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Hillebrecht AL, Höfer K, Blasi A, Wicht MJ, Barbe AG. Comparison of facilitators and barriers to providing oral hygiene measures in dependent older people and young children: A systematic review. Gerodontology 2024; 41:111-124. [PMID: 36924414 DOI: 10.1111/ger.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE The objective of the study was to systematically compare barriers/facilitators providing oral hygiene to young children and dependent older people and to generate ideas to improve the implementation of oral hygiene measures. BACKGROUND Many older people, like children, rely on third-party assistance for teeth cleaning. Barriers/facilitators in providing oral care services have been described in recent works. The aim of our study was to compare these results for both groups and to increase knowledge on analogies/differences in barriers/intermediaries. METHODS We performed a systematic review. Studies reporting on knowledge, attitudes and beliefs acting as barriers/facilitators for provision of teeth cleaning were included. Thematic analysis was used and identified themes translated to domains and constructs of the theoretical domains framework and aligned to the behaviour change wheel. Based on three published reviews in children or older people, our search (PubMed via Medline), Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science, Google Scholar, last search (21 January 2023) encompassed both populations dated from their last publication (28 February 2018). The review was registered (Prospero, CRD42021278944). For quality assessment, the Newcastle-Ottawa Scale (NOS) was used. RESULTS Seventeen articles were identified (older people (n = 8), children (n = 9)). Deficits exist for both in terms of "knowledge/skills" among caregivers, with special difficulties in children with challenging behaviour and older people. "Capability" as one of the main elements of behavioural factors that are the basis for behaviour to take place (COM-B, Capability, Opportunity, Motivation-Behaviour) is most often mentioned for children and "opportunity" for older people. CONCLUSIONS Most of the facilitators and barriers affecting oral care provision in children are also relevant in older people. Approaches for the development of strategies for better implementation of oral hygiene measures in older people are presented.
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Affiliation(s)
- Anna-Lena Hillebrecht
- Department of Prosthetic Dentistry, Centre for Dental Medicine, Medical Centre - University of Freiburg, Freiburg, Germany
| | - Karolin Höfer
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Köln, Germany
| | - Alicia Blasi
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Köln, Germany
| | - Michael J Wicht
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Köln, Germany
| | - Anna Greta Barbe
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Köln, Germany
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Cruz S, Holland H, Chi DL. Validating a Conceptual Model on Topical Fluoride Hesitancy With Latino Parents. HEALTH EDUCATION & BEHAVIOR 2024:10901981241231500. [PMID: 38372277 DOI: 10.1177/10901981241231500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Fluoride hesitancy is a growing public health challenge and interventions to address it may need to be tailored for minoritized subgroups to address oral health inequities. The goals of this qualitative study were to investigate the extent to which an existing conceptual model on topical fluoride hesitancy is applicable to Latino parents and whether applicability differed between Spanish-speaking Latino (SL) and English-speaking Latino (EL) parents. We conducted semi-structured one-on-one interviews with non-Latino English-speaking parents (N = 50), SL parents (n = 8), and EL parents (n = 8). We coded the transcripts deductively and compared our findings both qualitatively and quantitatively to an existing model on topical fluoride hesitancy comprising 21 categories classified into six domains. We compared frequencies across model domains and categories for Latino versus non-Latino parents as well as for SL versus EL parents. Latino parents were represented across all six domains and 21 categories of the conceptual model. Comparing Latino and non-Latino parents, representation was similar across Domains 1 to 3 (necessity, chemicals, and harm); Latino parents were more highly represented in Domains 4 to 6 (uncertainty, pressure, and choice) compared with non-Latino parents. A larger proportion of EL parents thought a healthy diet was more important than fluoride (Category 1d) and a larger proportion of SL parents felt they did not know enough about fluoride (Category 4a). An existing conceptual model on topical fluoride hesitancy was generally a good fit for SL and EL parents. However, differential representation across model categories suggests that fluoride-related communication and intervention approaches may need to be tailored to Latino parents based on language preference.
