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Raison H, Harris RV. Does the Self-Reported Behavioural Automaticity Index provide a valid measure of toothbrushing behaviour in adults? Community Dent Oral Epidemiol 2024; 52:381-388. [PMID: 37971078 DOI: 10.1111/cdoe.12922] [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: 10/10/2022] [Revised: 09/24/2023] [Accepted: 10/10/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Studies to promote regular toothbrushing usually rely on self-reports of toothbrushing frequency (SRF). However, toothbrushing frequency measures may be open to responder bias since twice-daily toothbrushing is a commonly accepted social norm. The validity of SRF measures is unclear, meaning that their use as outcomes in interventional work may be flawed. The study's aim was to compare two different self-reported toothbrushing measures: SRF and the Self-Reported Behavioural Automaticity Index (SRBAI); with measurement of observed toothbrushing frequency tracked over 6 weeks. A secondary aim was to explore the interaction effect of various moderators (age, ethnicity, socioeconomic status (SES), sex, self-efficacy, participant personality and routine preference) upon the correlation between SRBAI and observed toothbrushing frequency. METHODS One hundred and sixty-four adults were recruited via a number of different community groups and workplaces outside the dental setting. After consent, participants completed a questionnaire which collected demographic and participant characteristics measures (age, ethnicity, SES, sex, self-efficacy, participant personality and routine preference) and self-reported toothbrushing habits. Participants then attached a 'Brushlink' device to their toothbrush for 6 weeks to track their observed toothbrushing frequency. RESULTS Using the Pearson correlation coefficient, a moderately strong positive linear association (r = 0.65) between SRBAI and observed toothbrushing frequency was found. By comparison, the correlation between SRF and observed toothbrushing frequency was weak (r = 0.39). There was a weak positive association between self-reported behaviour frequency and SRBAI score (r = 0.35). Using multivariable linear regression, no statistically significant interactional effect was demonstrated for any moderator variable upon the correlation coefficient of SRBAI and observed toothbrushing frequency. CONCLUSIONS The SRBAI provided a stronger association with observed toothbrushing frequency than the SRF measure. A moderately strong relationship between SRBAI and observed toothbrushing frequency was found, compared to a weak positive relationship between self-reported behaviour frequency and SRBAI score. This suggests that the SRBAI score could be a suitable proxy to measure observed toothbrushing behaviour and preferable to SRF in interventional work.
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Affiliation(s)
- Heather Raison
- Dental Public Health, Institute of Population Health, The University of Liverpool, Liverpool, UK
| | - Rebecca V Harris
- Dental Public Health, Institute of Population Health, The University of Liverpool, Liverpool, UK
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Carpenter SM, Greer ZM, Newman R, Murphy SA, Shetty V, Nahum-Shani I. Developing Message Strategies to Engage Racial and Ethnic Minority Groups in Digital Oral Self-Care Interventions: Participatory Co-Design Approach. JMIR Form Res 2023; 7:e49179. [PMID: 38079204 PMCID: PMC10750234 DOI: 10.2196/49179] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/01/2023] [Accepted: 08/25/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND The prevention of oral health diseases is a key public health issue and a major challenge for racial and ethnic minority groups, who often face barriers in accessing dental care. Daily toothbrushing is an important self-care behavior necessary for sustaining good oral health, yet engagement in regular brushing remains a challenge. Identifying strategies to promote engagement in regular oral self-care behaviors among populations at risk of poor oral health is critical. OBJECTIVE The formative research described here focused on creating messages for a digital oral self-care intervention targeting a racially and ethnically diverse population. Theoretically grounded strategies (reciprocity, reciprocity-by-proxy, and curiosity) were used to promote engagement in 3 aspects: oral self-care behaviors, an oral care smartphone app, and digital messages. A web-based participatory co-design approach was used to develop messages that are resource efficient, appealing, and novel; this approach involved dental experts, individuals from the general population, and individuals from the target population-dental patients from