PSPC POR number: POR-126-22
HC POR – 22-32
Prepared for Health Canada
Supplier Name: The Strategic Counsel
Contract number: CW2271909
Contract Value: $198,398.62
Award Date: 2023-02-07
Delivery Date: 2023-03-31
Registration number: POR 126-22
For more information on this report, please contact Health Canada at:
hc.cpab.por-rop.dgcap.sc@canada.ca
Ce rapport est aussi disponible en français.
Prepared for: Health Canada
Supplier: The Strategic Counsel
March 2023
This public opinion research report presents the results of an online survey conducted by The Strategic Counsel on behalf of Health Canada. The research study was conducted with 2,200 parents of children under 12 with a household income of less than $90,000 between March 3 and March 30, 2023.
Cette publication est aussi disponible en français sous le titre: Enquête de référence sur la Prestation dentaire canadienne – Sommaire
This publication may be reproduced for non-commercial purposes only. Prior written permission must be obtained from Health Canada. For more information on this report, please contact Health Canada at hc.cpab.por-rop.dgcap.sc@canada.ca or at:
Health Canada, CPAB
200 Eglantine Driveway, Tunney's Pasture
Jeanne Mance Building, AL 1915C
Ottawa, Ontario K1A 0K9
Catalogue Number:
H14-442/2023E-PDF
International Standard Book Number (ISBN):
978-0-660-49335-0
Related Publication (Registration Number: POR-126-22)
Catalogue Number:H14-442/2023F-PDF (Final Report, French)
International Standard Book Number (ISBN):978-0-660-49336-7
©His Majesty the King in Right of Canada, as represented by the Minister of Health, 2023.
As part of the Government of Canada's plan to improve dental care for Canadians, the federal government passed legislation in November 2022 for the implementation of a new, interim Canada Dental Benefit. This benefit is intended to help lower dental costs for eligible families earning less than $90,000 per year, allowing children under 12 who do not have access to private dental care insurance to get the dental care they need while the Government of Canada develops a comprehensive, long-term, national dental care program.
Applications to the Canada Dental Benefit opened on December 1, 2022. As part of the first stage, parents and guardians can apply if the child receiving dental care is under 12 years old and does not have access to private dental insurance. For each eligible child, a tax-free payment of $260, $390, or $650 is available, depending on the family's adjusted net income. For this benefit, one can apply for a maximum of two payments for each eligible child. The first benefit period is for children under 12 years old as of December 1, 2022 who receive dental care between October 1, 2022 and June 30, 2023.
To support the promotion of this benefit, Health Canada is committed to running an advertising campaign targeting parents of children under 12 within the income threshold for this benefit. To evaluate the effectiveness and reach of marketing and advertising activities regarding the Canada Dental Benefit, more information is needed to understand current levels of awareness among target beneficiaries, their intended uptake of the program, and what barriers might exist to accessing the benefit and dental care. Additionally, Health Canada is utilizing a subset of the Advertising Campaign Evaluation Tool (ACET) to evaluate and refine communications used to advertise the benefit in order to improve future efforts.
In 2002, following a Cabinet directive identifying the need for a standard advertising evaluation approach across departments the ACET was created. The main objectives were to bring rigor and consistency to ad campaign evaluation and to develop norms for key ad metrics against which campaigns could be evaluated. While ACET is not a requirement for advertising campaigns with less than $1 million in media buy, a post-campaign evaluation is desired to inform the next phases of this initiative.
The research findings will help to inform and refine future communications, advertising, and marketing activities on the Canada Dental Benefit to ensure that they better reach and resonate with the key target audience. Furthermore, the findings will inform the development of messaging for the comprehensive, long-term, national dental care program. The research will also assist in identifying opportunities to improve the uptake of the benefit and the barriers that exist to accessing the benefit and dental care in order to ensure these can be addressed in communications.
The primary objective of this research is to establish a baseline level of awareness and assess the barriers to access among those eligible to receive the Canada Dental Benefit. More specifically, this research study was designed to address the following:
A 15-minute online survey was administered to 2,200 adult Canadians, aged 18 and older who met the eligibility criteria for the interim Canada Dental Benefit. Eligible respondents included only those with at least one child in the household under 12 years of age and whose household income was under $90,000 per year.
