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van Nes KA, van Loveren C, Aartman IHA. Validation of an improved questionnaire assessing the social cognitive constructs of the Health Action Process Approach among parents regarding brushing their children's teeth. PLoS One 2024; 19:e0300432. [PMID: 38833490 PMCID: PMC11149846 DOI: 10.1371/journal.pone.0300432] [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: 11/08/2023] [Accepted: 02/27/2024] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVE The Health Action Process Approach (HAPA) describes social cognitive constructs related to behaviour change. A validated questionnaire is needed to measure these constructs in paediatric dentistry. The aim of this study was to improve an existing HAPA-based questionnaire for parents regarding brushing their children's teeth and to assess its validity and reliability in a population of parents of high caries risk children. METHODS Parents of high caries risk children of 3-10 years filled out the adjusted HAPA-based questionnaire. Mokken scale analysis, graded response model analyses, factor analyses and reliability analyses were performed according to the protocol of Dima. Discriminant validity was assessed by comparing the mean scores of the HAPA constructs between two groups of participants, based on different levels of caries experience, brushing frequency and education level of the mother. RESULTS The Mokken scale analysis and factor analyses indicated a multidimensional eight factor scale. The graded response model did not fit our data. The subscale action control could be identified as a two-factor subscale. Reliability indices from the Dima protocol varied, for instance Cronbach alpha ranged from 0.73 to 0.96. The constructs coping self-efficacy, action planning and action control discriminated between brushing frequencies. CONCLUSIONS The adjusted HAPA-based questionnaire is an improved, valid and reliable instrument that could be used to evaluate HAPA-based interventions to improve children's oral health.
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Affiliation(s)
- Karin Alexandra van Nes
- Department of Paediatric Dentistry, Academic Centre for Dentistry, University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
| | - Cor van Loveren
- Department of Paediatric Dentistry, Academic Centre for Dentistry, University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
| | - Irene Helena Adriana Aartman
- Department of Oral Public Health, Academic Centre for Dentistry, University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
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Goldthorpe J, Kilbee L, Pretty I, Cotterill S, Hart J, Peters S. Supporting post-pandemic recovery: a qualitative study of the capabilities, opportunities and motivations to deliver oral health behaviour change messages to parents of young children in community settings. BMC Oral Health 2024; 24:580. [PMID: 38762726 PMCID: PMC11102627 DOI: 10.1186/s12903-024-04344-0] [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] [Received: 01/16/2023] [Accepted: 05/07/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic exacerbated vulnerabilities and inequalities in children's oral health, and treatment activity virtually ceased during periods of lockdown. Primary care dentistry is still in the post-pandemic recovery phase, and it may be some years before normal service is resumed in NHS dentistry. However, opportunities to support the dental workforce through offering some preventative care in outreach settings may exist. This has the additional benefit of potentially reaching children who do not routinely see a dentist. The aim of this research was therefore to explore views around upskilling practitioners working in early years educational and care settings to support families of pre-school aged children to adopt and maintain preventative oral health behaviours. METHODS Using the Capability, Opportunity and Motivation model of behaviour (COM-B) to structure our data collection and analysis, we conducted semi-structured interviews with 16 practitioners (dental and non-dental) and analysed the data using deductive framework analysis. RESULTS The data were a good fit with the COM-B model, and further themes were developed within each construct, representing insights from the data. CONCLUSION Early years practitioners can reach vulnerable children who are not usually brought to see a dentist, and have the capability, opportunity and motivation to support the oral health behaviours of families of children in their care. Further research is needed to identify training needs (oral health and behaviour change knowledge and skills), acceptability to parents, and supporting dental practice teams to work in partnership with early years settings.
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Affiliation(s)
- Joanna Goldthorpe
- Manchester Centre for Health Psychology, Division of Health Research, University of Manchester, Manchester, UK
| | - Lauren Kilbee
- Manchester Centre for Health Psychology, Division of Health Research, University of Manchester, Manchester, UK
| | - Iain Pretty
- Division of Medical Sciences, Colgate Palmolive University of Manchester Dental Health Unit, Manchester, UK
| | - Sarah Cotterill
- Centre for Biostatistics, School of Health Sciences, University of Manchester, Manchester, UK
| | - Jo Hart
- Division of Medical Education, School of Medical Sciences, University of Manchester, Manchester, UK
| | - Sarah Peters
- Manchester Centre for Health Psychology, Division of Health Research, University of Manchester, Manchester, UK.
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Smith SR, Kroon J, Schwarzer R, Hamilton K. Promoting regular parental supervised toothbrushing: An additive intervention design adopting the Health Action Process Approach. Appl Psychol Health Well Being 2024; 16:315-337. [PMID: 37712357 DOI: 10.1111/aphw.12489] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/24/2023] [Indexed: 09/16/2023]
Abstract
The study aimed to test the efficacy of the core elements of the Health Action Process Approach (HAPA) in an intervention among parents to promote regular supervised toothbrushing of preschool-aged children. The pre-registered study (https://osf.io/fyzh3/) tested the effects of an intervention employing information provision, behavioural instruction, implementation intention and mental imagery techniques, adopting a randomised controlled design in a sample of Australian parents of preschoolers (N = 254). The intervention used an additive design with four conditions-education, self-efficacy, planning and action control-progressively layered to show the cumulative impact of incorporating self-efficacy, planning and action control strategies with a foundational education component. The intervention was delivered online, and participants completed self-report measures of parental supervised toothbrushing and HAPA-based social cognition constructs pre-intervention and 4 weeks post-intervention. Although no significant intervention effects on behaviour were observed, mixed-model analyses of variance (ANOVAs) revealed an increase in intention and task self-efficacy within the action control condition and an increase in action planning in both the action control and planning conditions from pre-intervention to follow-up. Despite no anticipated changes in behaviour, these findings endorse the use of theory- and evidence-based behaviour change strategies to inspire change in HAPA-based determinants of parental supervised toothbrushing: intention, action planning and task self-efficacy.
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Affiliation(s)
- Stephanie R Smith
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Jeroen Kroon
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Ralf Schwarzer
- Division of Health Psychology, Freie Universität Berlin, Berlin, Germany
- Faculty of Psychology, SWPS University, Wroclaw, Poland
| | - Kyra Hamilton
- School of Applied Psychology, Griffith University, Brisbane, Australia
- Health Sciences Research Institute, University of California, Merced, California, USA
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Kötting L, Henschel N, Keller FM, Derksen C, Lippke S. Social-cognitive correlates of expectant mothers’ safe communication behaviour: Applying an adapted HAPA model. COGENT PSYCHOLOGY 2023. [DOI: 10.1080/23311908.2023.2173996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Affiliation(s)
- L. Kötting
- Constructor University gGmbH, Bremen, Germany
| | | | | | - C. Derksen
- Constructor University gGmbH, Bremen, Germany
| | - S. Lippke
- Constructor University gGmbH, Bremen, Germany
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Akşit-Bıçak D. Dentist Mothers' Attitudes, Challenges and Facilitators in the Oral Health Promotion of Their Young Children. CHILDREN (BASEL, SWITZERLAND) 2023; 11:59. [PMID: 38255372 PMCID: PMC10813851 DOI: 10.3390/children11010059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/25/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024]
Abstract
Twice daily parental supervised brushing (PSB) is recommended for the effective oral hygiene of children with toothpaste including fluoride. This cross-sectional study aimed to identify dentist mothers' attitudes, challenges, and facilitators in the oral health promotion of their young children. An online questionnaire was prepared and distributed to dentists via e-mail with a link to the form. Of all the mothers, 46.50% started brushing their children's teeth after the eruption of the first primary teeth. Nearly 50% of the mothers thought that they should brush their children's teeth until at least the age of 7-8 years old. In terms of the main barriers to toothbrushing, 52.9% said children could fall asleep at home or in the car, while 27.5% of all mothers reported being tired as the main barrier to toothbrushing. Although dentist mothers have sufficient knowledge to promote oral and dental health, they do not always have ideal attitudes and behaviors and they may encounter various barriers regarding themselves and their children in practical applications. Providing oral care for young children goes beyond 'knowledge' and is sometimes 'challenging'; however, it could be 'possible' by developing and implementing the most appropriate solution strategies suitable for each unique family and child.
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Affiliation(s)
- Damla Akşit-Bıçak
- Department of Pediatric Dentistry, Faculty of Dentistry, Final International University, Mersin 10, Nicosia 99010, Turkey
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Zaborskis A, Kavaliauskienė A, Levi S, Tesler R, Dimitrova E. Adolescent Toothbrushing and Its Association with Sociodemographic Factors-Time Trends from 1994 to 2018 in Twenty Countries. Healthcare (Basel) 2023; 11:3148. [PMID: 38132038 PMCID: PMC10742657 DOI: 10.3390/healthcare11243148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
Regular toothbrushing is the primary self-care method to prevent the most common dental diseases and is considered an important public health indicator. This retrospective observational study aimed to examine cross-national time trends in adolescent toothbrushing behaviour and its association with sociodemographic factors between 1994 and 2018. We studied data from 20 countries that conducted seven surveys of the Health Behaviour in School-aged Children (HBSC) study. Adolescents aged 11, 13 and 15 years responded to questions on their toothbrushing frequency, family affluence and structure. Altogether, reports of 691,559 students were analysed using descriptive statistics and binominal logistic regression. The findings showed an overall positive trend in the prevalence of more-than-once-a-day toothbrushing frequency during the entire study period mainly due to a noticeable increase from 1994 to 2010 (except Denmark and Sweden); this trend continued significantly thereafter in 12 of 20 countries. Across all countries, girls and adolescents from more affluent families were more likely to brush their teeth regularly. These relationships remained unchanged throughout the study period, whereas the age-related difference in toothbrushing prevalence decreased noticeably, and the negative relationship between toothbrushing and living in a non-intact family became evident. While the prevalence of regular toothbrushing among adolescents has increased in recent decades, it is still far behind the recommended level of twice-daily brushing for everyone across all countries. The promotion of toothbrushing needs to start at an early age, with a special focus on boys and adolescents from low-affluence and non-intact families.
