Influence of maternal psychosocial factors on child's oral health behavior
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OBJECTIVES: This study investigates the relationships between maternal psycho-social factors and brushing practices in low-income children aged 1-5 years old. METHODS: Data from The Oral Health Advocates in Public Housing (OHAPH) study was used. Analyses were limited to 1–5 year old children and their mothers (n =941). Mothers were surveyed regarding their knowledge about child’s oral health, self-efficacy and self-motivation related to brushing their children’s teeth twice a day. The main outcome measure was children’s brushing frequency reported by their mothers. Analyses were conducted in SAS 9.4 to account for the complex sampling design. RESULTS: Maternal knowledge about child’s oral health was significantly associated with maternal self-efficacy (OR=1.95; 95% CI=1.44-2.64), significant association was also found with maternal self-motivation (OR=3.24; 95% CI=1.42-7.36). Self-efficacy and self-motivation were highly associated (p-value <0.0001), mothers who reported having high level of self-efficacy were highly motivated as well (77.8%). Most of the children in this sample had their teeth brushed twice or more a day (65.3%). Maternal self-efficacy was a strong and significant predictor of child’s brushing frequency (OR=10.51; 95% CI= 6.98-15.81). Maternal self-motivation has also showed a statistically significant association with child’s brushing frequency (OR=7.41; 95% CI=2.63-20.85). However, higher level of maternal knowledge about child’s oral health was not significantly associated with having the child’s teeth brushed twice or more a day (OR= 1.33, 95% CI= 0.96-1.84). Older children and those who had visited the dentist within the past year showed higher odds of having their teeth brushed twice a day in comparison with younger children and those who didn’t visit the dentist. Being a Hispanic child lowers the odds of brushing frequency. Mediation analysis showed that maternal self-efficacy and self-motivation are both mediators in the pathway between maternal knowledge about child’s oral health and child’s brushing frequency, full mediation was observed. CONCLUSION: Maternal self-efficacy and self-motivation are associated with children’s brushing practices. Since these factors are modifiable, designing tailored interventions targeting mothers with the aim of improving child’s brushing frequency could be the key to increase the oral health potential for young children from low-income families early in life.