Humboldt County Fluoride Survey.

Note from Fluoride Action Network,
Below is the survey that was publicly released online in Humboldt County. See the article on the survey at: What do you think about fluoride? Local health officials would like to hear it. Chris L. Coker, research analyst at the California Center for Rural Policy, explains:

“The California Center for Rural Policy has partnered with Redwood Community Action Agency, Smile Humboldt, and a team of local dental providers to conduct a county-wide survey to deepen our understanding of fluoride use and oral health practices in Humboldt County. Results from the survey will be used to inform a final report and presentation for local oral health providers and community leaders reflecting on what oral health care and fluoride use look like in our county, and how we can try to improve oral health care for our local communities moving forth.

“We are making an effort to include underrepresented or underserved populations in our Humboldt Fluoride Survey. In doing so, we would like to do some direct outreach for select groups in our local communities, some of these groups include but are not limited to: family resource centers, parents, Native communities, Spanish speaking communities, lower socioeconomic communities, displaced or unhoused communities, and many others.”

Take the fluoride survey right here and maybe win a fancy electric toothbrush!

Page 1.

Community Survey

The following section describes the purpose of the survey and asks for your consent to participate. Please review before taking the survey.

If you would like to enter our raffle for a chance to win a free Oral-B Genius electric toothbrush (Est. retail value = $115.00) from SMILE Humboldt, please enter your email at the end of the survey. Completion of the survey is not necessary to enter. Thank you for taking our fluoride survey!

1. Informed Consent for Participation

You are invited to take part in a survey by California Center for Rural Policy (CCRP) and Redwood Community Action Agency (RCAA) to share your viewpoints on fluoride. You have been asked to take part because you live (or receive services) in Humboldt County. The information you provide will be included in a summary report.

Overall Description of Participation

If you decide to be a part of this project, you will be asked to “sign” this consent form which will allow you to move through the survey on-line. There are no potential risks associated with participation in this survey. The survey is anonymous—your name is not anywhere on the consent form, and your consent is indicated by selecting the “yes” response below. The information you provide in your survey will be part of a dataset that will be used by CCRP and shared with RCAA. Your name will not be linked to the information on the survey.

Length of Participation

The survey should take about 10-15 minutes to complete.

Compensation

Participants will have the chance to enter a raffle to win one of five (5) electric toothbrushes provided by the Humboldt County Department of Health and Human Services and Smile Humboldt. You do not have to complete the survey to enter.

Volunteer Statement

You are a volunteer. Participating in this project is up to you and you may stop at any time.

Confidentiality Statement

Your name will not be linked to any information you give us as part of this study. If results are shared publicly, your name will be kept private.

Rights of Participants

If you have any concerns with this study or questions about your rights as a participant, contact the Institutional Review Board for the Protection of Human Subjects at irb@humboldt.edu or (707) 826-5165.

For specific questions about this study, you may contact research analyst Chris Coker at the California Center for Rural Policy (707-826-3400), or the program principal investigator, Dawn Arledge, California Center for Rural Policy, HSU (707-826-3402).

Statement of Informed Consent

I have read and understand what it means to be a part of this project and acknowledge that there are no harms associated with participation in this survey. I understand that the investigator or program coordinator will answer any questions I may have concerning the investigation or the procedures at any time. I also understand that my participation is entirely voluntary and that I may decline to enter this study or may withdraw from it at any time.

By clicking the “agree” statement below, I indicate that would like to be a part of this project and consent to take the survey.

Investigator: Dawn Arledge, Executive Director of the California Center for Rural Policy at Humboldt State University.

Yes, I agree to participate in this survey.

No, I do not agree to participate in this survey.

Page 2.