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Affiliation(s)
- Apolinaras Zaborskis
- Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
| | - Aistė Kavaliauskienė
- Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania;
| | - Sharon Levi
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 4077625, Israel; (S.L.); (R.T.)
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Afula 1930600, Israel
| | - Riki Tesler
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 4077625, Israel; (S.L.); (R.T.)
| | - Elitsa Dimitrova
- Institute for Population and Human Studies, Bulgarian Academy of Sciences & Plovdiv University Paisii Hilendarski, 1000 Sofia, Bulgaria;
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Saraf T, Hegde R, Shah P. A comparative evaluation of the learning outcome of toothbrushing in preschoolers by a novel cartoon-based education aid with conventional toothbrushing model education technique: A randomized controlled trial. J Indian Soc Pedod Prev Dent 2023; 41:302-308. [PMID: 38235816 DOI: 10.4103/jisppd.jisppd_496_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND The recommendation of toothbrushing which is twice daily for 2 min is well known, but for most parents, getting their children to brush is a stressful task. The barriers are numerous. In this study, we focused on imparting knowledge and motivation to toothbrushing while making it into a playful activity for the child as well as their parents. AIM The aim of this study was to comparatively evaluate the learning outcome of toothbrushing by a novel cartoon-based education aid with conventional toothbrushing model education technique in preschoolers. MATERIALS AND METHODS The study included 43 children aged between 3 and 5 years randomly allocated into two groups: Group A received toothbrushing instruction through play with a novel cartoon-based education aid and Group B received instructions through an acrylic brushing model. Both the groups were recalled on the 8th day, and the glass index was used to assess for plaque estimation. The intergroup comparison was done by unpaired t-test and the intragroup analysis by paired t-test. RESULTS The comparison of the mean plaque scores in both the groups at the 8th day was not significant statistically (P = 0.965). The intragroup analysis, from baseline to the 8th day, in Group A, with mean difference (0.277 ± 0.751), was not statistically significant (P = 0.135), whereas in Group B, the mean difference (0.400 ± 0.598) was statistically significant (P = 0.008). CONCLUSIONS The reduced mean of plaque scores proves that both the techniques had a positive impact on reducing the plaque scores; however, the comparison between the two groups was not statistically significant.
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Affiliation(s)
- Tanvi Saraf
- Department of Pediatric and Preventive Dentistry, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be University), Navi Mumbai, Maharashtra, India
| | - Rahul Hegde
- Department of Pediatric and Preventive Dentistry, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be University), Navi Mumbai, Maharashtra, India
| | - Preetam Shah
- Department of Pediatric and Preventive Dentistry, D.Y. Patil Dental College, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
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Torlińska-Walkowiak N, Łukaszewicz K, Morawska A, Sowińska A, Pawlaczyk-Kamieńska T, Opydo-Szymaczek J. Diet, Oral Hygiene Habits, and Approach to Dental Visits of Early School-Aged Children during the COVID-19 Pandemic and Possible Long-Term Health Consequences. J Clin Med 2023; 12:5690. [PMID: 37685757 PMCID: PMC10488684 DOI: 10.3390/jcm12175690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/27/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
INTRODUCTION Early school-aged children are in a transitional phase from primary to permanent dentition. Established dietary and oral hygiene habits will influence the condition of the oral cavity in the future. AIM This study aimed to evaluate alterations in early school children's dietary and oral hygiene practices during the COVID-19 pandemic and to anticipate potential long-term health implications. MATERIAL AND METHODS This cross-sectional online study involved guardians of Polish children aged 6-10 years, living in Western Poland, who were socially isolated at home during the COVID-19 pandemic. A total of 180 guardians were invited to participate in this study. The questionnaire included 17 questions divided into four different sections-the child's anthropometric data, dietary habits, oral health, and attitude to dental visits. RESULTS The survey was completed by 106 guardians. The mean (standard deviation) age of the children was 8.12 (0.93) years (range 6-10 years). Overall, 24.5% of the surveyed individuals reported buying healthy products (fresh vegetables, fruit) more frequently during the pandemic. Furthermore, 35.8% admitted to snacking between meals more frequently and 16.0% less frequently. Almost one-quarter of the parents acknowledged that their children were less motivated to maintain oral hygiene during the pandemic and 28.3% declared a lower frequency of visits to the dentist from the outbreak of the pandemic for two main reasons: a fear of coronavirus transmission and economic reasons. CONCLUSIONS In the group studied, the results of the assessment indicate that the COVID-19 pandemic had some effects on oral health that may lead to an increased risk of oral disease development, such as tooth decay in children. None of the respondents noticed an increase in their child's motivation about good oral hygiene despite spending more time at home. The irregularity of follow-up visits for one-third of the respondents hindered preventive measures and the continuation of dental treatment.
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Affiliation(s)
| | - Karolina Łukaszewicz
- Scientific Circle at Department of Pediatric Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Alicja Morawska
- Scientific Circle at Department of Pediatric Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Anna Sowińska
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | - Tamara Pawlaczyk-Kamieńska
- Department of Risk Group Dentistry, Pediatric Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Justyna Opydo-Szymaczek
- Department of Pediatric Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland
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van Nes KA, van der Ark LA, van Loveren C, Aartman IHA. Construction of a questionnaire based on the Health Action Process Approach for psycho-social cognitive determinants of parents in brushing children's teeth in the Netherlands. PLoS One 2023; 18:e0289337. [PMID: 37535634 PMCID: PMC10399854 DOI: 10.1371/journal.pone.0289337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/18/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND The health action process approach (HAPA) model is promising to increase the frequency of brushing children's teeth by parents to improve their children's oral health. A validated HAPA questionnaire is needed as one of the measures of the effects of such an intervention. OBJECTIVES The aim of this study was to evaluate whether our data, based on a translated and adopted version of the Health Action Process Approach (HAPA)-based questionnaire on dental flossing, supported the constructs of the HAPA model. If so, a next aim was to assess whether these constructs could be measured reliably. METHODS In this cross-sectional study, 269 questionnaires filled out in dental offices by parents of children 1-10 years old were analysed. Scale validation was performed according to the 6-step protocol of Dima, including Mokken scale analyses (MSA), graded response model (GRM), factor analyses and reliability measures. Pearson correlation coefficients were calculated to identify divergent validity and test-retest reliability. RESULTS MSA showed a unidimensional, medium total scale. Three items were removed based on this analysis. The total scale with the remaining 26 items did not fit the GRM. Factor analysis extracted five factors and two components for the total scale. The separate subscales, except the 'intention' construct, fitted the MSA and did not fit the GRM. The data fitted a seven-factor model better than a one-factor model. Reliability measures varied from acceptable to excellent, but were poor for 'action control'. Test-retest reliability (r's 0.60-0.83) was questionable to good. CONCLUSION Our results did not fully support the constructs of the HAPA model. To support the HAPA constructs, modification to the subscales risk perceptions, intention, action planning, action control and self-reported behaviour are suggested. With these adjustments, the reliability and validity of the questionnaire could be significantly improved".
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Affiliation(s)
- Karin Alexandra van Nes
- Department of Paediatric Dentistry, Academic Centre for Dentistry (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
| | - L Andries van der Ark
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Cor van Loveren
- Department of Paediatric Dentistry, Academic Centre for Dentistry (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
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Parkinson J, Hannan T, McDonald N, Moriarty S, Nguyen TM, Hamilton K. Health action process approach: promoting physical activity, and fruit and vegetable intake among Australian adults. Health Promot Int 2023; 38:daad095. [PMID: 37647521 PMCID: PMC10468016 DOI: 10.1093/heapro/daad095] [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: 09/01/2023] Open
Abstract
Based on the health action process approach (HAPA) this study examined whether changes in social cognition constructs could predict change in physical activity and fruit and vegetable intake for adult participants in My health for life, an Australian health promotion behaviour change program. Variance-based structural equation modelling was used to analyse data obtained from Australian adult program participants (n = 167) at baseline (T1), week 14 (T2), week 26 (T2), and 6-month post-program (T4). Change scores were calculated for the social cognition constructs and behaviour. Changes in action self-efficacy and outcome expectancies positively predicted changes in intentions. Action self-efficacy changes also predicted changes in maintenance self-efficacy which, in turn, mediated the effect of action self-efficacy on recovery self-efficacy and planning. Planning was predicted by changes in intentions and maintenance self-efficacy. Findings support the use of the HAPA model in designing complex health behaviour change interventions to achieve sustained behaviour change.