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Adeniyi AA, Folayan MO, Chukwumah NM, Oziegbe EO, El Tantawi M. Associations between maternal mental health, child dental anxiety, and oral health of 6- to 12-year-olds in Nigeria. Braz Oral Res 2023; 37:e091. [PMID: 37820250 DOI: 10.1590/1807-3107bor-2023.vol37.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 04/19/2023] [Indexed: 10/13/2023] Open
Abstract
Maternal mental health affects their children's oral health. This study assessed the associations between maternal mental health and dental anxiety level, dental caries experience, oral hygiene, and gingival status among 6- to 12-year-old children in Nigeria. This was a cross-sectional study that recruited mother-child dyad participants through a household survey conducted in Ile-Ife, Nigeria. Data collected included the independent (maternal mental health risk, depressive symptoms, and child's dental anxiety), and dependent (caries experience, oral hygiene status, and gingival health status) variables. Multivariate logistic regression analysis was conducted to determine the associations between dependent and independent variables after adjusting for confounders (mothers' age, child's age, sex, and socioeconomic status). Statistical significance was set at p < 0.05. Of the 1411 mothers recruited, 1248 (88.4%) had low mental health risk, and 896 (63.5%) had mild depressive symptoms. As for the children, 53 (3.8%) had caries, 745 (52.8%) had moderate to high dental anxiety, 953 (63.0%) had gingivitis and 36 (2.6%) had poor oral hygiene. The maternal mental health risk was not significantly associated with the child's caries experience (AOR: 1.012; 95%CI: 0.860-1.190; p = 0.886), poor oral hygiene (AOR:1.037; 95%CI: 0.975-1.104; p=0.250), and moderate/severe gingivitis (AOR:0.887; 95%CI: 0.764-1.030; p = 0.115). Maternal depression status was not significantly associated with the child's caries experience (AOR: 0.910; 95%CI: 0.802-1.033; p = 0.145), poor oral hygiene (AOR: 1.016; 95%CI: 0.976-1.057; p = 0.439), and moderate/severe gingivitis (AOR: 0.963; 95%CI: 0.861-1.077; p = 0.509). Maternal mental health risk and depression do not seem to be risk factors for schoolchildren's oral health in Nigeria. Further studies are needed to understand these findings.
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Affiliation(s)
- Abiola Adetokunbo Adeniyi
- University of British Columbia, Faculty of Dentistry, Department of Oral Health Sciences, Vancouver, Canada
| | | | - Nneka Maureen Chukwumah
- University of Benin, School of Dentistry, Department of Preventive Dentistry, Benin City, Nigeria
| | | | - Maha El Tantawi
- Alexandria University, Faculty of Dentistry, Department of Pediatric Dentistry and Dental Public Health, Alexandria, Egypt
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Suprabha BS, Shenoy R, Mahabala KY, Nayak AP, Rao A, D'Souza V. Early Feeding and Weaning Practices of Indian Children with Early Childhood Caries: A Qualitative Exploration. JDR Clin Trans Res 2023; 8:131-138. [PMID: 35302409 DOI: 10.1177/23800844221083645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To describe the early feeding, weaning, and oral hygiene practices of children with early childhood caries (ECC), their parents' knowledge and attitudes regarding infant feeding, and the feeding-related challenges faced by the parents. METHODS This descriptive qualitative study involved parents of children with ECC who sought dental treatment at an academic dental college in India. Data were collected though focus groups conducted with the 27 parents of children with ECC, using a focus group discussion guide. Data were analyzed using the content analysis method. RESULTS Community norms, such as learning from the older women in the families or neighborhoods, guided the feeding method, duration of feeding, and weaning. Breastfeeding or bottle-feeding at bedtime beyond 12 mo of age and feeding sugary drinks during weaning were standard practices, despite knowing the risk for dental caries. Parents faced multiple challenges regarding weaning and were unaware of the significance of infant oral hygiene practices. CONCLUSION In children with ECC, infant feeding practices included prolonged breastfeeding or bottle-feeding beyond the required age, feeding at bedtime, and feeding sugary drinks. Although the parents knew that these feeding habits could increase the risk for caries, they lacked the self-efficacy to translate their knowledge into action during weaning. Also, they lacked awareness regarding infant oral hygiene practices. KNOWLEDGE TRANSFER STATEMENT The study provides information on the feeding habits of infants that can increase the risk for caries, the challenges faced by the parents of these children in altering these risky habits, and their lack of knowledge on infant oral hygiene practices. Policy/decision makers can advocate for pediatricians and pediatric dentists to incorporate anticipatory guidance or motivational interviewing techniques to tailor the preventive program for ECC for Indian children.