predominantly low-income racial and ethnic minority groups. Given that many individuals from racially and ethnically diverse populations face anonymity and confidentiality concerns when participating in research, we used an approach to message development that aimed to mitigate these concerns. METHODS Messages were initially developed with feedback from dental experts and Amazon Mechanical Turk workers. Dental patients were then recruited for 2 facilitator-mediated group webinar sessions held over Zoom (Zoom Video Communications; session 1: n=13; session 2: n=7), in which they provided both quantitative ratings and qualitative feedback on the messages. Participants interacted with the facilitator through Zoom polls and a chat window that was anonymous to other participants. Participants did not directly interact with each other, and the facilitator mediated sessions by verbally asking for message feedback and sharing key suggestions with the group for additional feedback. This approach plausibly enhanced participant anonymity and confidentiality during the sessions. RESULTS Participants rated messages highly in terms of liking (overall rating: mean 2.63, SD 0.58; reciprocity: mean 2.65, SD 0.52; reciprocity-by-proxy: mean 2.58, SD 0.53; curiosity involving interactive oral health questions and answers: mean 2.45, SD 0.69; curiosity involving tailored brushing feedback: mean 2.77, SD 0.48) on a scale ranging from 1 (do not like it) to 3 (like it). Qualitative feedback indicated that the participants preferred messages that were straightforward, enthusiastic, conversational, relatable, and authentic. CONCLUSIONS This formative research has the potential to guide the design of messages for future digital health behavioral interventions targeting individuals from diverse racial and ethnic populations. Insights emphasize the importance of identifying key stimuli and tasks that require engagement, gathering multiple perspectives during message development, and using new approaches for collecting both quantitative and qualitative data while mitigating anonymity and confidentiality concerns.
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Affiliation(s)
- Stephanie M Carpenter
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | - Zara M Greer
- Oral and Maxillofacial Surgery, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Rebecca Newman
- Oral and Maxillofacial Surgery, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Susan A Murphy
- Department of Statistics, Harvard University, Cambridge, MA, United States
- Department of Computer Science, Harvard University, Cambridge, MA, United States
| | - Vivek Shetty
- Oral and Maxillofacial Surgery, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Inbal Nahum-Shani
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
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Lee HY, Kim NH, Jeong JY, Shin SJ, Park HJ, Kawachi I. Factors predicting different times for brushing teeth during the day: multilevel analyses. BMC Oral Health 2023; 23:916. [PMID: 38001518 PMCID: PMC10668384 DOI: 10.1186/s12903-023-03555-1] [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] [Received: 05/02/2023] [Accepted: 10/19/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The most effective and simple intervention for preventing oral disease is toothbrushing. However, there is substantial variation in the timing of brushing teeth during the day. We aimed to identify a comprehensive set of predictors of toothbrushing after lunch and after dinner and estimated contextual (i.e., geographic) variation in brushing behavior at different times of the day. METHODS We constructed a conceptual framework for toothbrushing by reviewing health behavior models. The main data source was the 2017 Community Health Survey. We performed a four-level random intercept logistic regression to predict toothbrushing behavior. (individual, household, Gi/Gun/Gu, and Si/Do). RESULTS Individuals under 30 years of age had higher likelihood of brushing after lunch, while brushing after dinner was higher among those aged 40-79 years. People engaged in service/sales, agriculture/fishing/labor/mechanics, as well as student/housewife/unemployed were 0.60, 0.41, and 0.49 times less likely to brush their teeth after lunch, respectively, compared to those working in the office, but the gap narrowed to 0.97, 0.96, 0.94 for brushing after dinner. We also found significant area-level variations in the timing of brushing. CONCLUSIONS Different patterns in association with various factors at individual-, household- and Si/Gun/Gu-levels with toothbrushing after lunch versus toothbrushing after dinner suggests a need for tailored interventions to improve toothbrushing behavior depending on the time of day.