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Affiliation(s)
- Joy Parkinson
- Faculty of Law and Business, Australian Catholic University, Banyo, Australia
- Griffith Business School, Griffith University, Nathan, Australia
| | - Thomas Hannan
- Griffith Business School, Griffith University, Nathan, Australia
| | - Nicole McDonald
- Menzies Health Institute of Queensland, Griffith University, Nathan, Australia
| | | | - Tuyet-Mai Nguyen
- Griffith Business School, Griffith University, Nathan, Australia
| | - Kyra Hamilton
- Menzies Health Institute of Queensland, Griffith University, Nathan, Australia
- School of Applied Psychology, Griffith University, Mt Gravatt, Australia
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Liu S, Chongsuvivatwong V, Zhang S, Thearmontree A. Pathway of Effects of Socioeconomic Status on Rural Left-behind Children to Receive Oral Health Services: A Structural Equation Modeling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1068. [PMID: 36673824 PMCID: PMC9858901 DOI: 10.3390/ijerph20021068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
In a rural area with a high proportion of left-behind children (LBC), we aimed to identify the pathway of influence of socioeconomic status (SES) on LBCs to receive oral health services after individualized advice. Between September and October 2020, in a rural area of Yunnan, a survey of 238 LBC and 210 non-left-behind children (NLBC) showed that 91.9% and 94.2% had primary teeth caries, respectively. Their caregivers were advised on (1) dental care: bringing the children to seek professional dental care; and (2) self-care: supervising the children's oral health behaviors. Two to three months later, the children and their caregivers were visited to assess the compliance with these items of advice. Structural equation modeling (SEM) was used to handle the association between SES and compliance with the advice. A heatmap was used to visualize the data of reasons for seeking dental care or not. A total of 183 (87.1%) NLBCs and 206 (86.6%) LBCs were given the above advice; 32.9% of caregivers complied with dental care advice without a statistical difference between the LBC and NLBC group; 69.9% of caregivers of NLBCs complied with self-care advice, statistically more than those LBCs (59.2%). The education of caregivers was significantly associated with compliance with both advice items in univariate analysis. SES had a direct effect on the children being left behind and the level of oral health knowledge and awareness of the caregivers. Being left behind did not have an independent effect on receiving oral health services for children. "Dental disease was not severe" and "having no pain" were the main reasons for not seeking dental care. There was no clear grouping of participants with different background information based on the reasons given for seeking or not seeking dental care. Our study pointed to the importance of SES level. Being left behind alone may not be a risk factor for missing oral health services among rural children.
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Affiliation(s)
- Sichen Liu
- Improvement of Oral Health Care Research Unit, Community Dentistry Division, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla 90110, Thailand
- Department of Dental Public Health, School of Stomatology, Kunming Medical University, Kunming 650000, China
| | | | - Shinan Zhang
- Department of Dental Public Health, School of Stomatology, Kunming Medical University, Kunming 650000, China
| | - Angkana Thearmontree
- Improvement of Oral Health Care Research Unit, Community Dentistry Division, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla 90110, Thailand
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Tahani B, Asgari I, Golkar S, Ghorani A, Hasan Zadeh Tehrani N, Arezoo Moghadam F. Effectiveness of an integrated model of oral health-promoting schools in improving children's knowledge and the KAP of their parents, Iran. BMC Oral Health 2022; 22:599. [PMID: 36510207 PMCID: PMC9744048 DOI: 10.1186/s12903-022-02644-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The aim of our study was to investigate the effect of an Oral Health Promoting School (OHPS) model on children's oral health in Iran. METHODS This interventional quasi-experimental study was conducted in the academic year 2019-20 among 354 primary school students and their parents. A questionnaire including 17 questions was distributed among children before and 5 months after the program (The ranges of possible scores = 0-17). Training workshops for the parents based on the theoretical domains framework were designed. Using educational sessions, pamphlets, tooth brushing dairies, assignments to do at home, educational videos and messages as reminders in social networks, parents were educated about dental caries, its risk factors and prevention principles. Best recommended oral health behaviors including tooth brushing and the use of fluoridated tooth paste were also educated. A questionnaire consisting of 18 knowledge (The ranges of possible scores = 0-18), 13 attitude and 10 practice questions were distributed among parents before and after the workshops. The data were fed into SPSS and analyzed by descriptive and analytic statistics such as T-test, ANOVA and Correlation Coefficients (α = 0.05). RESULTS The mean pre-test knowledge (7.8 ± 1.7) was increased significantly in three schools after program, p < 0.001. In the post-test, girls gained significantly higher scores (9.61 ± 1.98 vs. 9.06 ± 1.4, p = 0.025). Among 147 parents, the mean knowledge was raised from 12.3 ± 3.1 (5-18) to 15 ± 3.03 (6-18), p < 0.001. Knowledge score of the parents attending both sessions was higher. Practice of the parents regarding the use of fluoridated tooth-paste was significantly improved (p < 0.001). Also, their attitude toward the ability of children to take care of their teeth was improved (p = 0.029). Based on the self-report of parents, 71.4% (n = 47) of mothers and 45.6% (n = 67) of their children used to brush once or two times daily and there was a correlation between their behaviors (p < 0.001, Spearman Correlation Coefficient = 0.4). CONCLUSION It seems that the education provided in OHPS had positive effects on increasing students' awareness and to some extent, the knowledge, attitude and practice of the parents.
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Affiliation(s)
- Bahareh Tahani
- grid.411036.10000 0001 1498 685XDepartment of Oral Public Health, Dental Research Center, Dental research Institute,School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Imaneh Asgari
- grid.411036.10000 0001 1498 685XDepartment of Oral Public Health, Dental Material Research Center, Dental Research Institute,School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shayan Golkar
- grid.411036.10000 0001 1498 685XDental Students Research Commiittee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Ghorani
- grid.411036.10000 0001 1498 685XDental Students Research Commiittee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nooshin Hasan Zadeh Tehrani
- grid.411036.10000 0001 1498 685XDental Students Research Commiittee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Arezoo Moghadam
- grid.411036.10000 0001 1498 685XDental Students Research Commiittee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Tadakamadla SK, Rathore V, Mitchell AE, Johnson N, Morawska A. Protocol of a cluster randomised controlled trial evaluating the effectiveness of an online parenting intervention for promoting oral health of 2-6 years old Australian children. BMJ Open 2022; 12:e056269. [PMID: 36229155 PMCID: PMC9562284 DOI: 10.1136/bmjopen-2021-056269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Dental decay is a major problem among Australian children. It can be prevented through good self-care and limiting sugar intake, but many parents/caregivers lack the skills and confidence to help their children adopt these practices. This trial will evaluate the efficacy of Healthy Habits Triple P - Oral health, a web-based online programme, in improving children's oral health-related behaviours (toothbrushing, snacking practices and dental visits) and related parenting practices, thereby preventing dental caries. METHODS AND ANALYSIS This is a cluster, parallel-group, single-blinded, randomised controlled trial of an online intervention for parents/caregivers of children aged 2-6 years. From the City of Gold Coast (Australia), 18 childcare centres will be randomly selected, with equal numbers randomised into intervention and control arms. Intervention arm parents/caregivers will receive access to a web-based parenting intervention while those in the control arm will be directed to oral health-related information published by Australian oral health agencies. After the completion of the study, the Healthy Habits Triple P - Oral health intervention will be offered to parents/caregivers in the control arm. The primary outcome of this trial is toothbrushing frequency, which will be assessed via Bluetooth supported smart toothbrushes and parent/caregiver report. Data on other outcomes: parenting practices and child behaviour during toothbrushing, consumption of sugar rich foods and parents' confidence in dealing with children's demands for sugar rich food, and dental visiting practices, will be collected through a self-administered questionnaire at baseline (before randomisation), and 6 weeks (primary endpoint), 6 months and 12 months after randomisation. Data on dental caries will be collected at baseline, 12 and 18 months post-randomisation. ETHICS AND DISSEMINATION Ethical approval has been obtained from Human Research Ethics Committees of Griffith University (2020/700) and the University of Queensland (2020002839). Findings will be submitted for publication in leading international peer-reviewed journals. TRIAL REGISTRATION NUMBER ACTRN12621000566831.
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Affiliation(s)
- Santosh Kumar Tadakamadla
- Dentistry and Oral Health, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Vatsna Rathore
- Dentistry and Oral Health, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Amy E Mitchell
- School of Nursing and Midwifery & Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- Parenting and Family Support Centre, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Newell Johnson
- School of Medicine and Dentistry & Menzies Health Institute Queensland, Griffith University - Gold Coast Campus, Gold Coast, Queensland, Australia
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Alina Morawska
- Parenting and Family Support Centre, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
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Tadakamadla SK, Rathore V, Mitchell AE, Kaul A, Morawska A. Child- and family-level factors associated with toothbrushing frequency in a sample of Australian children. Int J Paediatr Dent 2022; 32:639-648. [PMID: 34811821 DOI: 10.1111/ipd.12942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/10/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Identifying the factors that are conducive to good toothbrushing practices is fundamental for planning oral health promotion interventions. AIM This study evaluated the relationships between child and family socio-demographic characteristics; children's behaviour during toothbrushing; family support for toothbrushing; parents' practices, attitudes and knowledge related to toothbrushing; general parenting practices; and children's behavioural problems, and children's toothbrushing frequency. DESIGN A cross-sectional survey was conducted between February and May 2020 with parents of children aged 2-8 years, recruited through childcare centres throughout Australia. Parents completed self-administered surveys on child and family characteristics. RESULTS A total of 606 parents completed the survey. Only half (52.5%) of the children of surveyed parents brushed their teeth twice or more/day. Children of university-educated parents [odds ratio (OR): 6.48; 95% confidence intervals (CIs): 1.21-34.71] and those concerned about their child's toothbrushing (OR: 1.44; 95% CI: 1.21-1.72) were more likely to brush twice or more/day. Where children were non-compliant during toothbrushing or parents reported using ineffective parenting strategies during toothbrushing, children were less likely to brush their teeth twice or more/day. Lack of concern of parent about toothbrushing was associated with brushing less than twice/day in children CONCLUSIONS: Measures of parenting and child behaviour that were specific to the toothbrushing context were associated with twice daily brushing while general measures of parenting and child behaviour were not correlated with twice daily brushing.