Demographics – Tell us about yourself

6. What is the 5-digit ZIP code where you live?

7. What is the highest level of education you have completed?

8. What is your total annual household income?

Less than $20,000

$20,000 to $34,999

$35,000 to $49,999

$50,000 to $74,999

$75,000 to $99,999

$100,000 to $149,999

$150,000 or More

9. What is your political affiliation?

Constitution

Democrat

Green

Independent/No political affiliation

Libertarian

Natural Law

Reform

Republican

Socialist

Decline to state

10. Do you think vaccines reduce the risk for other community members to become infected?

Yes, vaccines reduce community risk

No, vaccines do not reduce community risk

I don’t know

11. Do you think vaccines are more dangerous than the diseases they are designed to prevent?

Yes, more dangerous

No, not more dangerous

I don’t know

12. Do you have dental insurance of any kind?

Through my employer or a family member’s employer

Through Denti-Cal (Medi-Cal)

ACA/Covered California

Through the Department of Veteran Affairs

Private insurance (Delta Dental, etc.)

Through a source not listed

I can’t afford insurance

I do not have insurance, I pay out of pocket

I do not have insurance, I don’t go to the dentist

I don’t want insurance

I don’t know

13. When was the last time you went to the dentist?

Within the last six months

Within the last year

Within the last two years

Within the last five years or more

Never

I don’t remember

14. Are you a parent or caretaker of children (age 17 or younger)?

Yes

Page 3.

General Fluoride Knowledge

This section is to assess participants’ oral health practices and general fluoride knowledge.

15. How often do you..? (Please respond to each prompt below)

	More than twice a day	Twice a day	Once a day	A couple times a week	Once a week	When I remember to	Never
Brush your teeth	Brush your teeth More than twice a day	Brush your teeth Twice a day	Brush your teeth Once a day	Brush your teeth A couple times a week	Brush your teeth Once a week	Brush your teeth When I remember to	Brush your teeth Never
Floss	Floss More than twice a day	Floss Twice a day	Floss Once a day	Floss A couple times a week	Floss Once a week	Floss When I remember to	Floss Never
Use mouthwash	Use mouthwash More than twice a day	Use mouthwash Twice a day	Use mouthwash Once a day	Use mouthwash A couple times a week	Use mouthwash Once a week	Use mouthwash When I remember to	Use mouthwash Never

16. At what times during the day do you..? (Please select all that apply)

	When I wake up	Before I eat	After I eat	Before I go to sleep	When I remember to	Never
Brush your teeth	Brush your teeth When I wake up	Brush your teeth Before I eat	Brush your teeth After I eat	Brush your teeth Before I go to sleep	Brush your teeth When I remember to	Brush your teeth Never
Floss	Floss When I wake up	Floss Before I eat	Floss After I eat	Floss Before I go to sleep	Floss When I remember to	Floss Never
Use mouthwash	Use mouthwash When I wake up	Use mouthwash Before I eat	Use mouthwash After I eat	Use mouthwash Before I go to sleep	Use mouthwash When I remember to	Use mouthwash Never

17. How important are the following oral health measures for your teeth? (Please answer all)

	Extremely important	Very important	Somewhat important	Not too important	Not at all important	I don’t know
Going to the dentist for regular check-ups?	Going to the dentist for regular check-ups? Extremely important	Going to the dentist for regular check-ups? Very important	Going to the dentist for regular check-ups? Somewhat important	Going to the dentist for regular check-ups? Not too important	Going to the dentist for regular check-ups? Not at all important	Going to the dentist for regular check-ups? I don’t know
Community water fluoridation when applied at optimal and recommended levels?	Community water fluoridation when applied at optimal and recommended levels? Extremely important	Community water fluoridation when applied at optimal and recommended levels? Very important	Community water fluoridation when applied at optimal and recommended levels? Somewhat important	Community water fluoridation when applied at optimal and recommended levels? Not too important	Community water fluoridation when applied at optimal and recommended levels? Not at all important	Community water fluoridation when applied at optimal and recommended levels? I don’t know
Fluoride treatment (concentrated rinse, foam, gel, or varnish) when applied at the dentist office?	Fluoride treatment (concentrated rinse, foam, gel, or varnish) when applied at the dentist office? Extremely important	Fluoride treatment (concentrated rinse, foam, gel, or varnish) when applied at the dentist office? Very important	Fluoride treatment (concentrated rinse, foam, gel, or varnish) when applied at the dentist office? Somewhat important	Fluoride treatment (concentrated rinse, foam, gel, or varnish) when applied at the dentist office? Not too important	Fluoride treatment (concentrated rinse, foam, gel, or varnish) when applied at the dentist office? Not at all important	Fluoride treatment (concentrated rinse, foam, gel, or varnish) when applied at the dentist office? I don’t know
Brushing with fluoride-based toothpaste?	Brushing with fluoride-based toothpaste? Extremely important	Brushing with fluoride-based toothpaste? Very important	Brushing with fluoride-based toothpaste? Somewhat important	Brushing with fluoride-based toothpaste? Not too important	Brushing with fluoride-based toothpaste? Not at all important	Brushing with fluoride-based toothpaste? I don’t know

