Changes in children’s oral health-related behavior, knowledge and attitudes during a 3.4-yr randomized clinical trial and oral health-promotion program (original) (raw)
Related papers
Trials, 2013
Background: Dental caries (tooth decay) is highly prevalent and is largely attributable to unhealthy self-care behaviors (diet and oral hygiene). The conventional (health) education (CE), focusing on disseminating information and giving normative advice, often fails to achieve sustained behavioral changes. This study incorporates two innovative elements into CE: (i) motivational interviewing (MI), a client-centered counseling for changing behaviors, and (ii) an interactive caries risk assessment (RA) tool, which is devised to facilitate dental counseling and may enhance MI in several ways. Through a randomized, controlled, evaluator-blinded trial, three intervention schemes (CE, CE + MI, and CE + MI + RA) will be compared for their effectiveness in eliciting dentally healthy behaviors and preventing caries in preschool children. Methods/Design: This study targets 3-year-old children who are at a critical stage for embedding health habits. Children with unfavorable dental behaviors (insufficient toothbrushing and/or frequent snacking) and their parents will be recruited from 12 participating kindergartens. Parent-child dyads (n = 690) will be randomly assigned into three groups. In the first group (CE), oral health information and advice will be delivered to parents through pamphlets. In the second group (CE + MI), in addition to the pamphlets, individual MI counseling with each parent will be performed by one of two trained dental hygienists. In the third group (CE + MI + RA), besides pamphlets and MI, interactive RA will be integrated into MI to motivate parents and facilitate their informed decision making and goal planning. At baseline and after 12 and 24 months, parents will complete a questionnaire and children will undergo a dental examination. The effectiveness of the intervention schemes will be compared over 12 and 24 months. The primary outcome will be caries increment in children and proportion of caries-free children. Secondary outcomes will be changes in parental efficacy for protecting children's oral health and changes in children's dental behaviors.
Effect evaluation of an oral health promotion intervention in preschool children
The European Journal of Public Health, 2013
Objective. This study evaluates the effectiveness of a multi-component oral health intervention in preschool children in a non-randomized intervention study with a complementary baseline control. Methods. Participants in the main study were 2137 children born between October 2003 and July 2004 in Flanders, Belgium. In the intervention group (50.5% of participants), an oral health education program was added to a standard preventive care program during the first 3 years of life. Oral health examinations were performed by trained dentists when the children were 3 years old. Data on dietary habits, oral hygiene habits and dental attendance were obtained through structured questionnaires. Regression analyses were applied to compare the results of the intervention and control group with baseline measurements obtained before the intervention in other cohorts of 3-(N = 1291) and 5-year-olds (N = 1325) living in the same regions. Results. The prevalence of caries experience was generally lower in the main study compared with the baseline cohorts, with little differences between the intervention and control group. For the oral health-related behaviours, the control group scored mostly better. Nevertheless, compared with baseline, limited differences were observed in dental attendance, tooth brushing, helping with tooth brushing and consuming in-between drinks (P < 0.05). Conclusion. The study illustrates that a multi-component, theory-based intervention at community level had only a limited and temporary effect on oral health-related behaviours in the community under study. Further research is needed to determine how oral health in young children can be improved in the long term.
PubMed, 2023
Objectives: Literature on the effectiveness of theory-based oral health education on the oral hygiene of children is limited. We aimed to determine the effectiveness of an health behaviour theory-based school oral health education intervention on 1) oral hygiene and 2) oral health-related knowledge, attitude and practices among 6-12-year-old children in Kerala, India. Methods: Cluster randomized controlled trial. Sixteen class divisions (clusters) were randomized into intervention and control groups of 225 and 228 children respectively. Primary and secondary outcomes were plaque score as measured using the simplified oral hygiene index (OHI-S) and oral health-related knowledge, attitude and practices respectively. The intervention group received structured oral health education classes for three months and materials including pamphlets. Children in the control group were not given the classes or materials. Results: Post-intervention OHI-S scores in the intervention group and control groups were 1.65 and 2.17 respectively (difference = -0.52, 95%CI -0.86, -0.18). All the secondary outcomes improved in the intervention group compared to the control group. Conclusions: The intervention improved the oral hygiene status, oral health-related knowledge, attitude and practices of the children. Longer term follow-up and economic appraisal are needed to help policymakers plan and develop OHEI based on health behaviour theories.
Children’s oral health-related behaviors: individual stability and stage transitions
Community Dentistry and Oral Epidemiology, 2010
Various interventions with different designs and implementations have been tried with the aim of improving children's oral health-related behavior, knowledge, and attitudes. The results of most of these studies indicate that knowledge can be improved and attitudes changed, but changing behaviors is more difficult (1) because education and motivation are not enough to achieve longterm changes (2). There is no evidence that information or improvement in knowledge or attitudes alone would lead to health benefits (1, 3, 4). Similar (good or poor) health-and oral health-related behaviors, such as irregular toothbrushing and frequent consumption of sweets, cluster (5-12). Similar clustering has been observed in health-and oral health-related knowledge and attitudes . To improve behaviors, children need to receive social support from their parents, peers, and others in their daily environment (1, 13-17). According to present knowledge, change is a process that unfolds over time and progresses through different stages . Behaviors tend to be stable but when an attempt is made to improve them, temporary improvements and lapses occur before the final pattern of behavior is established.