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Affiliation(s)
- Santosh Kumar Tadakamadla
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Vatsna Rathore
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Amy E Mitchell
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia.,Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Anshul Kaul
- Health Improvement, Strategy Policy and Planning, Department of Health, Darwin, Northern Territory, Australia
| | - Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
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Lee HH, Avenetti D, Edomwande Y, Sundararajan V, Cui L, Berbaum M, Nordgren R, Sandoval A, Martin MA. Oral community health worker-led interventions in households with average levels of psychosocial factors. FRONTIERS IN ORAL HEALTH 2022; 3:962849. [PMID: 36035381 PMCID: PMC9403266 DOI: 10.3389/froh.2022.962849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionHousehold-level psychosocial stress levels have been linked to child tooth brushing behaviors. Community health worker (CHW) interventions that target psychosocial factors in high-risk communities have been associated with changes in health behaviors.AimObserve changes in psychosocial factors over time and an association between psychosocial factors and CHW intervention dose amongst urban Chicago families.Patients and methodsParticipants (N = 420 families) were recruited from 10 community clinics and 10 Women, Infants, or Children (WIC) centers in Cook County, Illinois to participate in a clinical trial. Research staff collected participant-reported psychosocial factors (family functioning and caregiver reports of depression, anxiety, support, and social functioning) and characteristics of CHW-led oral health intervention visits (number, content, child engagement) at 0, 6, and 12 months. CHWs recorded field observations after home visits on household environment, social circumstances, stressors, and supports.ResultsParticipants across the cohort reported levels of psychosocial factors consistent with average levels for the general population for nearly all measures. Psychosocial factors did not vary over time. Social functioning was the only measure reported at low levels [32.0 (6.9); 32.1 (6.7); 32.7 (6.9); mean = 50 (standard deviation)] at 0, 6, and 12 months. We did not observe a meaningful difference in social functioning scores over time by exposure to CHW-led intervention visits (control arm, 0, 1, 2, 3, and 4 visits). Field observations made by CHWs described a range of psychosocial stress related to poverty, language barriers, and immigration status.ConclusionThe unexpectedly average and unchanging psychosocial factors over time, in the context of field observations of stress related to poverty, lack of support, immigration status, and language barriers, suggests that our study did not adequately capture the social determinants of health related to oral health behaviors or that measurement biases precluded accurate assessment. Future studies will assess psychosocial factors using a variety of instruments in an attempt to better measure psychosocial factors including social support, depression, anxiety, functioning, trauma and resilience within our urban population. We will also look at neighborhood-level factors of community distress and resilience to better apply the social ecologic model to child oral health behaviors.
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Affiliation(s)
- Helen H. Lee
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, United States
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
- *Correspondence: Helen H. Lee
| | - David Avenetti
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
- Department of Pediatric Dentistry, University of Illinois at Chicago, Chicago, IL, United States
| | - Yuwa Edomwande
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Vyshiali Sundararajan
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Liyong Cui
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Michael Berbaum
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Rachel Nordgren
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Anna Sandoval
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Molly A. Martin
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, United States
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Chou WJ, Hsiao RC, Yen CF. Parental Efficacy in Managing Smartphone Use of Adolescents with Attention-Deficit/Hyperactivity Disorder: Parental and Adolescent Related Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159505. [PMID: 35954859 PMCID: PMC9368458 DOI: 10.3390/ijerph19159505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/24/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023]
Abstract
Parental management has an important role in preventing problematic smartphone use among adolescents with attention-deficit/hyperactivity disorder (ADHD). This study aimed to examine the parental factors (e.g., demographics, depressive symptoms and parenting styles) and adolescent factors (e.g., demographics, ADHD and oppositional defiant disorder [ODD] symptoms, and problematic smartphone use) related to parental efficacy in managing adolescent smartphone use (PEMASU) among 237 parents of adolescents with ADHD. PEMASU was measured by the Parental Smartphone Use Management Scale. Parental depressive symptoms and parenting styles (parental affection/care and overprotection) were measured by the Center for Epidemiologic Studies—Depression Scale and Parental Bonding Instrument, respectively. Adolescent ADHD and ODD symptoms and problematic smartphone use were measured by the Swanson, Nolan, and Pelham, version IV scale and Problematic Smartphone Use Questionnaire, respectively. Three models of hierarchical linear regression were performed to examine the parental and adolescent factors related to PEMASU. The results indicated that adolescent older age and more severe ODD symptoms and problematic smartphone use were significantly associated with lower PEMASU, whereas greater parental affection/care was significantly associated with higher PEMASU. This study demonstrated that both parental and adolescent factors contribute to PEMASU among parents of adolescents with ADHD. Intervention programs aiming to enhancing PEMASU need to take these related factors into consideration.
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Affiliation(s)
- Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98295, USA;
- Department of Psychiatry, Seattle Children’s, Seattle, WA 98105, USA
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Psychiatry, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: ; Tel.: +886-7-3121101 (ext. 6822)
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Oral Hygiene Habits and Use of Fluoride in Developmental Age: Role of Parents and Impact on their Children. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6779165. [PMID: 35860800 PMCID: PMC9293534 DOI: 10.1155/2022/6779165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/11/2022] [Accepted: 06/14/2022] [Indexed: 11/23/2022]
Abstract
Introduction In healthcare, the need to pay more attention to the achievement of two objectives within the society arises: health promotion and prevention in terms of nutrition, good education, sport, and health education. Scientific evidence shows that adequate health standards must be learned since childhood through the help of parents and appropriate school projects. Parental intervention must be appropriate to support the responsibility of their children's health. In oral health, it has been established for many years that there is a correlation between parental behaviors and lifestyles and children's attitude. The aim of this study is to verify the close relation between behaviors, habits, lifestyles, and the knowledge of parents about their oral health and, consequently, their focus and care for their own children's oral health. Furthermore, the awareness of parents about the importance and use of fluorine was to be determined. Materials and Methods The study lasted 15 months and was conducted from April 2018 to July 2019: an anonymous 29-question questionnaire was administered to all parents who accompanied their children (aged between 3 and 12 years) going under treatment in the Pediatric Dentistry Unit of the University Hospital Policlinico Umberto I, Rome. Anamnestic data, sociodemographic context (e.g., educational level and occupation), oral health habits, and prevention of parents and children and fluoride knowledge were investigated. The study received ethical approval. 204 questionnaires were collected. The data gathered were recorded with a specifically designed computer program and collected and analyzed using a Microsoft Excel 10 database. Data were evaluated using standard statistical analysis software; descriptive statistics including mean ± SD values and percentage were calculated for each variable. The relationship between the age of parents, between mother or father and the parents' degree of education levels, and the knowledge for their own children's oral health was explored using the chi-square test of homogeneity and Fisher's exact test (P value of < 0.05 considered as statistically significant). Results From the acquired data, it is possible to deduce that the major respondents were mothers aged from 36 to 45, while only a small part were fathers aged above 45 years. Questions related to parents' oral hygiene habits were included in the questionnaire, and from the sample taken into consideration, it emerges that 64.7% of the respondents (67.1% mothers and 57.7% fathers) periodically attend a dental office for a checkup, 20.9% tend to postpone the treatment, and 15.2% go there just for emergency. Some of the questions showed that 80% of the interviewed subjects use fluoride toothpaste for their child's oral hygiene. Conclusion Prevention in childhood, in addition to being synonymous with monitoring the oral health of the child, means first of all to pay attention to parents who are the main behavioral reference. It emerged that there is no adequate knowledge about fluorine, especially when the subjects have a low educational level. A role of fundamental importance for the diffusion of adequate concepts in the field of oral hygiene is covered, according to the data received from the study carried out, by the dentist and dental hygienist.
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Ihab M, El Din WE, Ammar N, Yassin R, El Tantawi M. Using mHealth to promote parents' brushing of preschool children's teeth: a protocol for a randomized factorial trial using the Multi-phase Optimization Strategy (MOST). Trials 2022; 23:17. [PMID: 34991701 PMCID: PMC8733768 DOI: 10.1186/s13063-021-05931-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/09/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Early childhood caries is a highly prevalent disease affecting young children. Parental brushing of children's teeth is recommended during preschool years. Interventions to promote parental brushing of children's teeth are assessed as a package in randomized clinical trials and the efficacy of separate components is not known. METHODS AND ANALYSIS The aim of this study is to develop an optimized behavior modification intervention to increase parents' brushing of their pre-school children's teeth using the multi-phase optimization strategy (MOST) guided by the Theory of Planned Behavior. Behavior change will be assessed by the percent reduction in children's dental plaque index after 6 months and parents reporting of toothbrushing frequency. Two phases of MOST will be carried out. First, the preparation phase comprises the development of a conceptual framework, identifying candidate components, conducting a feasibility pilot study to assess the acceptability and the design features of three intervention components (motivational interviewing (MI), and two mobile health (mHealth) components: oral health promotion messages and storytelling videos delivered using WhatsApp messenger) in addition to setting an optimization objective. Second, the optimization phase constitutes a factorial trial assessing the three intervention components and developing the intervention by selecting the most effective components within the optimization constraint. Each component will be set at two levels: yes (the intervention is applied) and no (the intervention is not applied). A linear regression model will be used to assess the effect of the intervention components on the percent reduction in dental plaque index (primary outcome measure). The secondary outcome measure is the change in the frequency of parents' brushing of the child's teeth. The combination of components making up the new optimized intervention will be selected. DISCUSSION This will be the first study to apply the MOST framework in the field of dentistry. The results of this study can guide the development of an optimized behavior modification interventions using mHealth and MI. TRIAL REGISTRATION ClinicalTrials.gov, NCT04923581, Registered 11 June 2021.
