Department of Oral Health Sciences, University of Washington, Seattle, Washington, USA.
Department of Community and Behavioral Health, University of Iowa, Iowa City, Iowa, USA.
J Public Health Dent. 2023 Mar;83(1):3-8. doi: 10.1111/jphd.12512. Epub 2022 Mar 14.
Topical fluoride helps prevent dental caries. However, many caregivers are hesitant about topical fluoride for their children and may refuse it during clinic visits. In this qualitative study, we assessed the relevance of the extended parallel process model (EPPM) and health belief model (HBM) in caregivers' decision-making about topical fluoride.
We interviewed 56 fluoride-hesitant or fluoride-refusing caregivers using a semi-structured interview script that included questions based on select constructs from the EPPM (perceived severity, susceptibility, response efficacy) and HBM (perceived benefits and consequences). Two team members conducted a thematic analysis of the interview data.
Most caregivers acknowledged the severity of cavities but did not believe their child was susceptible. Caregivers also understood the general benefits of fluoride in preventing tooth decay, but reported low response efficacy of fluoride for their children especially compared to the other ways of reducing caries risk like reducing sugar intake and toothbrushing. Many caregivers had concerns about topical fluoride, especially regarding safety, with the potential consequences of fluoride outweighing its benefits.
Our findings were generally consistent with the EPPM and HBM, which appear to be relevant in understanding fluoride hesitancy behaviors. Additional research is needed on ways to improve provider communications about topical fluoride with caregivers.
局部用氟化物有助于预防龋齿。然而，许多看护者对儿童局部用氟化物持犹豫态度，在就诊时可能会拒绝使用。在这项定性研究中，我们评估了扩展平行过程模型（EPPM）和健康信念模型（HBM）在看护者局部用氟化物决策中的相关性。
我们使用半结构化访谈脚本采访了 56 名局部用氟化物犹豫或拒绝的看护者，访谈脚本包括基于 EPPM（感知严重性、易感性、反应效果）和 HBM（感知益处和后果）的选定结构的问题。两名团队成员对访谈数据进行了主题分析。
大多数看护者承认龋齿的严重性，但不认为他们的孩子易受影响。看护者也了解氟化物在预防龋齿方面的一般益处，但报告说氟化物对他们孩子的反应效果较低，尤其是与减少龋齿风险的其他方法（如减少糖摄入量和刷牙）相比。许多看护者对局部用氟化物有顾虑，特别是对安全性的担忧，氟化物的潜在后果超过了其益处。
我们的发现与 EPPM 和 HBM 基本一致，这些模型似乎与理解局部用氟化物犹豫行为有关。需要进一步研究如何改善提供者与看护者之间关于局部用氟化物的沟通方式。