Of the total sample of n=2,200 Canadian parents who completed the survey, n=2,000 comprised the base sample. A strict quota was set on this portion of the sample to ensure that approximately 70% of respondents did not have access to private dental care insurance (another requirement to be eligible for the Canada Dental Benefit). The remainder (30%) comprised those who did have dental insurance. The sample was structured in this manner to allow for comparisons in the attitudes and behaviours between those with and without access to insurance coverage.
Regional quotas were also applied to the base sample, and monitoring was undertaken while the survey was in field in order to obtain broad representation from all regions of Canada. A disproportionate sampling plan was employed, including oversampling in Atlantic Canada, the Prairies, and British Columbia to ensure sufficiently robust samples in these areas to be able to analyze the results within and between regions. A weighting scheme was applied in order to bring the final sample back into line with the distribution of the population in Canada, by region1. Given the highly targeted audience for this survey no additional quotas were set for gender or age.
Two additional 'sample boosts' of n=100 each were undertaken to increase representation from ethnic groups as well as those residing in rural and remote areas of Canada. This approach was taken based on the assumption that the nationwide online panel used to deploy the base sample may not yield sufficient completes to provide sufficient insight into these two segments of the population.
This was a non-probability sample primarily relying on a commercial online panel. As such, a margin of error cannot be applied to the final sample and no inferences can be made to the broader target population. The fieldwork was conducted between March 3 rd and 30th, 2023.
The contract value was $198,398.62 including HST.
All respondents report high levels of concern about accessing affordable dental care in Canada and being able to obtain the services of a dentist or oral health professional.
In terms of attitudes towards dental care, there is a high degree of importance placed on regular visits to a dental office – 94% say it's important for themselves; 97% say it's important for their children.
There are marked differences between those with and without access to private dental insurance regarding the frequency of and reasons for visits to a dental office for themselves and their children. Those with insurance coverage are more likely to have access to dental services for the whole family and to visit the dentist on a more regular basis compared to those without coverage.
There are a wide range of issues which act as barriers to accessing dental services, impacting both adults and children.Foremost among these is the cost of the service, followed by a lack of insurance, and the cost of getting to the dentist or oral health professional. While there are clear differences in the frequency with which each is cited based on access to private dental insurance coverage, the differences are starker when it comes to barriers specifically preventing parents from taking their children to an oral health professional.
Many have heard something about the Canada Dental Benefit (64% of all respondents), although relatively few are well informed about it (22%). Over one-third (36%) have not heard anything about the benefit. Awareness of the benefit appears to have been generated mainly through coverage in the news, although one quarter to one third also identified social media and friends or family as a source of information. The announcement of the benefit generated significant interest among the target audience, with 54% of those without insurance (and aware of the benefit) reporting having looked for information about it in the last 3 months. Interest was also reasonably high among those with access to private dental insurance (40%).
There are high levels of support for the Canada Dental Benefit (CDB), across the board – overall 87% of respondents support it and this does not vary significantly between those with/without insurance coverage. Almost two thirds (64%) strongly support the introduction of the interim CDB.
The Government of Canada's advertising campaign about the Canada Dental Benefit appears to have broken through, generating good levels of unaided and aided recall in a fairly crowded media marketplace. Just over one third of all respondents (35%) have seen, heard, or read something about the Canada Dental Benefit in the last 3 months (unaided recall), while just over one in five (22%) recall seeing, hearing or reading the ads, after being exposed to some examples of the advertising campaign in the survey (aided recall).
The study results indicate that the interim Canada Dental Benefit is addressing a clear need among those without dental insurance who also meet the other requirements in order to be eligible for the benefit, such as household income and age of children. Affordability is a key issue, particularly for those with more than one child. While many parents, regardless of their ability to access private dental insurance, are taking their children to the dentist on a regular basis (e.g., at least yearly), those without insurance are more likely to cite a lack of coverage and the cost of dental services for multiple children who need dental care as barriers. And, although many parents report taking their children to the dentist for routine cleanings and preventive care, a significantly higher proportion of those without insurance visit the dentist's office to obtain urgent care for their child/children or schedule appointments for their children only when absolutely necessary – this is particularly the case among the subset of the target audience with less than $40,000 annual household income. Almost nine in ten of those without insurance indicate that having some extra money would increase the likelihood they would schedule more regular visits to the dentist for their child or children, compared to seven in ten of those with insurance coverage. Moreover, those without access to dental insurance exhibit a higher likelihood of paying for dental services in cash or by credit card. They are also more likely to visit free dental clinics or to negotiate a flexible payment plan with their dental provider.