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Affiliation(s)
- B S Suprabha
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - R Shenoy
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - K Y Mahabala
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - A P Nayak
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - A Rao
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - V D'Souza
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
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Burgette JM, Trivedi AV, Dahl ZT, Weyant RJ, McNeil DW, Foxman B, Marazita ML. Mother's Experience of Conflict Within Their Family Social Network when Advocating for Children's oral Health. Matern Child Health J 2023; 27:151-157. [PMID: 36352279 PMCID: PMC10425745 DOI: 10.1007/s10995-022-03529-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Examine whether mothers perceived that child oral health was a source of conflict in family relationships. METHODS This cross-sectional qualitative study consisted of 126 semi-structured interviews with mothers of 3-5 year-old children from West Virginia and Pittsburgh, Pennsylvania. Interviews consisted of open-ended questions on the mother's social relationships that affected child dental visits, oral hygiene, and diet. The data were analyzed using template analysis. RESULTS Over 85% (n = 111/126) of mothers reported interpersonal conflict in their familial relationships related to child oral health. Most (78%) mothers reported conflict with their partners and 58% of mothers reported conflict with the child's grandparents. Conflicts primarily centered around keeping a consistent oral hygiene routine for the child and the promotion of a low-cariogenic diet. CONCLUSIONS FOR PRACTICE Mothers perceived child oral health promotion as a source of conflict in the family. This study suggests that identifying effective strategies to reduce conflict with caretakers are indicated. Oral health professionals can take an active role not only in communicating with the mother, but also with other caretaking adults in the family to promote oral health practices that benefit all children.
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Affiliation(s)
- Jacqueline M Burgette
- Departments of Dental Public Health and Pediatric Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, United States.
- Center for Oral Health Research in Appalachia, Morgantown, USA.
| | - Ami V Trivedi
- Center for Oral Health Research in Appalachia, Morgantown, USA
- DMD and MMPH Candidate, School of Dental Medicine, School of Public Health, University of Pittsburgh, Pittsburgh, United States
| | - Zelda T Dahl
- Center for Oral Health Research in Appalachia, Morgantown, USA
- Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, United States
| | - Robert J Weyant
- Center for Oral Health Research in Appalachia, Morgantown, USA
- Department of Dental Public Health, School of Dental Medicine, University of Pittsburgh, 3501 Terrace Street, 15261, Pittsburgh, PA, USA
| | - Daniel W McNeil
- Center for Oral Health Research in Appalachia, Morgantown, USA
- Department of Psychology, Eberly College of Arts & Sciences; and Clinical Professor, Department of Dental Public Health and Professional Practice, School of Dentistry, West Virginia University, Morgantown, USA
| | - Betsy Foxman
- Hunein F. and Hilda Maassab Endowed Professor, and Director, Center for Molecular and Clinical Epidemiology of Infectious Disease, Department of Epidemiology, University of Michigan School of Public Health, Washington , USA
| | - Mary L Marazita
- Center for Oral Health Research in Appalachia, Morgantown, USA
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics School of Dental Medicine, Pittsburgh, USA
- Department of Human Genetics, Graduate School of Public Health; Professor, Clinical and Translational Science, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Adeniyi AA, Folayan MO, Arowolo O, Oziegbe EO, Chukwumah NM, El-Tantawi M. Associations between oral habits, dental anxiety, dental service utilization, and maternal mental health status among 6- to 12-year-old children in Ile-Ife, Nigeria. Eur Arch Paediatr Dent 2022; 24:177-185. [PMID: 36367680 DOI: 10.1007/s40368-022-00767-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE The current study sought to determine the associations between maternal mental health and oral habits, dental anxiety, and dental service utilization of 6- to 12-year-old children in Ile-Ife, Nigeria. METHODS Data were obtained from a household survey involving 1411 mothers and their 6- to 12-year-old children. Data collected were the confounding (maternal age, child's age at last birthday, sex at birth and socioeconomic status), independent (maternal psychological distress, and depression status) and dependent (child's non-nutritive oral habits, dental anxiety level, and most recent dental visit) variables. Bivariate analyses were conducted to test the associations between the dependent and independent variables. After controlling for confounding variables, the associations between the dependent and independent variables were determined using multivariable linear and logistic regression analyses. RESULTS Overall, 479 (33.9%) reported one oral habit, 189 (13.4%) reported two and 99 (7.0%) children reported three or more oral habits. Only 25 (1.7%) children reported a dental visit in the year preceding the study. Higher maternal psychological distress was associated with higher dental anxiety in children (AOR: 0.094; 95% CI - 0.080 to - 0.293; p < 0.001). There was no significant association between maternal psychological distress, child's non-nutritive oral habits, and the child's most recent dental visit. There was also no association between maternal depression and the child's non-nutritive oral habits, dental anxiety level, and most recent dental visit. CONCLUSION Maternal psychological distress was a significant risk indicator for dental anxiety, but not for dental service utilization or non-nutritive oral habits among children in Ile-Ife, Nigeria. Maternal educational status was also associated with dental anxiety. Further research is needed to elucidate the study's findings.