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Affiliation(s)
- Hwa-Young Lee
- Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, Seoul, South Korea
- Catholic Institute for Public Health and Healthcare Management, The Catholic University of Korea, Seoul, South Korea
- Department of Dental Hygiene, Mirae Campus, Yonsei University, Wonju, South Korea
| | - Nam-Hee Kim
- Department of Dental Hygiene, Mirae Campus, Yonsei University, Wonju, South Korea.
| | - Jin-Young Jeong
- Hallym Research Institute of Clinical Epidemiology, Hallym University, Chuncheon, South Korea
| | - Sun-Jung Shin
- Department of Dental Hygiene, College of Dentistry, Gangneung Wonju National University, Gangneung, South Korea
| | - Hee-Jung Park
- Department of Dental Hygiene, College of Health Science, Kangwon National University, Samcheok, South Korea
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Martin MA, Sundararajan V, Ochoa N, Dziak J, Berbaum M, Lee HH, Avenetti DM, Zhang T, Sandoval A, Torres J, Wu A. Oral Health Behaviors for Young Low-Income Urban Children during the COVID-19 Pandemic: A Mixed Methods Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1329. [PMID: 37628328 PMCID: PMC10453313 DOI: 10.3390/children10081329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/21/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023]
Abstract
This research assessed oral health behaviors changes in urban families with young children during the stay-at-home period of the COVID-19 pandemic (Nov 2020-August 2021). Survey data on oral health behaviors were collected in homes at three points before COVID-19, and via phone during COVID-19. A subset of parents and key informants from clinics and social service agencies completed in-depth interviews via video/phone. Of the 387 parents invited, 254 completed surveys in English or Spanish (65.6%) during COVID-19. Fifteen key informant interviews (25 participants) and 21 family interviews were conducted. The mean child age was 4.3 years. Children identified as mainly Hispanic (57%) and Black race (38%). Parents reported increased child tooth brushing frequency during the pandemic. Family interviews highlighted changes in family routines that impacted oral health behaviors and eating patterns, suggesting less optimal brushing and nutrition. This was linked to changed home routines and social presentability. Key informants described major disruptions in oral health services, family fear, and stress. In conclusion, the stay-at-home period of the COVID-19 pandemic was a time of extreme routine change and stress for families. Oral health interventions that target family routines and social presentability are important for families during times of extreme crisis.
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Affiliation(s)
- Molly A. Martin
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Vyshiali Sundararajan
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Nadia Ochoa
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - John Dziak
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Michael Berbaum
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Helen H. Lee
- College of Medicine Department of Anesthesiology, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA;
| | - David M. Avenetti
- College of Dentistry Department of Pediatrics, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA;
| | - Tong Zhang
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Anna Sandoval
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Javier Torres
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Andy Wu
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
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Martin MA, Sundararajan V, Ochoa N, Dziak J, Berbaum M, Lee HH, Avenetti DM, Zhang T, Sandoval A, Torres J, Wu A. Oral health behaviors for young low-income urban children during the COVID-19 pandemic: a mixed methods analysis. RESEARCH SQUARE 2023:rs.3.rs-2956733. [PMID: 37292971 PMCID: PMC10246233 DOI: 10.21203/rs.3.rs-2956733/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This research assessed oral health behaviors changes in urban families with young children during the stay-at-home period of the COVID-19 pandemic. Survey data on oral health behaviors were collected in homes at three points over one year before COVID-19, and then via phone during COVID-19. Multivariate logistic regression was used to model tooth brushing frequency. A subset of parents completed in-depth interviews via video/phone that expanded on oral health and COVID-19. Key informant interviews via video/phone were also conducted with leadership from 20 clinics and social service agencies. Interview data were transcribed and coded, and themes were extracted. COVID-19 data collection went from Nov 2020 - August 2021. Of the 387 parents invited, 254 completed surveys in English or Spanish (65.6%) during COVID-19. Fifteen key informant (25 participants) and 21 parent interviews were conducted. The mean child age was approximately 4.3 years. Children identified as mainly Hispanic (57%) and Black race (38%). Parents reported increased child tooth brushing frequency during the pandemic. Parent interviews highlighted significant changes in family routines that impacted oral health behaviors and eating patterns, suggesting less optimal brushing and nutrition. This was linked to changed home routines and social presentability. Key informants described major disruptions in their oral health services and significant family fear and stress. In conclusion, the stay-at-home period of the COVID-19 pandemic was a time of extreme routine change and stress for families. Oral health interventions that target family routines and social presentability are important for families during times of extreme crisis.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Andy Wu