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Affiliation(s)
- Merna Ihab
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, Alexandria, 21527, Egypt.
| | - Wafaa Essam El Din
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, Alexandria, 21527, Egypt
| | - Nour Ammar
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, Alexandria, 21527, Egypt
| | - Randa Yassin
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, Alexandria, 21527, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, Alexandria, 21527, Egypt
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Soares GH, Santiago PHR, Biazevic MGH, Michel-Crosato E, Jamieson L. Do network centrality measures predict dental outcomes of Indigenous children over time? Int J Paediatr Dent 2021; 31:634-646. [PMID: 33222405 DOI: 10.1111/ipd.12749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/18/2020] [Accepted: 11/03/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Centrality measures identify items that are central to a network, which may inform potential targets for oral interventions. AIM We tested whether centrality measures in a cross-sectional network of mothers' baseline factors are able to predict the association with children's dental outcomes at age 5 years. DESIGN A network approach was applied to longitudinal data from a randomised controlled trial of dental caries prevention delivered to 448 women pregnant with an Indigenous child in South Australia. Central items were identified at baseline using three centrality measures (strength, betweenness, and closeness). Centrality values of mothers' outcomes were regressed with their predictive values to dental caries experience and dental service utilisation at child age 5 years. RESULTS Items of oral health self-efficacy and oral health literacy were central to mothers' baseline network. Strength at baseline explained 51% and 45% of items' predictive values to dental caries experience and dental service utilisation at child age 5 years, respectively. Adjusted and unadjusted values of node strength for the children's oral health network were highly correlated. CONCLUSION Strength at baseline successfully identified mothers' items with greater importance to dental caries experience and dental service utilisation at child age 5 years.
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Affiliation(s)
| | | | | | | | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia
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Which determinants should be considered to reduce social inequalities in paediatric dental care access? A cross-sectional study in France. PLoS One 2021; 16:e0255360. [PMID: 34347827 PMCID: PMC8336796 DOI: 10.1371/journal.pone.0255360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/14/2021] [Indexed: 12/03/2022] Open
Abstract
Better access to dental care through systemic and educational strategies is needed to lessen the burden of disease due to severe early caries. Our study aims to describe family characteristics associated with severe early caries: parental knowledge, attitudes, practices in oral health and socio-demographic factors. For this cross-sectional study, 102 parents of children aged under 6 years with severe early caries and attending paediatric dentistry service in France completed a questionnaire during face-to-face interviews. Caries were diagnosed clinically by calibrated investigators, using the American Academy of Paediatric Dentistry criteria, and dental status was recorded using the decayed, missing, and filled teeth index. The majority of children were from underprivileged backgrounds and had poor oral health status, with a median dmft index of 10. Parents highlighted the difficulty of finding suitable dental care in private practices. Parents appeared to have good oral health knowledge and engaged in adapted behaviours but showed a low sense of self-efficacy. They perceived the severity of early caries as important but the susceptibility of their child as moderate. The study affirmed the importance of improving the accessibility of paediatric dental care and developing educational strategies to enhance the knowledge, skills, and oral health practices of families.
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Gudipaneni RK, Patil SR, Assiry AA, Karobari MI, Bandela V, Metta KK, Almuhanna R. Association of oral hygiene practices with the outcome of untreated dental caries and its clinical consequences in pre- and primary school children: A cross-sectional study in a northern province of Saudi Arabia. Clin Exp Dent Res 2021; 7:968-977. [PMID: 34080323 PMCID: PMC8638273 DOI: 10.1002/cre2.438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/06/2021] [Accepted: 04/17/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives To assess the association amongst oral hygiene practices, untreated dental caries (UDC) and clinical consequences of UDC in pre‐ and primary school children aged 3–5 and 6–7 years. Materials and methods A total of 250 subjects were recruited. The demographic and oral hygiene data were collected using a closed‐ended questionnaire. The UDC was measured using the ‘d/D' component of the decayed, missing, filled teeth (dmft/DMFT) index, and its clinical consequences were recorded using the ‘p/P' component of the pulpal involvement, ulceration, fistula and abscess (pufa/PUFA) index. The data were analyzed by multiple logistic regression. Results Overall, 94.2% and 56.5% of the participants had one or more UDC and pulp involvement (p ≥ 1), respectively in 3–5‐year‐old age group. In the 6‐7‐year‐ age group the prevalence of UDC was 26.7% and the pulp involvement was 11.6%. Children who brushed with their fingers were 4.7 times more likely to have UDC (crude odds ratio [COR] = 4.71; 95% CI: 1.21–18.40). Twice‐daily brushing resulted in a 39% (p = 0.732) lower likelihood of having UDC compared with once‐daily brushing (COR = 0.61; 95% CI: 0.04, 10.09). Children with irregular brushing frequency were 3.2 times more likely to have pulpal involvement (COR = 3.21; 95% CI: 1.74–5.93). Conclusion Finger brushing, irregular frequency of brushing and lack of parental supervision whilst brushing were associated with UDC and its consequences.
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Affiliation(s)
- Ravi Kumar Gudipaneni
- Department of Preventive Dentistry, Pediatric Dentistry Division, College of Dentistry, Jouf University, Sakaka, Al Jouf, Saudi Arabia
| | - Santosh R Patil
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Ali A Assiry
- Preventive Dental Science Department, Faculty of Dentistry, Najran University, Najran, Saudi Arabia
| | - Mohmed Isaqali Karobari
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Vinod Bandela
- Fixed Division, Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Kiran Kumar Metta
- Department of Conservative Dental Sciences, Ibn Sina National College for Medical Studies, Jeddah, Saudi Arabia
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Khan IM, Mani SA, Doss JG, Danaee M, Kong LYL. Pre-schoolers' tooth brushing behaviour and association with their oral health: a cross sectional study. BMC Oral Health 2021; 21:283. [PMID: 34078349 PMCID: PMC8173819 DOI: 10.1186/s12903-021-01643-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/22/2021] [Indexed: 01/04/2023] Open
Abstract
Background Toothbrushing is an important yet neglected behaviour that affects the oral health of preschool children. Little is reported on parental supervision, an essential aspect of routine effective toothbrushing in this age group. The aim of this study was to evaluate pre-schoolers’ toothbrushing behaviour including parental involvement and its association with their oral health. Methods This was a cross-sectional study. A total of 92 preschool children (4–6 years) were invited to participate with their parents/guardians. Nine parameters of toothbrushing behaviour were assessed from parental responses (questionnaire) and observation of child and parents/guardians (video recording). Oral examination included recording plaque, gingival and dental caries indices. BORIS software was used to assess toothbrushing parameters and Smart PLS was used to perform association with a second-generation multivariate analysis to create models with and without confounding factors. Results Girls were slightly more (53%) than boys (47%). Children aged 4 years were slightly more in number (38%), followed by 6-year-olds and 5-year-olds. Nearly, 90% parents had tertiary education and 46% had more than 2 children. Differences were recorded in the reported and observed behaviour. Thirty-five percent parents/guardians reported using pea-size toothpaste amount but only 28% were observed. Forty percent reported to brush for 30 s–1 min, however 51% were observed to brush for 1–2 min. Half the children were observed to use fluoridated toothpaste (F < 1000 ppm) under parental supervision (11%). The mean (SD) plaque score reduction after toothbrushing was 10.80 (2.46), mean pre-brushing plaque score was 90.3 (10.2), mean gingival index was 0.89 (0.65) and mean dental caries status (ICDAS(1–6)) was 18.87 (12.39). Toothbrushing behaviour in terms of toothbrushing technique, duration, pattern and frequency, toothbrush type and grip type, toothpaste type and amount, post-brushing mouth rinsing and parental involvement contributed significantly to plaque score change (86%), dental caries status (73%), gingival index (66%) and pre-brushing plaque score (31%). The significant confounding variables had a small influence on oral health of preschool children. Conclusions Preschool children’s toothbrushing behaviour was inadequate while their oral health was poor, with a significant association between the two parameters.
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Affiliation(s)
- Iqra Muhammad Khan
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Shani Ann Mani
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Jennifer Geraldine Doss
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mahmoud Danaee
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Lydia Yi Li Kong
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
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Kitsaras G, Goodwin M, Kelly MP, Pretty IA. Bedtime Oral Hygiene Behaviours, Dietary Habits and Children's Dental Health. CHILDREN (BASEL, SWITZERLAND) 2021; 8:416. [PMID: 34069504 PMCID: PMC8160840 DOI: 10.3390/children8050416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 11/17/2022]
Abstract
Background: Oral hygiene behaviours as well as dietary habits before bed can affect children's dental health resulting in higher prevalence of dental disease. Dental disease can affect children's health, development and even school performance. If left untreated, dental disease can progress and it can lead to extractions under general anaesthetic causing further distress for children and families. Consistent and appropriate oral hygiene behaviours and dietary habits can prevent dental diseases from occurring in the first place. Objective: This cross-sectional study examines the relationship between oral hygiene behaviours, dietary habits around bedtime and children's dental health. Methods: A total of 185 parents with children between the ages of 3 and 7 years from deprived areas participated in the study. Data on bedtime routine activities were collected using an automated text-survey system. Children's dental health status was established through examination of dental charts and dmft (decayed, missed, filled teeth) scores. Results: In total, 52.4% of parents reported that their children's teeth were brushed every night. The majority of children (58.9%) had dmft scores over zero. In total, 51 (46.7% of children with dmft score over 0 and 27.5% of all children) children had active decay. The mean dmft score for those experiencing decay was 2.96 (SD = 2.22) with an overall mean dmft score of 1.75 (SD = 2.24). There were significant correlations between frequency of tooth brushing, frequency of snacks/drinks before bed and dmft scores (r = -0.584, p < 0.001 and r = 0.547, p = 0.001 respectively). Finally, higher brushing frequency was associated with a lower likelihood of a dmft score greater than 0 (Exp(B) = 0.9). Conclusions: Despite families implementing oral hygiene behaviours as part of their bedtime routines those behaviours varied in their consistency. Results of this study highlight the need for additional studies that consider bedtime routine-related activities and especially the combined effects of oral hygiene practices and dietary habits due to their potentially important relationship with children's dental health.