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Folayan MO, El Tantawi M, Oginni A, Adeniyi A, Alade M, Finlayson TL. Psychosocial, education, economic factors, decision-making ability, and caries status of mothers of children younger than 6 years in suburban Nigeria. BMC Oral Health 2020; 20:131. [PMID: 32375771 PMCID: PMC7201958 DOI: 10.1186/s12903-020-01120-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/26/2020] [Indexed: 12/12/2022] Open
Abstract
Background Little information is available on the relationship between mothers’ psychosocial profile and caries status, and less information is available on the oral health status and psychosocial status of mothers of young children in Africa. This study examined the association between the psychosocial profile of mothers in Nigeria and their prevalence of caries. Methods The prevalence of caries and severe caries (DMFT > 3) in mothers with children 71 months old and younger recruited through a household survey in Ile-Ife, Nigeria, was estimated through clinical examination. The explanatory variables were maternal education, income, decision-making status, and psychosocial status (dental anxiety, general anxiety, depressive symptoms, parenting stress, executive dysfunction, sense of coherence, fatalism and social support). The risk indicators for maternal caries were analyzed with logistic regression. Results The prevalence of caries was 3.3%. Twenty (39.2%) of the 51 women with caries had DMFT > 3. Most study participants were 25–34 years old (59.3%), had secondary level education (63.1%), earned N18,000 ($49)-N30000 ($84) per month (42.9%), and can make autonomous decisions about their health care, household purchases, or visits to family/relatives (68.8%). Most women had normal general anxiety (79.9%), low dental anxiety (90.4%), and normal stress (76.4%) levels. Most also had high fatalism (56.6%), perceived moderate social support (81.6%), had normal depressive symptoms (75.9%), low executive dysfunction (55.9%), and high sense of coherence (53.8%). Mothers who had clinically significant levels of stress were twice more likely to have caries than were those whose level of stress was normal (AOR: 2.26; 95%CI: 1.04–4.89; P = 0.039). Also, mothers who had high fatalism were less likely to have caries than were those with low fatalism (AOR: 0.40; 95%CI: 0.21–0.75; P = 0.004). Conclusion High levels of parenting stress was a risk indicator for caries while high fatalism was protective from caries in mothers of children younger than 6-years. Maternal education, income and decision-making ability were not associated with maternal caries. Though the caries prevalence for women with young children was low, the prevalence of severe caries was high and this because of the possible negative effect on their health and wellbeing.
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Affiliation(s)
| | - Maha El Tantawi
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Abiola Adeniyi
- Lagos State University College of Medicine, Lagos, Nigeria
| | - Michael Alade
- Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Nigeria
| | - Tracy L Finlayson
- School of Public Health, San Diego State University, San Diego, CA, USA
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Floríndez LI, Floríndez DC, Floríndez FM, Como DH, Pyatak E, Baezconde-Garbanati L, Polido JC, Cermak SA. Oral Care Experiences of Latino Parents/Caregivers with Children with Autism and with Typically Developing Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2905. [PMID: 31416123 PMCID: PMC6721061 DOI: 10.3390/ijerph16162905] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/03/2019] [Accepted: 08/09/2019] [Indexed: 12/17/2022]
Abstract
As a result of various barriers, several pediatric populations are at risk for poor oral health, including children with disabilities and children from under-represented populations, such as Latinos. To this end, this study aimed to better understand the factors that affect the oral health experiences of 32 Latino parents/caregivers from 18 families (n = 8 with a typically developing child and n = 10 with a child with Autism). Using a qualitative descriptive methodology, each family was interviewed twice. Interviews were audio-recorded, transcribed verbatim, and coded thematically to identify the individual, social, systemic, and culturally rooted factors contributing to oral health disparities in the families. The three themes that arose were "Why would I want to start trouble?": Latino parents' dissatisfaction with dental treatments, costs, and fear of the dentist and health care providers because of their ethnic minority status as key factors inhibiting receipt of dental care; "We have to put our children first": prioritizing the oral care activities of their children over their own individual oral care needs; and "We always keep baking soda around": familial and cultural influences on oral care habits. Understanding the oral health beliefs and experiences of Latino parents and caregivers of children with and without autism is critical for developing targeted prevention and intervention programs and reducing oral health disparities.
