Albino Judith, Tiwari Tamanna, Henderson William G, Thomas Jacob F, Braun Patricia A, Batliner Terrence S
Center for Native Oral Health Research (CNOHR), University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Community Dent Oral Epidemiol. 2018 Aug;46(4):360-368. doi: 10.1111/cdoe.12376. Epub 2018 Apr 10.
The objective of this study was to examine the association among psychological and social variables reported by American Indian parents/caregivers of preschool children and changes in their Oral Health Knowledge and Behaviors related to care of their children's teeth. We also investigated the relationship of these factors with progression of caries, as reflected by changes in their children's dmfs.
The data used for this study were collected at baseline in a clinical trial of an oral health promotion intervention comprising behavioural and clinical interventions for caries prevention delivered by tribal members on a large Southwestern American Indian reservation. Linear regression analyses were performed for changes (baseline to Year 1) in dmfs, Oral Health Knowledge and Oral Health Behavior scores, with baseline psychosocial measures, taken individually, as the independent variables.
Parents' attitudes and beliefs were associated with increases in their Oral Health Knowledge and Behavior and also with the progression of caries for their children. When all participants were considered together, increases in children's dmfs were smaller when the caregiver had higher Internal Oral Health Locus of Control (e = -1.33, P = .004), higher Health Literacy (e = -1.55, P < .01), and higher Financial Stability (e = -4.46, P = .03), and lower scores for the Barriers subscale (e = 1.57, P < .01) of the Health Belief Model. For parents in the Intervention group, higher scores on Locus of Control, reflecting beliefs that chance, or other people determine their children's oral health, were associated with larger increases in Oral Health Knowledge (e = 1.73, P = .04) and Behaviors (e = 4.00, P = .005).
Prevention of early childhood caries in American Indian children has proved to be especially challenging. Some of the measures identified in this report may suggest promising directions to prevention through approaches that build on competencies and skills to be learned and used within a context more broadly focused on parenting and management of health and family challenges.
本研究的目的是检验美国印第安学龄前儿童的父母/照顾者报告的心理和社会变量与他们在儿童牙齿护理方面的口腔健康知识和行为变化之间的关联。我们还研究了这些因素与龋齿进展的关系，以儿童的龋失补牙面数（dmfs）变化来反映。
本研究使用的数据是在一项口腔健康促进干预临床试验的基线阶段收集的，该干预包括由部落成员在美国西南部一个大型印第安保留地进行的预防龋齿的行为和临床干预。对龋失补牙面数、口腔健康知识和口腔健康行为得分从基线到第1年的变化进行线性回归分析，分别将基线心理社会测量指标作为自变量。
父母的态度和信念与他们口腔健康知识和行为的增加以及孩子龋齿的进展有关。当将所有参与者综合考虑时，照顾者的口腔健康内部控制点较高（β = -1.33，P = .004）、健康素养较高（β = -1.55，P < .01）、经济稳定性较高（β = -4.46，P = .03）以及健康信念模型的障碍子量表得分较低（β = 1.57，P < .01）时，儿童龋失补牙面数的增加较小。对于干预组的父母，控制点得分较高，反映出认为机会或其他人决定孩子口腔健康的信念，与口腔健康知识（β = 1.73，P = .04）和行为（β = 4.00，P = .005）的更大增加有关。
事实证明，预防美国印第安儿童的幼儿龋齿特别具有挑战性。本报告中确定的一些措施可能通过基于在更广泛关注育儿以及健康和家庭挑战管理的背景下要学习和使用的能力与技能的方法，为预防提供有前景的方向。