Overall, the introduction of the Canada Dental Benefit is strongly supported by the target audience. The campaign appears to have prompted interest among those with and without dental insurance. Recall among the target audience for the benefit, on both on an unaided and aided basis, while modest does suggests that key messages relating to the purpose and nature of the benefit as well as the eligibility criteria are penetrating to some extent. Moreover, the ads have had an impact prompting a significant percentage of the target audience to consider dental care for their children, look for more information about the benefit and visit the landing page or dedicated website. The ads have also generated a reasonable level of word-of-mouth marketing activity along with early indications that the target audience has either booked an appointment or taken their child/children to get dental care using the benefit payment(s).
Notably, support for the benefit is higher among visible minorities, a group which also reported higher levels of awareness of and familiarity with the Canada Dental Benefit along with higher application rates. Interest in the CDB is particularly high among visible minority groups and those who self-identified as Indigenous, with a higher share of these communities reporting that they have looked for information about it in the past 3 months. Additionally, visible minorities and Indigenous respondents are among those groups who generally responded more positively to the ads and reported uptake of the CDB based on having seen the ad is higher among visible minorities relative to other sub-groups. At the same time, it should be noted that Indigenous respondents report that they and their child/children frequent the dentist with regularity despite the fact that a relatively small proportion (10%) of this community indicate having private dental coverage. Other issues regarding access to dental care within their communities should be examined as well as Indigenous respondents are more likely to cite the dental office location being inconvenient as a barrier.
Some variations in the experiences and attitudes of parents based on household income and gender were evident which could inform future communications on this initiative or the expanded Dental Care Benefit. A higher proportion within the subset of those with lower household incomes (under $40,000 annually) are without access to a dental professional and are among the least likely to have visited a dental office within the last 6 months, compared to those with annual household incomes above $40,000. A higher proportion of this subset are also more likely to visit a dentist only when there is an emergency, while being far less likely to report taking their children to the dentist for preventive care. Cost is also mentioned as a key barrier by a larger share of those in lower income households relative to those in the higher income bracket (e.g., between $60,000 to just under $90,000 annually). It is important to note, however, that when asked about how they pay for dental services those with a household income of less than $20,000 annually are more likely to say that the cost of dental services for their child/children is covered by insurance relative to those in the higher income brackets. This suggests that children residing in households at the lowest end of the eligibility range for the CDB, based on household income, may qualify for other programs offered at the provincial or territorial level (e.g., the Healthy Smiles Ontario).
Connecting with women in particular is key to increasing uptake of the interim CDB. Women exhibit higher levels of awareness of the Canada Dental Benefit and are more likely to have sole responsibility within the family unit for scheduling dental appointments. From a communications perspective, women are more motivated to apply for the benefit to improve the health of their family and children.
Any additional communications efforts should also consider families with younger and older children (within the 0-11 age range eligible for the interim CDB), and those with larger households. A higher percentage of those with older children and in larger households report having applied for the benefit, and those with multiple children indicate having more than one child needing dental care is both a barrier to access as well as a key motivator for applying. While the research suggests that parents may be prioritizing the dental needs of older children in the household, respondents with children aged 5 or younger are more likely to recall having seen, read, or heard about Government of Canada advertising of the Canada Dental Benefit compared to those with children aged 9 to 11. An additional advertising push targeting those with younger children may prompt habit forming preventive dental care at an earlier age. Dental education for parents with young children, highlighting the benefits of regular dental care may prove beneficial.
Statement of Political Neutrality
I hereby certify as Senior Officer of The Strategic Counsel that the deliverables fully comply with the Government of Canada political neutrality requirements outlined in the Government of Canada's Policy on Communications and Federal Identity and Directive on the Management of Communications. Specifically, the deliverables do not include information on electoral voting intentions, political party preferences, party standings with the electorate, or ratings of the performance of a political party or its leaders.
Signed:
Donna Nixon, Partner
[1] The weighting scheme was developed to align the data regionally with Census 2021 data from Statistics Canada.