- University of Illinois Chicago
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Liu M, Song Q, Xu X, Lai G. Early childhood caries prevalence and associated factors among preschoolers aged 3-5 years in Xiangyun, China: A cross-sectional study. Front Public Health 2022; 10:959125. [PMID: 36052000 PMCID: PMC9424677 DOI: 10.3389/fpubh.2022.959125] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/13/2022] [Indexed: 01/24/2023] Open
Abstract
Purpose This study aimed to investigate the early childhood caries (ECC) prevalence among preschoolers aged 3-5 years in Xiangyun of Yunnan, China and explore the factors associated with the prevalence. Materials and methods A cross-sectional survey including 3-5-year-old children was conducted in Xiangyun County, China, between September and November 2020. According to the dental examination standard of the WHO 2013 criteria, the presence of ECC was recorded. Besides the dental examination for children, their parents completed questionnaires about caries-related factors, including demographic variables, family socioeconomic status, feeding, and oral health-related habits, parental dental knowledge, and the condition of dental service utilization. SPSS Statistics 25.0 (IBM, Chicago, IL, USA) was used for data analysis. Statistical significance was set at p < 0.05. Results The ECC prevalence among a sample of 1,280 children aged 3-5 years consisting of 665 boys and 615 girls in this study, was 74.3%, and the mean decayed-missing-filled teeth (dmft) was 4.9 ± 5.0. There were no statistically significant differences in the ECC prevalence between the sexes and among different ethnic groups. Children with different dietary and oral hygiene habits showed no significantly different prevalence of ECC. Logistic regression analysis showed that the most significantly associated factors were older age, lower family income, and worse parental perception of children's oral health status. Conclusion The ECC prevalence among 3-5-year-old preschool children in Xiangyun was higher than the average national ECC prevalence in China. This study implies that more attention should be given to children's caries prevention from early childhood; oral health education and promotion should be intensified to reduce the ECC prevalence and improve the oral health status of children in Xiangyun.
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Affiliation(s)
- Mingshan Liu
- Department of Stomatology, People's Hospital of Xiangyun Affiliated to Dali University, Dali, China
| | - Qianqian Song
- Department of Stomatology, People's Hospital of Xiangyun Affiliated to Dali University, Dali, China
| | - Xiaoqin Xu
- Department of Stomatology, People's Hospital of Xiangyun Affiliated to Dali University, Dali, China
| | - Guangyun Lai
- Department of Pediatric Dentistry, Shanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China,*Correspondence: Guangyun Lai
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Evaluation of the Effects of Mouthwash on the Morphology and Cell Viability of Osteoblast-Like Cells. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5884974. [PMID: 35155676 PMCID: PMC8837424 DOI: 10.1155/2022/5884974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/16/2022] [Accepted: 01/26/2022] [Indexed: 11/18/2022]
Abstract
This study evaluated the effects of multiple mouthwashes on the cellular viability or the morphology of preosteoblasts. Mouse calvarial osteoblast-like cells were cultured and treated with mouthwashes of (1) benzydamine hydrochloride; (2) cetylpyridinium chloride and benzalkonium chloride; (3) methyl salicylate, menthol, eucalyptol, and thymol; and (4) sodium fluoride, xylitol, and chitosan. The treatment times were 30 seconds, 90 seconds, and 270 seconds. Cell morphology was evaluated with a microscope, and the viability of the treated cells was analyzed quantitatively using a commercially available kit. The untreated control group exhibited well-stretched fibroblast-like morphology. Treatment with mouthwash resulted in morphological changes in all groups. Treatment with sodium fluoride resulted in more noticeable changes. Treatment with mouthwash for 30 seconds produced a significant decrease in cell viability. An increase in time to 90 and 270 seconds did not produce additional noticeable changes. To conclude, commercially available mouthwashes created changes in cell morphology and decreased the cell viability of osteoblast-like cells irrespective of ingredients and treatment time.
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