An evaluation of a storybook targeting parental attitudes, intention, and self-efficacy to change their child’s oral health behavior.

Abstract

Objective: Methods for reducing dental disease have traditionally focused on health education rather than targeting psychosocial determinants of the core behaviors through behavior change strategies. This study tested a novel intervention in the form of a children's story (Kitten's First Tooth) embedded with behavior change techniques (Abraham & Michie, 2008) with the aim of investigating how effective the intervention was at improving parents' efficacy and intention to enact oral health behaviors for their child. Method: A controlled before and after study conducted in a deprived area of England (n ϭ 149; child mean age 4 years) with an intervention and control group. Changes in task specific parental self-efficacy (PSE) and intention were measured using the Oral Health Behaviors Questionnaire (OHBQ; Adair et al., 2004) at baseline and 3 months following intervention. Results: Of the 149 participants, 129 returned both baseline and evaluation questionnaires (retention 86.6%), 125 of these pairs of questionnaires were used in the analysis (83.4%). The OHBQ was analyzed using a general linear model (ANCOVA). A significant difference was found in favor of the intervention group for PSE related to child tooth brushing behaviors, F (1,1) ϭ 12.04, p ϭ .001, however no change was observed for PSE related to control of dietary sugars. Conclusions: A theorized children's story can be effective as an oral health promotion intervention by supporting parents to improve their child's oral health-related behavior. Change was observed for child tooth brushing but not sugar control. This may reflect story contents or may be indicative of difficulties of changing dietary behavior.

Parental supervision for their children's toothbrushing: Mediating effects of planning, self‐efficacy, and action control

“…Interventions that have manipulated mastery experience (i.e., prompting successful behaviour practice) and vicarious experience (i.e., observing a model performing the behaviour) have been shown to produce high levels of self‐efficacy, as well as providing feedback on past or others’ performance (Ashford et al ., ; Luszczynska & Schwarzer, ). Also, using storybook techniques that embed strategies that map onto parents’ self‐efficacy have been shown to improve parental self‐efficacy towards child toothbrushing behaviours (O'Malley et al ., ). In addition, given social support is important for parental health behaviours (Hamilton & White, , ) and has been shown to buffer the effect of low self‐efficacy (Hamilton, Warner, & Schwarzer, ; Zhou, Gan, Hamilton, & Schwarzer, ), providing support to parents (e.g., providing encouragement, giving information) may help to facilitate action.…”

Maternal perceptions of childhood vaccination: explanations of reasons for and against vaccination

“…The second strategy would be to explore use of storybooks to target parental attitudes towards childhood vaccination. This technique has been used with parental attitudes towards children’s oral health behavior and found to be effective [32]. The premise is that the story is written for children but subtly gets parents to think about their attitudes towards the subject.…”

Oral health behavior of children and guardians’ beliefs about children’s dental caries in Vientiane, Lao People’s Democratic Republic (Lao PDR)

“…Also, a study of primary school children in Australia reported that higher parental self-efficacy was associated with more frequent tooth brushing by parent and child [18]. Intervention studies suggested that parents’ self-efficacy was modifiable: an intervention using a storybook that was embedded with behavioral change techniques showed that parental self-efficacy and intention to enact oral health behavior for their young children was significantly improved in England [19]. Similarly, four small 90-min group sessions that provided educational information, direct instruction, practice, and peer-to-peer problem solving improved parental self-efficacy for tooth brushing, and the proportion of parents who reported brushing their young children’s teeth twice per day increased significantly in the USA [20].…”