The Southeast Asian Journal of Tropical Medicine and Public Health, 2012
Abstract. This study reports the effects of a pilot multi-level oral health intervention on caregivers' oral health practices and their determinants. Quasi-experimental, pretest-posttest evaluations using a comparison group design were employed to evaluate the effectiveness of a proposed intervention for promoting caregiver oral health behavior. The intervention consisted of three components: home visits by lay health workers (LHWs), enhancing oral health education and services at health centers, and community mobilization. These components were designed to target factors at intrapersonal, interpersonal, organizational and community levels based on a Social Ecological Model (SEM). Four oral health behaviors associated with early childhood caries (infant bottle feeding, tooth brushing, snack consumption and fluoride use), and multi-level determinants were assessed during pre- and post-tests. The one-year intervention demonstrated a positive effect on tooth brushing, using toothpaste, and fluoride supplements, but did not have a significant effect on bottle feeding and snack consumption among children. The intervention also had no effect on dental caries; in fact caries increased in both control and experimental groups. The caregiver knowledge, attitudes, outcome expectations, and self-efficacy towards these behaviors were significantly increased in the experimental group after intervention. Caregivers in the experimental group received greater social support by LHWs and health center staff than those in the control group (p < 0.001). The program had an impact on integrating oral health services at health centers and community participation in children's oral health. These findings confirm multi-level factors influence reported oral health behavior, but not outcomes in terms of caries. Process evaluation is needed to determine actual implementation levels, barriers and suggests for modification of the program in the future to improve outcomes in terms of caries.
Oral health promotion in early childhood: age of joining preventive program and behavioral aspects
Einstein (São Paulo), 2014
Objective: To analyze the interference of age in the entrance into a public dental care program for infants as well as family behavioral aspects about tooth decay experience in children 0 to 4 years old. Methods: Cross-sectional study involving 465 children who were divided into 3 groups: infants whose mothers joined the program during pregnancy (n=50); infants enrolled in the program during the first year of life (n=230); and infants enrolled in the program between 13 and 18 months old (n=185). The χ 2 and Kruskal-Walis tests (95% confidence interval) were used to assess the relationship among variables. Results: There was an association between the age of entrance in the programs and dental caries (p<0.001). A lower prevalence was seen in infants whose mothers joined the program during pregnancy, and among those infants enrolled in the program during the first year of life. The same low prevalence occurred in relation to mothers' commitment to attend follow-up visits with their infants, cariogenic diet, nighttime oral care, duration of night feeding and parents' educational level (p<0.001). Unfavorable socioeconomic conditions (p>0.05) and daily oral care (p=0.214) were common variables in the groups with 99% of occurrence. Commitment to attend follow-up visits, nighttime oral care and parents' educational level (p>0.05) were considered protective factors for dental caries. Cariogenic diet and night feeding were determinant factors to the appearance of dental caries. Conclusion: To promote children oral health it is essential to enroll children in oral health programs and adopt healthy habits as early as possible, besides the adherence of the child to their parents' advice.
Pesquisa Brasileira em Odontopediatria e Clínica Integrada, 2017
Objective: To compare the effectiveness of a traditional educational intervention with other two based on the implementation intentions psychological model on clinical and cognitive aspects related to the oral health of schoolchildren. Material and Methods: A sample of 160 children aged 7-10 years was divided into three groups: control (CG), Intervention 1 (IG1) and Intervention 2 (IG2). Plaque index (PI), gingival bleeding index (GBI) and knowledge on the oral health of schoolchildren were collected at baseline, 30, 60 and 120 days. All groups participated in educational lectures and had individual tooth brushing supervision and children from IG1 and IG2 participated in a self-regulatory strategy called implementation intentions aimed at facilitating behavior of brushing teeth at least three times a day. In addition, children from IG2 participated in a collaborative implementation intentions strategy with their parents in order motivate them to develop the behavior with their children. Results: All groups showed reductions in PI and GBI values and improvements in oral health knowledge, but IG1 and IG2 showed statistically significant differences in these variables compared to CG. Conclusion: The use of the Implementation Intentions psychological model in oral health educational programs showed a greater impact on the knowledge about oral health and plaque index of schoolchildren compared to traditional educational programs.
Evaluation of an Educational Program for Children with High Risk of Caries
Journal of Clinical Pediatric Dentistry, 2007
The goal of this study was to evaluate a 15-month educational program designed to children. The sample consisted of 60 six-year olds, randomly assigned into control and experimental group. The control consisted of tooth brushing training, once a year. The experimental group received intensive individual tooth brushing training every three months and guidance on oral health. Initially, both groups were assessed using plaque, gingival, dmfs and DMF-S indexes every three months. In the control, no statistically significant difference was observed for plaque and gingival indexes. The experimental group showed a statistically significant reduction in mean values for two indexes. The caries indexes showed no statistically significant difference. The proposed educational program developed was efficient in reducing gingival and plaque indexes as well caries incidence.
Knowledge, attitudes and behavior of children in relation to oral health
Vojnosanitetski pregled, 2014
Background/Aim. Health education plays a very important role in maintaining health of individuals. Good oral health, as a part of general health, is largely dependent on the level of knowledge, attitudes and habits that children already have. The aim of this study is to examine the level of knowledge and habits in children regarding oral hygiene, diet and bad habits. Methods. The study included 506 school children aged 12 and 15 years in three towns (Foca, Cajnice, Kalinovik, Bosnia and Herzegovina). The survey was conducted in order to assess knowledge, attitudes and habits that children have in relation to their own oral health. Results. Most respondents stated that they began to brush their teeth at the age of 4, while a smaller number linked beginning of tooth brushing to the start of school. The parents more often help the boys during tooth brushing. A total of 54.9% of children brush their teeth after every meal, while 40.1% of them brush teeth only once during the day. Twelve...