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Affiliation(s)
- George Kitsaras
- Dental Health Unit, Division of Dentistry, The University of Manchester, Manchester M1 5GH, UK; (M.G.); (I.A.P.)
| | - Michaela Goodwin
- Dental Health Unit, Division of Dentistry, The University of Manchester, Manchester M1 5GH, UK; (M.G.); (I.A.P.)
| | - Michael P. Kelly
- Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK;
| | - Iain A. Pretty
- Dental Health Unit, Division of Dentistry, The University of Manchester, Manchester M1 5GH, UK; (M.G.); (I.A.P.)
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24
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Tadakamadla SK, Mitchell AE, Johnson NW, Morawska A. Development and validation of the parenting and child tooth brushing assessment questionnaire. Community Dent Oral Epidemiol 2021; 50:180-190. [PMID: 33904195 DOI: 10.1111/cdoe.12649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/10/2021] [Accepted: 03/28/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE We report the development and validation of a comprehensive Parenting and Child Tooth brushing Assessment (PACTA) questionnaire. METHODS This cross-sectional study was conducted with community-recruited Australian parents (N = 450) of children aged 2-8 years. Parents completed an online survey including the newly developed PACTA (comprising four scales assessing children's tooth brushing behaviours, parenting strategies, attitudes and knowledge) and established scales assessing parenting behaviours, attitudes and self-efficacy. RESULTS Exploratory factor analyses revealed two-factor structures for scales assessing child behaviour ('noncompliance' and 'avoidance behaviour'), parenting strategies ('effective strategies' and 'ineffective strategies') and attitudes ('emotional reactions' and 'lack of concern'), whereas the knowledge scale was unidimensional. Internal consistencies were satisfactory (>0.7) for all except the knowledge scale. There was good evidence of convergent and predictive validity. All subscales predicted children's parent-reported tooth brushing frequency; children were more likely to brush at least twice per day when parents reported fewer tooth brushing behavioural problems, using effective parenting strategies, and having better attitudes and knowledge. Poorer scores on the 'lack of concern' subscale of the attitudes scale were the strongest unique predictor of twice-daily brushing (OR, 95% CI: 1.51, 1.36-1.67). CONCLUSIONS PACTA demonstrates satisfactory validity and reliability. Further research assessing sensitivity to change following intervention is warranted.
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Affiliation(s)
- Santosh K Tadakamadla
- School of Medicine and Dentistry, Griffith University, Gold Coast, Qld, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
| | - Amy E Mitchell
- Parenting and Family Support Centre, The University of Queensland, Brisbane, Qld, Australia
| | - Newell W Johnson
- School of Medicine and Dentistry, Griffith University, Gold Coast, Qld, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Alina Morawska
- Parenting and Family Support Centre, The University of Queensland, Brisbane, Qld, Australia
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25
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Facilitators and barriers to home-based toothbrushing practices by parents of young children to reduce tooth decay: a systematic review. Clin Oral Investig 2021; 25:3383-3393. [PMID: 33743074 PMCID: PMC8137613 DOI: 10.1007/s00784-021-03890-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/12/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Parental supervised toothbrushing (PSB) is a collection of behaviours recommended by national guidance to improve oral health. This systematic review aimed to identify the barriers and facilitators to PSB. MATERIALS AND METHODS Studies investigating parental involvement in home-based toothbrushing in children under 8 years old and the impact on tooth decay were included. Electronic databases, references and unpublished literature databases were searched. The Theoretical Domains Framework (TDF) was used to code barriers/facilitators to PSB. RESULTS Of the 10,176 articles retrieved, 68 articles were included. Barriers and facilitators were found across all 12 TDF domains. Barriers included an inadequate toothbrushing environment and resources, knowledge of what PSB entails and child behaviour management. Facilitators were increased oral health knowledge, the adaption of the social environment to facilitate PSB and positive attitudes towards oral health. When only high-quality articles were synthesized, knowledge was not a common barrier/facilitator. CONCLUSIONS There are a comprehensive range of barriers/facilitators to PSB acting across all domains and at multiple levels of influence. This review identifies the most popular domains, thus informing the focus for supporting resources to supplement oral health conversations. CLINICAL RELEVANCE PSB is a complex behaviour. Practitioners need to understand and be able to explore the wide range of potential barriers and have practical suggestions to enable PSB. This review provides pragmatic examples of different barriers and facilitators and emphasises the importance of listening to parents and exploring their story to identify the barriers and solutions that are relevant to each family.
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26
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Smith SR, Kroon J, Schwarzer R, Hamilton K. Social-cognitive predictors of parental supervised toothbrushing: An application of the health action process approach. Br J Health Psychol 2021; 26:995-1015. [PMID: 33656231 DOI: 10.1111/bjhp.12516] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/09/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND We examined the social cognition determinants of parental supervised toothbrushing guided by the health action process approach (HAPA). METHODS In a prospective correlational survey study, participants (N = 185, 84.3% women) completed HAPA social cognition constructs at an initial time point (T1), and 12 weeks later (T2) self-reported on their parental supervised toothbrushing behaviour, toothbrushing habit, and action control. RESULTS Structural equation models exhibited adequate fit with the data when past behaviour and habit were either excluded or included. Intention, self-efficacy, planning, and action control were predictors of parental supervised toothbrushing; intention predicted action planning and coping planning; and self-efficacy and attitude were predictors of intention. Indirect effects of social cognition constructs through intentions, and intentions through planning constructs were also observed. Inclusion of past behaviour and habit attenuated model effects. CONCLUSION Results indicate that parental supervised toothbrushing is a function of motivational and volitional processes. This knowledge can be used to inform behaviour change interventions targeting parental supervised toothbrushing.
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Affiliation(s)
- Stephanie R Smith
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Queensland, Australia
| | - Jeroen Kroon
- School of Dentistry and Oral Health, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Ralf Schwarzer
- Department of Psychology, Freie Universität Berlin, Germany.,SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Kyra Hamilton
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Queensland, Australia
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27
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Bashirian S, Seyedzadeh-Sabounchi S, Shirahmadi S, Karimi-Shahanjarini A, Soltanian AR, Vahdatinia F. Predictors of oral health promotion behaviors among elementary school children: Examination of an extended social cognitive theory. Int J Paediatr Dent 2021; 31:191-203. [PMID: 32339312 DOI: 10.1111/ipd.12659] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Brushing teeth with fluoride-containing toothpaste and flossing are considered as effective solutions for preventing dental caries and periodontal diseases. AIM The aim of this study was to use the promoted social cognitive theory (SCT) to investigate factors influencing adherence to oral hygiene behaviors by elementary school children. DESIGN In this cross-sectional study, 988 elementary school children were chosen using the multistage cluster sampling method. Data were collected using the SCT scale, and its validity and reliability were confirmed. Theoretical models were examined using the structural equation modeling. RESULTS The SCT explained 50% of the variance in brushing with fluoridated toothpaste and 55.6% of the variance in flossing behaviors. The total effect of family environment (β = .60, P < .05), self-efficacy in overcoming impediments (β = .50, P < .05), and emotional coping (β = .40, P < .05) variables in the conceptual model had significantly influenced tooth brushing behavior. The total effect of self-efficacy (β = .79, P < .05), family environment (β = .41, P < .05), and situational perception (β = .35, P < .05) variables of the conceptual model significantly influenced the flossing behavior. CONCLUSIONS The SCT, self-efficacy, and family environment were strongly associated with brushing and flossing behaviors. Therefore, supportive family environments should be considered as one of the top contributors to successful oral health promotion.
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Affiliation(s)
- Saeed Bashirian
- Department of Public Health, Social Determinants of Health Research Center, Hamedan University of Medical Sciences, Hamedan, Iran
| | | | - Samane Shirahmadi
- Dental Research Center, School of Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Akram Karimi-Shahanjarini
- Department of Public Health, Social Determinants of Health Research Center, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Ali Reza Soltanian
- Communicable Disease Research Center, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Farshid Vahdatinia
- Dental Implants Research Center, School of Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran
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28
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Badarch J, Batbaatar S, Paulik E. Prevalence and Correlates of Poor Oral Hygiene among School-Going Students in Mongolia. Dent J (Basel) 2021; 9:dj9020012. [PMID: 33498221 PMCID: PMC7908969 DOI: 10.3390/dj9020012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/14/2021] [Accepted: 01/16/2021] [Indexed: 11/21/2022] Open
Abstract
Brushing at least twice a day is one of the most effective methods for the prevention of dental caries and oral diseases. The aim of the present study was to determine the prevalence and correlates of poor oral hygiene in Mongolian school-going students. A secondary analysis of nationally representative data from the 2013 Mongolian Global School-based Health Survey (GSHS) was performed. In the survey, a questionnaire was completed by 5393 students aged 12–16 years old. The prevalence of poor oral hygiene and its association with some independent variables were analyzed by frequency distribution, chi-squared test, and logistic regression. The overall prevalence of poor oral hygiene was 33%. In the multivariate analysis, male students, inadequate fruit and vegetable intake, parents’ smoking, being exposed to second-hand smoke, poor parental supervision and connectedness, physical inactivity, and sedentary behavior were significantly associated with poor oral hygiene. Meanwhile, students who ate fast food and drank carbonated soft drink were found to be less likely to be poor tooth-brushers in 2013. Various determinants were identified in connection with poor oral hygiene. Based on these findings, it is recommended that an oral health promotion program should be combined with general health promotion and lifestyle intervention programs for this target population.
