Maternal self-efficacy and 1-5 year old
children's brushing habits

Authors

Tracy L. Finlayson, PhD
Kristine Siefert, PhD, MPH
Amid I. Ismail, BDS, MPH, DrPH, MBA
Woosung Sohn, DDS, PhD, DrPH

Abstract

Objectives:
This study investigates the relationships between maternal cognitive, behavioral, and psychosocial factors and brushing practices in low-income African American preschool children.

Methods:
Data are from a population-based sample of 1021 African-American families with at least one child less than 6 years of age and living in the 39 low-income Census tracts in Detroit, Michigan (NIDCR grant # U-54 DE 14261-01). Analyses were limited to 1-5 year old children and their mothers (N=719). Mothers were surveyed about oral health -related self-efficacy (OHSE), knowledge about appropriate bottle use (KBU), knowledge about children's oral hygiene (KCOH), oral health fatalism (OHF), their own toothbrushing behavior, depressive symptoms (CES-D), parenting stress, practical social support, and their child's dental history. Children's one-week reported brushing frequency was the main outcome measure. Analyses were conducted in SUDAAN to account for the complex sampling design.

Results:
Children's one-week brushing frequency (range 0-40) averaged 8.50 times per week among 1-3 year olds and 9.75 among the 4-5 year olds. Maternal OHSE was a strong and significant predictor of children's brushing frequency; for each unit increase in OHSE, 1-3 year olds were expected to brush 18% more frequently on average during one week (IDR=1.18, 95% confidence interval (CI) 1.08-1.28; p<.001), and 4-5 year olds were expected to brush 9% more often (IDR=1.09, CI 1.00-1.19; p<.10). Mothers' KCOH score was also significantly positively associated with brushing frequency; for each unit increase on the KCOH scale, 1-3 year olds were expected to brush 22% more frequently (IDR=1.22, CI 1.10-1.35; p<.001) and 4-5 year olds were expected to brush 13% more frequently (IDR=1.13, CI 1.02-1.26; p<.05). If a mother brushed her own teeth at bedtime during the week, her 1-3 year old child's brushing frequency was expected to increase by one-third (IDR=1.34, CI 1.12-1.60; p<.01) and among the 4-5 year olds, the child's frequency was expected to increase by one-quarter (IDR=1.26, CI 1.12-1.42; p<.001). Availability of help with transportation and financial support were also relevant variables for 1-3 year olds. Higher family income and dental insurance coverage were both positively associated with brushing among 4-5 year olds.

Conclusions:
Several maternal cognitive, behavioral, and psychosocial factors were associated with young children's brushing practices. Oral health-specific self-efficacy and knowledge measures are potentially modifiable cognitions; findings suggest that intervening on these factors could help foster healthy dental habits and increase children's brushing frequency early in life.

This paper is scheduled to be published in 2007
in Community Dentistry and Oral Epidemiology.