19. On a scale from 0 to 10 (0 being harmful and 10 being beneficial), how do you feel about toothpaste with fluoride?

0 (Toothpaste with fluoride is harmful)

5 (Not sure if toothpaste with fluoride hurts or helps you)

10 (Toothpaste with fluoride is beneficial)

20. On a scale from 0 to 10 (0 being harmful and 10 being beneficial), how do you feel about fluoride in drinking water, at optimal and recommended levels?

0 (Fluoride in drinking water at recommended levels is harmful)

5 (Not sure if fluoride in drinking water at recommended levels hurts or helps you)

10 (Fluoride in drinking water at recommended levels is beneficial)

21. On a scale from 0 to 10 (0 being harmful and 10 being beneficial), how do you feel about fluoride rinse that’s been prescribed by a dentist?

0 (Fluoride rinse prescribed by a dentist is harmful)

5 (Not sure if fluoride rinse prescribed by a dentist hurts or helps you)

10 (Fluoride rinse prescribed by a dentist is beneficial)

22. Do you think the following statements are true or false?

	True	False	I don’t know
Fluoride strengthens teeth?	Fluoride strengthens teeth? True	Fluoride strengthens teeth? False	Fluoride strengthens teeth? I don’t know
Fluoride prevents cavities?	Fluoride prevents cavities? True	Fluoride prevents cavities? False	Fluoride prevents cavities? I don’t know
Fluoride treated water (at optimal and recommended levels) is good for your health?	Fluoride treated water (at optimal and recommended levels) is good for your health? True	Fluoride treated water (at optimal and recommended levels) is good for your health? False	Fluoride treated water (at optimal and recommended levels) is good for your health? I don’t know
Fluoridated toothpaste is good for your health?	Fluoridated toothpaste is good for your health? True	Fluoridated toothpaste is good for your health? False	Fluoridated toothpaste is good for your health? I don’t know
Too much fluoride in your body can be bad for your health?	Too much fluoride in your body can be bad for your health? True	Too much fluoride in your body can be bad for your health? False	Too much fluoride in your body can be bad for your health? I don’t know

23. What is your fluoride intake/how do you get your fluoride? (Check all that apply)

I buy toothpaste with fluoride

I get fluoride treatments at the dentist

I drink tap water with fluoride

I get my teeth cleaned with fluoride at the dentist

I don’t know about my fluoride intake

I don’t know what fluoride is

I avoid fluoride

24. How comfortable are you with using the following products (at recommended levels for healthy teeth)?

	Very Comfortable	Comfortable	Neutral	Uncomfortable	Very Uncomfortable
Toothpaste with fluoride	Toothpaste with fluoride Very Comfortable	Toothpaste with fluoride Comfortable	Toothpaste with fluoride Neutral	Toothpaste with fluoride Uncomfortable	Toothpaste with fluoride Very Uncomfortable
Mouthwash with fluoride	Mouthwash with fluoride Very Comfortable	Mouthwash with fluoride Comfortable	Mouthwash with fluoride Neutral	Mouthwash with fluoride Uncomfortable	Mouthwash with fluoride Very Uncomfortable
Professional cleaning with fluoride at dentist office	Professional cleaning with fluoride at dentist office Very Comfortable	Professional cleaning with fluoride at dentist office Comfortable	Professional cleaning with fluoride at dentist office Neutral	Professional cleaning with fluoride at dentist office Uncomfortable	Professional cleaning with fluoride at dentist office Very Uncomfortable
Drinking optimally fluoridated water	Drinking optimally fluoridated water Very Comfortable	Drinking optimally fluoridated water Comfortable	Drinking optimally fluoridated water Neutral	Drinking optimally fluoridated water Uncomfortable	Drinking optimally fluoridated water Very Uncomfortable

25. What is the primary source of your tap/drinking water?

Well water

County/city water

Bottled water

I don’t know

Other (please specify)

26. Do you know if the water source you use currently is fluoridated, meaning fluoride levels in the water have been adjusted to optimal levels for healthy teeth?

