Finlayson Tracy L, Siefert Kristine, Ismail Amid I, Sohn Woosung
Agency for Healthcare Research and Quality (AHRQ), University of California, Berkeley, CA, USA.
Community Dent Oral Epidemiol. 2007 Aug;35(4):272-81. doi: 10.1111/j.1600-0528.2007.00313.x.
This study investigates the relationships between maternal cognitive, behavioral, and psychosocial factors and brushing practices in low-income African-American preschool children.
Data are from a population-based sample of 1021 African-American families with at least one child <6 years of age and living in the 39 low-income Census tracts in Detroit, Michigan. Analyses were limited to 1-5-year-old children and their mothers (n = 719). Mothers were surveyed about oral health-related self-efficacy (OHSE), knowledge about appropriate bottle use (KBU), knowledge about children's oral hygiene (KCOH), oral health fatalism (OHF), their own toothbrushing behavior, depressive symptoms (CES-D), parenting stress, practical social support, and their child's dental history. Children's 1-week reported brushing frequency was the main outcome measure. Analyses were conducted in SUDAAN to account for the complex sampling design.
Children's 1-week brushing frequency (range 0-40) averaged 8.50 times per week among 1-3-year olds and 9.75 among the 4-5-year olds. Maternal OHSE was a strong and significant predictor of children's brushing frequency; for each unit increase in OHSE, 1-3-year olds were expected to brush 18% more frequently on average during 1 week [incidence density ratios (IDR) = 1.18, 95% confidence interval (CI) 1.08-1.28; P < 0.001], and 4-5-year olds were expected to brush 9% more often (IDR = 1.09, 95% CI 1.00-1.19; P < 0.10). Mothers' KCOH score was also significantly positively associated with brushing frequency; for each unit increase on the KCOH scale, 1-3-year olds were expected to brush 22% more frequently (IDR = 1.22, 95% CI 1.10-1.35; P < 0.001) and 4-5-year olds were expected to brush 13% more frequently (IDR = 1.13, 95% CI 1.02-1.26; P < 0.05). If a mother brushed her own teeth at bedtime during the week, her 1-3-year old child's brushing frequency was expected to increase by one-third (IDR = 1.34, 95% CI 1.12-1.60; P < 0.01) and among the 4-5-year olds, the child's frequency was expected to increase by one-quarter (IDR = 1.26, 95% CI 1.12-1.42; P < 0.001). Availability of help with transportation and financial support were also relevant variables for 1-3-year olds. Higher family income and dental insurance coverage were both positively associated with brushing among 4-5-year olds.
Several maternal cognitive, behavioral, and psychosocial factors were associated with young children's brushing practices. Oral health-specific self-efficacy and knowledge measures are potentially modifiable cognitions; findings suggest that intervening on these factors could help foster healthy dental habits and increase children's brushing frequency early in life.
本研究调查低收入非裔美国学龄前儿童的母亲认知、行为和心理社会因素与刷牙习惯之间的关系。
数据来自对1021个非裔美国家庭的基于人群的抽样调查，这些家庭至少有一个6岁以下的孩子，居住在密歇根州底特律的39个低收入普查区。分析仅限于1至5岁的儿童及其母亲（n = 719）。对母亲进行了关于口腔健康相关自我效能感（OHSE）、正确使用奶瓶的知识（KBU）、儿童口腔卫生知识（KCOH）、口腔健康宿命论（OHF）、她们自己的刷牙行为、抑郁症状（CES-D）、育儿压力、实际社会支持以及孩子的牙科病史的调查。儿童报告的1周刷牙频率是主要结局指标。在SUDAAN中进行分析以考虑复杂的抽样设计。
1至3岁儿童的1周刷牙频率（范围0 - 40）平均为每周8.50次，4至5岁儿童为9.75次。母亲的OHSE是儿童刷牙频率的一个强有力且显著的预测因素；OHSE每增加一个单位，1至3岁儿童预计在1周内平均刷牙频率增加18%[发病密度比（IDR）= 1.18, 95%置信区间（CI）1.08 - 1.28；P < 0.001]，4至5岁儿童预计刷牙频率增加9%（IDR = 1.09, 95% CI 1.00 - 1.19；P < 0.10）。母亲的KCOH得分也与刷牙频率显著正相关；KCOH量表每增加一个单位，1至3岁儿童预计刷牙频率增加22%（IDR = 1.22, 95% CI 1.10 - 1.35；P < 0.001），4至5岁儿童预计刷牙频率增加13%（IDR = 1.13, 95% CI 1.02 - 1.26；P < 0.05）。如果母亲在一周内睡前自己刷牙，她1至3岁孩子的刷牙频率预计增加三分之一（IDR = 1.34, 95% CI 1.12 - 1.60；P < 0.01），在4至5岁儿童中，孩子的刷牙频率预计增加四分之一（IDR = 1.26, 95% CI 1.12 - 1.42；P < 0.001）。交通帮助和经济支持的可获得性也是1至3岁儿童的相关变量。较高的家庭收入和牙科保险覆盖与4至5岁儿童的刷牙行为均呈正相关。
几个母亲认知、行为和心理社会因素与幼儿的刷牙习惯有关。口腔健康特定的自我效能感和知识指标是潜在可改变的认知；研究结果表明，对这些因素进行干预可能有助于培养健康的牙齿习惯并在儿童早期提高刷牙频率。