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Affiliation(s)
- Javzan Badarch
- Department of Public Health, Faculty of Medicine, University of Szeged, 6720 Szeged, Hungary;
- Correspondence:
| | - Suvd Batbaatar
- Department of Environmental Health, National Center for Public Health, Ulaanbaatar 210349, Mongolia;
| | - Edit Paulik
- Department of Public Health, Faculty of Medicine, University of Szeged, 6720 Szeged, Hungary;
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Baptista AS, Prado IM, Perazzo MF, Pinho T, Paiva SM, Pordeus IA, Serra‐Negra JM. Can children's oral hygiene and sleep routines be compromised during the COVID-19 pandemic? Int J Paediatr Dent 2021; 31:12-19. [PMID: 32978848 PMCID: PMC7537505 DOI: 10.1111/ipd.12732] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/17/2020] [Accepted: 09/17/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND During COVID-19 pandemic, children are confined at home, with changes in family routines. AIM Evaluate sleep disorders among Brazilian and Portuguese children during social distancing, and its association with parental perception of child's oral hygiene. DESIGN In this cross-sectional study, Portuguese and Brazilian parents/caregivers of 3- to 15-year-old children, practicing social distancing due to COVID-19 pandemic, answered an online questionnaire, from April 24-26, 2020, evaluating sociodemographic characteristics, child's school activities online, child's sleep quality during social distancing. Two questions from the questionnaire, developed based on previous studies, evaluated the parental perception of child's oral hygiene quality and routine changes during social distancing. Parents/caregivers answered five domains of the Portuguese-language version of the Sleep Disturbances Scale for Children, evaluating sleep-breathing disorders, disorders of arousal, sleep-wake transition disorders, disorders of excessive somnolence and sleep hyperhidrosis. Descriptive, Linear-by-linear association, Kruskal-Wallis and post hoc analysis were performed (P ≤ .05). RESULTS Participated in the study 253 parents/caregivers, 50.2% from Brazil. Most parents (72.2%) reported changes in child's routine during social distancing. Sleep breathing disorders (P = .019), sleep-wake transition disorders (P = .022), and disorders of excessive somnolence (P < .001) were associated with poor oral hygiene during social distancing. CONCLUSION Sleep disorders are associated with poor oral hygiene during social distancing.
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Affiliation(s)
- Ana Sofia Baptista
- CESPUInstituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS)GandraPortugal
| | - Ivana Meyer Prado
- Department of Pediatric DestistryUniversidade Federal de Minas GeraisBelo HorizonteBrazil
| | - Matheus França Perazzo
- Department of Pediatric DestistryUniversidade Federal de Minas GeraisBelo HorizonteBrazil
| | - Teresa Pinho
- CESPUInstituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS)GandraPortugal,IBMC ‐ Instituto de Biologia Molecular e Celular, i3S ‐ Instituto de Investigações e Inovações em SaúdeUniversidade do PortoPortoPortugal
| | - Saul Martins Paiva
- Department of Pediatric DestistryUniversidade Federal de Minas GeraisBelo HorizonteBrazil
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30
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Smith SR, Kroon J, Schwarzer R, Hamilton K. Parental social-cognitive correlates of preschoolers' oral hygiene behavior: A systematic review and meta-analysis. Soc Sci Med 2020; 264:113322. [PMID: 32916333 DOI: 10.1016/j.socscimed.2020.113322] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/22/2020] [Accepted: 08/14/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Regular and consistent parental involvement in children's oral hygiene practices is crucial to prevent oral diseases in young children. This emphasizes the need for interventions targeting parental-supervised oral hygiene behavior. To inform the design of future interventions, this meta-analysis aimed to identify the parental social-cognitive factors associated with oral hygiene behavior of preschoolers. METHOD Five bibliographic databases were searched. A study was eligible for inclusion when it reported an association between a parental social-cognitive factor and an oral hygiene behavior in the targeted age cohort. Meta-analyses were performed when there were at least four independent effect sizes (k > 3). RESULTS Of the 5945 records identified, 25 studies contained eligible data to be included in four meta-analyses: attitude (k = 12); self-efficacy (k = 12); intention (k = 6), and sense of coherence (k = 5). The results showed that greater frequency of preschoolers' oral hygiene behavior is significantly associated with parental attitudes (r+ = 0.18), self-efficacy (r+ = 0.34), and intention (r+ = 0.29), and not significantly associated with parental sense of coherence (r+ = 0.08). CONCLUSION Self-efficacy, attitudes, and intention were identified as significant correlates of parental-supervised oral hygiene behavior. However, this is a limited evidence base and many social-cognitive factors, such as self-regulatory processes including planning and action control, have yet to be explored in this context. The significant social-cognitive correlates identified in this study, as well as potential other self-regulatory factors, should be targeted in future intervention studies aimed at improving this important preventive behavior.
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Affiliation(s)
- Stephanie R Smith
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Mt Gravatt Campus, Queensland, Australia.
| | - Jeroen Kroon
- School of Dentistry and Oral Health, Griffith University, Gold Coast Campus, Queensland, Australia.
| | - Ralf Schwarzer
- Department of Psychology, Freie Universität Berlin, Berlin, Germany; SWPS University of Social Sciences and Humanities, Wroclaw, Poland.
| | - Kyra Hamilton
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Mt Gravatt Campus, Queensland, Australia.
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31
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Hamilton K, Smith SR, Keech JJ, Moyers SA, Hagger MS. Application of the Health Action Process Approach to Social Distancing Behavior During COVID-19. Appl Psychol Health Well Being 2020; 12:1244-1269. [PMID: 33006814 PMCID: PMC7537318 DOI: 10.1111/aphw.12231] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/15/2020] [Accepted: 08/22/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND This study examined the social cognition determinants of social distancing behavior during the COVID-19 pandemic in samples from Australia and the US guided by the health action process approach (HAPA). METHODS Participants (Australia: N = 495, 50.1% women; US: N = 701, 48.9% women) completed HAPA social cognition constructs at an initial time-point (T1), and one week later (T2) self-reported their social distancing behavior. RESULTS Single-indicator structural equation models that excluded and included past behavior exhibited adequate fit with the data. Intention and action control were significant predictors of social distancing behavior in both samples, and intention predicted action and coping planning in the US sample. Self-efficacy and action control were significant predictors of intention in both samples, with attitudes predicting intention in the Australia sample and risk perceptions predicting intention in the US sample. Significant indirect effects of social cognition constructs through intentions were observed. Inclusion of past behavior attenuated model effects. Multigroup analysis revealed no differences in model fit across samples, suggesting that observed variations in the parameter estimates were relatively trivial. CONCLUSION Results indicate that social distancing is a function of motivational and volitional processes. This knowledge can be used to inform messaging regarding social distancing during COVID-19 and in future pandemics.
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Affiliation(s)
| | | | - Jacob J Keech
- Griffith University, Australia.,University of the Sunshine Coast, Australia
| | | | - Martin S Hagger
- University of California, Merced, USA.,University of Jyväskylä, Finland
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33
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Lee J, Han DH, Kim H, Park SY. Factors related to children's tooth-brushing at different ages: an application of the theory of planned behavior. PSYCHOL HEALTH MED 2020; 26:228-241. [PMID: 32233784 DOI: 10.1080/13548506.2019.1683870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Tooth-brushing is one of the most important health behaviors to teach children considering potentially serious ramifications of poor dental health. However, children's tooth-brushing behavior is affected by various developmental factors. The aim of this cross-sectional study was to investigate factors related to the tooth-brushing behavior of children adopting the Theory of Planned Behavior. A preliminary elicitation study with 33 primary school students identified underlying beliefs related to tooth-brushing intentions. This data was analysed, synthesized, and incorporated into the development of survey items for three age-appropriate, closed-ended questionnaires administered to 709 primary public school students. Path analyses using structural equation modelling were used to discover the structural relationships among the direct and indirect determinants of tooth-brushing behaviors, and path estimates and the model fit were calculated. Social recognition, peer influence, self-motivating strategies, and cognitive aspects of tooth-brushing were found to become more influential in facilitating behavioral intention with age. In the path models, the tooth-brushing behavioral intention was significantly related to perceived behavioral control rather than behavioral beliefs and normative beliefs. Subjective norms were found to become more significant as children matured. This result suggests that education to improve children's tooth-brushing behavior needs be appropriate to the developmental stage of children.
