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The evaluation of a multi-level oral health intervention to improve oral health practices among caregivers of preschool children
Department of Community Dentistry, Faculty of Dentistry, Mahidol University.
Department of Health Behavior and Health Education, School of Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
3Department of Health Education and Behavioral Science, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
1Department of Community Dentistry, Faculty of Dentistry, Mahidol University.ORCID iD: 0000-0001-9309-543X
2012 (English)In: Southeast Asian Journal of Tropical Medicine and Public Health, ISSN 0125-1562, Vol. 43, no 2, p. 526-539Article in journal (Refereed) Published
Abstract [en]

This study reports the effects of a pilot multi-level oral health interventionon caregivers’ oral health practices and their determinants. Quasi-experimental,pretest-posttest evaluations using a comparison group design were employedto evaluate the effectiveness of a proposed intervention for promoting caregiveroral health behavior. The intervention consisted of three components: home visitsby lay health workers (LHWs), enhancing oral health education and services athealth centers, and community mobilization. These components were designedto target factors at intrapersonal, interpersonal, organizational and communitylevels based on a Social Ecological Model (SEM). Four oral health behaviors associatedwith early childhood caries (infant bottle feeding, tooth brushing, snackconsumption and fluoride use), and multi-level determinants were assessed duringpre- and post-tests. The one-year intervention demonstrated a positive effect ontooth brushing, using toothpaste, and fluoride supplements, but did not have asignificant effect on bottle feeding and snack consumption among children. Theintervention also had no effect on dental caries; in fact caries increased in bothcontrol and experimental groups. The caregiver knowledge, attitudes, outcomeexpectations, and self-efficacy towards these behaviors were significantly increasedin the experimental group after intervention. Caregivers in the experimentalgroup received greater social support by LHWs and health center staff than thosein the control group (p<0.001). The program had an impact on integrating oralhealth services at health centers and community participation in children’s oralhealth. These findings confirm multi-level factors influence reported oral healthbehavior, but not outcomes in terms of caries. Process evaluation is needed todetermine actual implementation levels, barriers and suggests for modificationof the program in the future to improve outcomes in terms of caries.

Place, publisher, year, edition, pages
2012. Vol. 43, no 2, p. 526-539
Keywords [en]
social ecoloical model, oral health promotion, early childhood caries, caregivers, preschool children
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Dental Hygiene
Identifiers
URN: urn:nbn:se:kau:diva-14287OAI: oai:DiVA.org:kau-14287DiVA, id: diva2:540490
Available from: 2012-07-10 Created: 2012-07-10 Last updated: 2018-06-20Bibliographically approved

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http://www.tm.mahidol.ac.th/seameo/2012-43-2/25-5090.pdf

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Lexomboon, Duangjai

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