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.”
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.
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.
You are a volunteer. Participating in this project is up to you and you may stop at any time.
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 firstname.lastname@example.org 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.
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?
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)?
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|
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)
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.