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Affiliation(s)
- Lucía I Floríndez
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA.
| | | | | | - Dominique H Como
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Elizabeth Pyatak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | | | - Jose C Polido
- Division of Dentistry, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - Sharon A Cermak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
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Finlayson TL, Cabudol M, Liu JX, Garza JR, Gansky SA, Ramos-Gomez F. A qualitative study of the multi-level influences on oral hygiene practices for young children in an Early Head Start program. BMC Oral Health 2019; 19:166. [PMID: 31349826 PMCID: PMC6660967 DOI: 10.1186/s12903-019-0857-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individual child-level risk factors for Early Childhood Caries (ECC) have been studied, but broader family- and community-level influences on child oral hygiene behaviors are less well understood. This study explored multiple levels of influence on oral hygiene behaviors for young children in Early Head Start (EHS) to inform a future behavioral intervention targeting children from low-income families. METHODS Twenty-four semi-structured interviews were conducted with mothers of children under 4 years old, enrolled in the home visitor (HV) component of one EHS program in Los Angeles, CA, who participated in the BEhavioral EConomics for Oral health iNnovation pilot study (BEECON) in 2016-7. Audio-recordings of interviews were translated if needed, and transcribed in English, and coding and analysis was facilitated by Dedoose qualitative software. This investigation used general thematic analysis guided by the Fisher-Owens child oral health conceptual framework to identify influences on oral hygiene behaviors for the young children. RESULTS Many mothers reported brushing their children's teeth twice/day, and concern that most children frequently resisted brushing. They identified children being sick or tired/asleep after outings as times when brushing was skipped. Several child-, family-, and community-level themes were identified as influences on child oral hygiene behaviors. At the child-level, the child's developmental stage and desire for independence was perceived as a negative influence. Family-level influences included the mother's own oral hygiene behaviors, other family role models, the mother's knowledge and attitudes about child oral health, and mothers' coping skills and strategies for overcoming challenges with brushing her child's teeth. Overall, mothers in the EHS-HV program were highly knowledgeable about ECC risk factors, including the roles of bacteria and sugar consumption, which motivated regular hygiene behavior. At the community-level, mothers discussed opportunities to connect with other EHS-HV families during parent meetings and playgroups that HV coordinated. A few mothers noted that EHS-HV playgroups included brushing children's teeth after snacking, which can be a potential positive influence on children's hygiene practices. CONCLUSION Child-, family- and community-level factors are important to consider to inform the development of tailored oral health preventive care programs for families in EHS-HV programs.
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Affiliation(s)
- Tracy L Finlayson
- School of Public Health, Health Management and Policy, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA.,Center to Address Disparities in Children's Oral Health (known as CAN DO), University of California San Francisco, School of Dentistry, Box #1361, San Francisco, CA, 94143, USA
| | - MarkJason Cabudol
- University of Washington (UCLA School of Dentistry at the time of this work), Seattle, WA, USA.,Center to Address Disparities in Children's Oral Health (known as CAN DO), University of California San Francisco, School of Dentistry, Box #1361, San Francisco, CA, 94143, USA
| | - Jenny X Liu
- Department of Social and Behavioral Sciences, School of Nursing, Institute for Health & Aging, University of California San Francisco, San Francisco, CA, 94143, USA.,Center to Address Disparities in Children's Oral Health (known as CAN DO), University of California San Francisco, School of Dentistry, Box #1361, San Francisco, CA, 94143, USA.,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, Box #0936, San Francisco, CA, 94143, USA
| | - Jeremiah R Garza
- Department of Health Policy and Management, UCLA Fielding School of Public Health, University of California, 650 South Charles E. Young Drive South, Box 951772, Los Angeles, CA, 90095-1772, USA.,Center to Address Disparities in Children's Oral Health (known as CAN DO), University of California San Francisco, School of Dentistry, Box #1361, San Francisco, CA, 94143, USA
| | - Stuart A Gansky
- School of Dentistry, University of California San Francisco, Box #1361, San Francisco, CA, 94143, USA. .,Center to Address Disparities in Children's Oral Health (known as CAN DO), University of California San Francisco, School of Dentistry, Box #1361, San Francisco, CA, 94143, USA. .,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, Box #0936, San Francisco, CA, 94143, USA.
| | - Francisco Ramos-Gomez
- Section of Pediatric Dentistry, University of California Los Angeles, School of Dentistry, 10833 Le Conte Avenue, Box 951668, CHS Room 23-020B, Los Angeles, CA, 90095-1668, USA.,Center to Address Disparities in Children's Oral Health (known as CAN DO), University of California San Francisco, School of Dentistry, Box #1361, San Francisco, CA, 94143, USA
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