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Affiliation(s)
- Jihyun Lee
- Dental Education Major, Seoul National University School of Dentistry , Seoul, Korea.,Dental Research Institute, Seoul National University , Seoul, Korea
| | - Dong-Hun Han
- Dental Research Institute, Seoul National University , Seoul, Korea.,Department of Preventive and Social Dentistry, Seoul National University School of Dentistry , Seoul, Korea
| | - Hyungsin Kim
- Dental Research Institute, Seoul National University , Seoul, Korea
| | - Shin-Young Park
- Dental Education Major, Seoul National University School of Dentistry , Seoul, Korea.,Dental Research Institute, Seoul National University , Seoul, Korea
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34
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Lee HH, Ochoa N, Moragne-O'Neal N, Rosales GF, Pugach O, Shadamoro A, Martin MA. Can an Instrument Validated to Assess Parent-Child Interactions in the Laboratory Setting Be Applied to Home-Based Observations? Front Pediatr 2020; 8:550922. [PMID: 33520881 PMCID: PMC7845142 DOI: 10.3389/fped.2020.550922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
Background: The Toothbrushing Observations Scale (TBOS) was developed in a laboratory setting to measure child and parent behaviors during toothbrushing. However, we required an instrument to assess home based behaviors. We assessed the feasibility of applying TBOS to observations of parents and their child (<3 years of age) in urban homes. Methods: Sample consisted of 36 families recruited from university and community pediatric dental/medical clinics and a Women, Infants, and Children center in Chicago as part of a pilot study for a larger clinical trial. The average age of children in our sample was 20.7 months. Most of the parent participants were mothers (90%), and 75% of the parents identified as Hispanic. Parent-child dyads were video-recorded during home-based toothbrushing activities and footage was reviewed by two independent TBOS coders. Results: The TBOS instrument consists of 12 parent and 18 child items. We were able to code five parent and ten child items. Conclusion: The feasibility of applying the TBOS measure to our study population was somewhat limited by factors related to home-based observations and the young age of children in our study. Instruments need to be validated across natural settings, such as the home, to increase the quality and accuracy of human behavioral data.
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Affiliation(s)
- Helen H Lee
- Department of Anesthesiology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States.,Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Nadia Ochoa
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Nia Moragne-O'Neal
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Genesis F Rosales
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Oksana Pugach
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States.,Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States
| | | | - Molly A Martin
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States.,Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
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35
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Scheerman JFM, Hamilton K, Sharif MO, Lindmark U, Pakpour AH. A theory-based intervention delivered by an online social media platform to promote oral health among Iranian adolescents: a cluster randomized controlled trial. Psychol Health 2019; 35:449-466. [PMID: 31621423 DOI: 10.1080/08870446.2019.1673895] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective: Based on the Health Action Process Approach, we tested the efficacy of a theory-based program using an online social media platform (Telegram) to promote good oral hygiene behaviour among Iranian adolescents.Design: A three-arm randomized-controlled trial design was used, consisting of an adolescent only intervention group (A group; n = 253), an adolescent and mother intervention group (A + M group; n = 260), and a control group (n = 278).Main outcome measures: Psychosocial variables, toothbrushing behaviour, Visual Plaque Index, and Community Periodontal Index.Results: Increases in adolescent toothbrushing at the one- and six-month follow-ups in both intervention groups compared to the control group were observed. Adolescents in the A + M group showed significant greater improvements in their toothbrushing behaviour, Visual Plaque Index, and Community Periodontal Index scores than adolescents in the A group. Improvements to toothbrushing social cognitions were also observed.Conclusions: Current results support the use of the theory-based program delivered by Telegram in improving good oral hygiene behaviour and oral health outcomes among Iranian adolescents. Involving mothers in an intervention can confer additional benefits for adolescent oral health.
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Affiliation(s)
| | - Kyra Hamilton
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,School of Psychology, Curtin University, Perth, Australia
| | | | - Ulrika Lindmark
- Department of Natural Science and Biomedicine, Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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36
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Deinzer R, Cordes O, Weber J, Hassebrauck L, Weik U, Krämer N, Pieper K, Margraf-Stiksrud J. Toothbrushing behavior in children - an observational study of toothbrushing performance in 12 year olds. BMC Oral Health 2019; 19:68. [PMID: 31035974 PMCID: PMC6489256 DOI: 10.1186/s12903-019-0755-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 04/03/2019] [Indexed: 12/02/2022] Open
Abstract
Background Many countries offer systematic group prevention programs in kindergarten and school in order to promote children’s oral health. Little is known, however, about the actual toothbrushing abilities of children when group prevention programs end. Methods In Germany, all children take advantage from a nationwide group prevention program (called “Gruppenprophylaxe”) lasting from kindergarten up to sixth grade (12 years of age). Standardized recommendations are given concerning brushing systematics and brushing movements. N = 174 children at the age of 12 were thus randomly selected from two German towns and were asked to perform toothbrushing to the best of their abilities in front of a mirror which also served as a camera. Brushing behavior was analyzed by video analysis. Results Children brushed their teeth for an average of 200 s ± 80.48 s (mean ± SD). Still, more than 55% missed at least one sextant when brushing inner surfaces, 16% missed them all. Only 7.5% of the children brushed both inner and outer surfaces by the intended movements (vertical movements on the inner surfaces and circular movements on the outer surfaces) for at least 90% of the respective brushing time. Instead, horizontal brushing was very common on the lateral surfaces. Conclusions The present analysis indicates that children have low efficiency to adopt the tooth-brushing recommendations given in prevention programs. This is surprising as great endeavors are made to help children internalize the recommendations. Future research is needed to better understand which factors impede adoption of toothbrushing recommendations in children and which efforts are necessary to improve their toothbrushing abilities. Electronic supplementary material The online version of this article (10.1186/s12903-019-0755-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Renate Deinzer
- Institute of Medical Psychology, Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, D-35392, Giessen, Germany.
| | - Oliver Cordes
- Institute of Medical Psychology, Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, D-35392, Giessen, Germany
| | - Julia Weber
- Institute of Medical Psychology, Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, D-35392, Giessen, Germany
| | - Lisa Hassebrauck
- Institute of Medical Psychology, Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, D-35392, Giessen, Germany
| | - Ulrike Weik
- Institute of Medical Psychology, Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, D-35392, Giessen, Germany
| | - Norbert Krämer
- Institute of Medical Psychology, Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, D-35392, Giessen, Germany
| | - Klaus Pieper
- Department of Medicine, Philipps University of Marburg, Georg-Voigt-Straße 3, D-35039, Marburg, Germany
| | - Jutta Margraf-Stiksrud
- Department of Psychology, Philipps University of Marburg, Gutenbergstr. 18, D-35032, Marburg, Germany
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O'Brien J, Hamilton K, Williams A, Fell J, Mulford J, Cheney M, Wu S, Bird ML. Improving physical activity, pain and function in patients waiting for hip and knee arthroplasty by combining targeted exercise training with behaviour change counselling: study protocol for a randomised controlled trial. Trials 2018; 19:425. [PMID: 30086780 PMCID: PMC6081939 DOI: 10.1186/s13063-018-2808-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 07/16/2018] [Indexed: 01/25/2023] Open
Abstract
Background Osteoarthritis often results in prolonged periods of reduced physical activity and is associated with adverse health outcomes, including increased risk of cardiovascular and metabolic diseases. Exercise interventions for patients on the waiting list for arthroplasty can reduce the risk of long-term adverse outcomes by increasing activity levels. However, uptake and ongoing positive rates of physical activity in this population are low and the impact of pre-operative behaviour counselling on exercise is not known. Method/design The exercise and behaviour change counselling (ENHANCE) trial is a two-arm assessor-blind randomised controlled trial to assess the effectiveness of a 12-week exercise intervention designed to improve long-term physical activity and functional abilities for people awaiting arthroplasty. Participants on the waiting list for hip and knee arthroplasty are recruited from one clinical site in Australia. After collection of baseline data, participants are randomised to either an intervention or control group. The control group receive usual care, as recommended by evidence-based guidelines. The intervention group receive an individualised programme of exercises and counselling sessions. The 12-week exercise programme integrates multiple elements, including up to five in-person counselling sessions, supported by written materials. Participants are encouraged to seek social support among their friends and self-monitor their physical activity. The primary outcome is physical activity (daily step count and percentage of day spent in sedentary activities). Secondary outcomes include pain ratings, physical function, psychosocial factors and changes in clinical markers linked with potential common chronic diseases (diabetes and cardiovascular disease). All outcomes are assessed at baseline and 26 weeks later and again at 26 weeks post-surgery. Discussion This study seeks to address a significant gap in current osteoarthritis management practice by providing evidence for the effectiveness of an exercise programme combined with behaviour counselling for adults waiting for hip and knee arthroplasty. Theory-driven evidence-based strategies that can improve an individual’s exercise self-efficacy and self-management capacity could have a significant impact on the development of secondary chronic disease in this population. Information gained from this study will contribute to the evidence base on the management of adults waiting for hip and knee arthroplasty. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12617000357358. Registered on 8 March 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2808-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jane O'Brien
- School of Health Sciences, University of Tasmania, Launceston, Australia.
| | - Kyra Hamilton
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Andrew Williams
- Sports & Exercise Science, School of Health Sciences, University of Tasmania, Launceston, Australia
| | - James Fell
- Sports & Exercise Science, School of Health Sciences, University of Tasmania, Launceston, Australia
| | | | - Michael Cheney
- Sports & Exercise Science, School of Health Sciences, University of Tasmania, Launceston, Australia
| | - Sam Wu
- Department of Health and Medical Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Marie-Louise Bird
- School of Health Sciences, University of Tasmania, Launceston, Australia.,Department of Physical Therapy, Faculty of Medicine, University of British Columbia, British Columbia, Canada
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