atribuído ao trabalho desse pessoal, realizado por meio de visitas domiciliares.
OBJECTIVE:To assess changes of knowledge and attitudes and health service access and utilization after the implementation of a community health worker program for oral health promotion. METHODS:A capacity building project including learning, support, and supervision activities was developed between July 2003 and August 2004. A study to assess changes was conducted including 36 community health workers and a representative sample of homemaker literate women and mothers aged 25 to 39 years living in 3-to 6-room dwelling in the city of Rio Grande da Serra, southeastern Brazil. Data on oral health knowledge, self-reported practices, and personal skills regarding self-examination, oral hygiene, number of people living in the same household, number of individual and collective toothbrushes, and dental service access and utilization were collected using structured interviews. Mean scores measured pre-and post-intervention program were compared for each group studied using Student's t-test. A 5% signifi cance level was set for the analysis.RESULTS: Statistically significant differences between pre-and postintervention program were seen regarding oral health knowledge among both health workers and women (p<0.05). The number of shared toothbrushes per family decreased. Frequency of toothbrushing and fl ossing increased. Self-assessment of oral hygiene effi cacy increased. Changes in practices and personal skills improved self-effi cacy. Women had more access to services (p<0.000) and used them more regularly (p<0.000). CONCLUSIONS:There were seen signifi cant changes of perception regarding oral health, self-effi cacy, and health service access and utilization. These changes may show that community health workers play a key role in oral health promotion.
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