Yes, I know that it is

Yes, I think that it is

I’m unsure/I don’t know

No, I know that it is not

No, I don’t think it is

27. If fluoride were added to the city’s water in your local area to prevent tooth decay, do you think you would drink more tap water, drink less tap water, or would the amount of tap water you drink stay about the same?

Less

About the same

I don’t know

It depends (please explain below)

28. What are your concerns about fluoride, if any? (Choose all that apply)

Fluoride is harmful for your body

There is not enough research on fluoride

Too much fluoride is dangerous

Fluoride causes arthritis

Fluoride causes lower IQ

The government uses fluoride as a tool for manipulation and possible harm

I would like more information on fluoride

I have no concerns about fluoride

I would like more access to fluoride

I don’t know enough about fluoride

Other (please specify)

29. Please indicate all places that you get your fluoride knowledge from? (Choose all that apply)

My Dentist

Other dental professionals – such as dental assistants, hygienist and community health workers.

Social media

Peers – Friends, Neighbors, or Family

Internet sites

Local community groups

Parent groups

Peer-reviewed academic sources

Trusted members of our community

I do my own research on Fluoride

Other (please specify)

30. Where do you get most of your fluoride knowledge from? (Choose only one)

My Dentist

Other dental professionals – such as dental assistants, hygienist and community health workers.

Social media

Peers – Friends, Neighbors, or Family

Internet sites

Local community groups

Parent groups

Peer-reviewed academic sources

Trusted members of our community

I do my own research on Fluoride

Other (please specify)

Page 4.

Free Oral Health Kit Raffle Entry

Thank you for your participation in our fluoride survey. We would like to offer you the chance to enter a free raffle.

Take the fluoride survey right here and maybe win a fancy electric toothbrush!

Page 1.

Community Survey

1. Informed Consent for Participation

Page 2.

Demographics – Tell us about yourself

2. What is your gender?

6. What is the 5-digit ZIP code where you live?

7. What is the highest level of education you have completed?

8. What is your total annual household income?

9. What is your political affiliation?

10. Do you think vaccines reduce the risk for other community members to become infected?

11. Do you think vaccines are more dangerous than the diseases they are designed to prevent?

12. Do you have dental insurance of any kind?

13. When was the last time you went to the dentist?

14. Are you a parent or caretaker of children (age 17 or younger)?

Page 3.

General Fluoride Knowledge

15. How often do you..? (Please respond to each prompt below)

16. At what times during the day do you..? (Please select all that apply)

17. How important are the following oral health measures for your teeth? (Please answer all)

19. On a scale from 0 to 10 (0 being harmful and 10 being beneficial), how do you feel about toothpaste with fluoride?

20. On a scale from 0 to 10 (0 being harmful and 10 being beneficial), how do you feel about fluoride in drinking water, at optimal and recommended levels?

21. On a scale from 0 to 10 (0 being harmful and 10 being beneficial), how do you feel about fluoride rinse that’s been prescribed by a dentist?

22. Do you think the following statements are true or false?

23. What is your fluoride intake/how do you get your fluoride? (Check all that apply)

24. How comfortable are you with using the following products (at recommended levels for healthy teeth)?

25. What is the primary source of your tap/drinking water?

26. Do you know if the water source you use currently is fluoridated, meaning fluoride levels in the water have been adjusted to optimal levels for healthy teeth?

27. If fluoride were added to the city’s water in your local area to prevent tooth decay, do you think you would drink more tap water, drink less tap water, or would the amount of tap water you drink stay about the same?

28. What are your concerns about fluoride, if any? (Choose all that apply)

29. Please indicate all places that you get your fluoride knowledge from? (Choose all that apply)

30. Where do you get most of your fluoride knowledge from? (Choose only one)

Page 4.

Free Oral Health Kit Raffle Entry

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