Dental attendance among low-income women and their children following a brief motivational counseling intervention: A community randomized trial

Abstract

This study tested a behavioral intervention to increase dental attendance among rural Oregonian low-income women and their children. It utilized a multi-site, single-blind, randomized trial design. Four hundred women were randomized into one of four conditions to receive prenatal or postpartum motivational interviewing/counseling (MI) or prenatal or postpartum health education (HE). Counselors also functioned as patient navigators. Primary outcomes were dental attendance during pregnancy for the mother and for the child by age 18 months. Attendance was obtained from the Oregon Division of Medical Assistance Programs and participant self-report. Statewide self-reported utilization data were obtained from the Oregon Pregnancy Risk Assessment Monitoring System (PRAMS). Maternal attendance was 92% in the prenatal MI group and 94% in the prenatal HE group (RR = 0.98; 95% CI = 0.93–1.04). Children’s attendance was 54% in postpartum MI group and 52% in the postpartum HE group (RR = 1.03; 95% CI = 0.82–1.28). Compared to statewide PRAMS, attendance was higher during pregnancy for study mothers (45% statewide; 95% CI = 40–50%) and for their children by 24 months (36% statewide; 95% CI = 27–44%). MI did not lead to greater attendance when compared to HE alone and cost more to implement. High attendance may be attributable to the counselors’ patient navigator function. Trial Registration: ClinicalTrials.gov Identifier NCT01120041

Impact of motivational interviewing on early childhood caries

“…After excluding similar and nonrelevant studies, the abstracts of 74 articles were assessed. Fourteen articles remained for full-text analysis, of which 6 12,13,19,[25][26][27] were excluded for reasons described in Table 2. Finally, 8 remaining articles were selected for inclusion in the evidence table.…”

“…A few inconclusive studies that were not included in our review focused on these behaviors as their primary outcomes. 13,25 However, additional studies targeting specific behaviors for recognizing the mechanism of MI impact are required.…”

SBIRT-Based Interventions to Improve Pediatric Oral Health Behaviors and Outcomes: Considerations for Future Behavioral SBIRT Interventions in Dentistry

“…Four of the interventions were randomized clinical trials to evaluate motivational interviewing (MI). Three of the MI interventions resulted in no improvements in dental use or caries rates [19, 20, 21] and one resulted in improved fluoride varnish use and decreased caries rates [•18]. The two non-randomized studies improved dental utilization and caries rates [22, 23].…”

“…Furthermore, only two studies described steps taken to assess fidelity, which is a key feature of intervention studies that needs to be developed at the time the intervention is designed [28]. Both studies used checklists as a fidelity monitoring tool [•18, 21]. The remaining studies did not mention fidelity.…”

“…In another study that evaluated motivational interviewing (MI) and health education (HE), 400 low-income pregnant women in rural Oregon were randomized to one of four groups [21]. The four groups were: 1) prenatal MI and postnatal MI; 2) prenatal MI and postnatal HE; 3) prenatal HE and postnatal MI; and 4) prenatal HE and postnatal HE.…”