Sigrid Van den Branden

Effects of time and socio-economic status on the determinants of oral health-related behaviours of parents of preschool children

The oral health-related beliefs of parents have an important impact on the oral health status of their children; however, they are not stable over time. This study aimed to assess the changes, over time, in the determinants of parental oral health-related behaviour based on the Theory of Planned Behaviour and to investigate socio-economic inequalities. The cohort consisted of the parents - mainly the mothers - of 1,057 children born in 2003 and 2004 in Flanders (Belgium). According to the Theory of Planned Behaviour, validated questionnaires, completed at childrens birth and at age 3 and 5 yr, assessed parental attitudes, social norms, perceived behavioural control, and intention towards three behaviours: dietary habits, oral hygiene habits, and dental attendance. Linear mixed-model analyses were applied. Positive parental attitudes towards oral health-related behaviours increased between birth and 3 yr of age, whereas the scores for subjective norms and intentions decreased. Scores remained stable for children between three and 5 yr of age. Highly educated mothers had significantly higher scores for attitudes, perceived behavioural control, and intentions than less-educated mothers. Health promotion campaigns should take these natural changes and inequalities of dental beliefs into account when developing and evaluating interventions.

Effect evaluation of an oral health promotion intervention in preschool children

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 (2007) and 5 (2009) 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 (2003) 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.

Predicting oral health-related behaviour in the parents of preschool children: An application of the Theory of Planned Behaviour

Objective: This study aimed to test the predictive validity of the Theory of Planned Behaviour (TPB) when applied to the oral health-related behaviours of parents towards their preschool children in a cross-sectional and prospective design over a 5-year interval. Methods: Data for this study were obtained from parents of 1,057 children born between October 2003 and July 2004 in two regions in Flanders, Belgium. Three behaviours related to oral health (dietary habits, oral hygiene habits, dental attendance) as well as their psychological determinants based on the TPB (attitude, subjective norms, perceived behavioural control (PBC), intention) were measured using validated self-report questionnaires when the children were 0 (2003–2004), 3 (February–June 2007) and 5 years old (March–June 2009). Results: Multiple linear regression analyses indicated cross-sectionally that the contribution of attitudes, subjective norms and PBC towards intention, and of intention and PBC towards the frequency of consumption of sugared snacks and drinks, tooth brushing and dental attendance was significant (p < .001). The combined determinants explained 27%–37% of the variance in intentions and 7%–39% of the variance in the behaviours. Across time, only parental PBC as measured at birth could significantly predict dietary and oral hygiene behaviours at children’s ages 3 and 5 years. Conclusion: This study supports the validity of the TPB to predict intentions and oral health-related behaviours of parents of preschool children. Interventions should aim to improve parental attitudes towards diet and dental attendance, and their PBC towards tooth brushing.