Design of a community-based intergenerational oral health study: “Baby Smiles”

BMC Oral Health

Marilynn Sutherland²  Darlene Smolen¹  Colleen E Huebner³  Gayle Garson¹  Lloyd A Mancl¹  Philip Weinstein¹  Christine A Riedy¹  Peter Milgrom¹ 

[1] Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, University of Washington, Box 357475, 98195-7475 Seattle, WA, USA;Klamath County Public Health, 403 Pine Street, Klamath Falls, OR, USA;Northwest Center to Reduce Oral Health Disparities, Department of Health Services, University of Washington, Box 357230, 98195-7230 Seattle, WA, USA

关键词: Infant;    Mothers;    Dental;    Health Education;    Early childhood caries;    Dental caries;    Motivation;    Counseling;   

Others  :  1125978
DOI  :  10.1186/1472-6831-13-38

 received in 2013-07-26, accepted in 2013-08-02,  发布年份 2013

【 摘 要 】

Background

Rural, low-income pregnant women and their children are at high risk for poor oral health and have low utilization rates of dental care. The Baby Smiles study was designed to increase low-income pregnant women’s utilization of dental care, increase young children’s dental care utilization, and improve home oral health care practices.

Methods/design

Baby Smiles was a five-year, four-site randomized intervention trial with a 2 × 2 factorial design. Four hundred participants were randomly assigned to one of four treatment arms in which they received either brief Motivational Interviewing (MI) or health education (HE) delivered during pregnancy and after the baby was born. In the prenatal study phase, the interventions were designed to encourage dental utilization during pregnancy. After childbirth, the focus was to utilize dental care for the infant by age one. The two primary outcome measures were dental utilization during pregnancy or up to two months postpartum for the mother, and preventive dental utilization by 18 months of age for the child. Medicaid claims data will be used to assess the primary outcomes. Questionnaires were administered at enrollment and 3, 9 and 18 months postpartum (study end) to assess mediating and moderating factors.

Discussion

This trial can help define the most effective way to provide one-on-one counseling to pregnant women and new mothers regarding visits to the dentist during pregnancy and after the child is born. It supports previous work demonstrating the potential of reducing mother-to-child transmission of Streptococcus mutans and the initiation of dental caries prevention in early childhood.

Trial registration

ClinicalTrials.gov Identifier NCT01120041

【 授权许可】

   
2013 Milgrom et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Skaret E, Milgrom P, Raadal M, Grembowski D: Factors influencing whether low-income mothers have a usual source of dental care. ASDC Dent Child 2001, 68(2):136-139.
• [2]Kinirons M, McCabe M: Familial and maternal factors affecting the dental health and dental attendance of preschool children. Community Dent Health 1995, 12(4):226-229.
• [3]Grembowski D, Spiekerman C, Milgrom P: Linking mother and child access to dental care. Pediatrics 2008, 122(4):e805-e814.
• [4]Breedlove G: Prioritizing oral health in pregnancy. Kans Nurse 2004, 79(10):4-6.
• [5]Huebner CE, Milgrom P, Conrad D, Lee SYL: Providing dental care to pregnant patients: a survey of Oregon general dentists. J Am Dent Assoc 2009, 140:211-222.
• [6]Mangskau KA, Arrindell B: Pregnancy and oral health: utilization of the oral health care system by pregnant women in North Dakota. Northwest Dent 1996, 75(6):23-28.
• [7]Gaffield ML, Gilbert BJ, Malvitz DM, Romaguera R: Oral health during pregnancy: an analysis of information collected by the pregnancy risk assessment monitoring system. J Am Dent Assoc 2001, 132(7):1009-1016.
• [8]Al Habashneh R, Guthmiller JM, Levy S, Johnson GK, Squier C, Dawson DV, Fang Q: Factors related to utilization of dental services during pregnancy. J Clin Periodontol 2005, 32:815-821.
• [9]Lydon-Rochelle MT, Krakowiak P, Hujoel PP, Peters RM: Dental care use and self-reported dental problems in relation to pregnancy. Am J Public Health 2004, 94:765-771.
• [10]Alpert JJ, Robertson LS, Kosa J, Heagarty MC, Haggerty RJ: Delivery of health care for children: report of an experiment. Pediatrics 1976, 57:917-930.
• [11]Mainous AG 3rd, Gill JM: The importance of continuity of care in the likelihood of future hospitalization: is site of care equivalent to a primary clinician? Am J Public Health 1998, 88(10):1539-1541.
• [12]Christakis DA, Mell L, Wright JA, Davis R, Connell FA: The association between greater continuity of care and timely measles-mumps-rubella vaccination. Am J Public Health 2000, 90(6):962-965.
• [13]Christakis DA, Feudtner C, Pihoker C, Connell FA: Continuity and quality of care for children with diabetes who are covered by Medicaid. Ambul Pediatr 2001, 1(2):99-103.
• [14]Christakis DA, Kazak AE, Wright JA, Zimmerman FJ, Bassett AL, Connell FA: What factors are associated with achieving high continuity of care? Fam Med 2004, 36(1):55-60.
• [15]Holve S: An observational study of the association of fluoride varnish applied during well child visits and the prevention of early childhood caries in American Indian Children. Matern Child Health J 2008, 12(Suppl 1):64-67.
• [16]Berkowitz RJ, Moss M, Billings RJ, Weinstein P: Clinical outcomes for nursing caries treated using general anesthesia. ASDC J Dent Child 1997, 64(3):210-211.
• [17]Varenne B, Petersen PE, Fournet F, Msellati P, Gary J, Ouattara S, Harang M, Salem G: Illness-related behaviour and utilization of oral health services among adult city-dwellers in Burkina Faso: evidence from a household survey. BMC Health Serv Res 2006, 27:164.
• [18]Bedos C, Brodeur JM, Levine A, Richard L, Boucheron L, Mereus W: Perception of dental illness among persons receiving public assistance in Montreal. Am J Public Health 2005, 95(8):1340-1344.
• [19]Weinstein P, Harrison R, Benton T: Motivating parents to prevent caries in their young children. J Am Dent Assoc 2004, 135(6):731-738.
• [20]Weinstein P, Harrison R, Benton T: Motivating mothers to prevent caries: confirming the beneficial effect of counseling. J Am Dent Assoc 2006, 137(6):789-793.
• [21]Ismail AI, Ondersma S, Jedele JM, Little RJ, Lepkowski JM: Evaluation of a brief tailored motivational intervention to prevent early childhood caries. Community Dent Oral Epidemiol 2011, 39:443-448.
• [22]Weinstein P, Milgrom P, Riedy CA, Mancl LA, Garson G, Huebner CE, Smolen D, Sutherland M, Nykamp A: Treatment fidelity of brief Motivational Interviewing and health education in a randomized clinical trial to promote dental attendance of low-income mothers and children: Community-Based Intergenerational Oral Health Study “Baby Smiles”. BMC Oral Healthin press
• [23]Milgrom P, Ludwig S, Shirtcliff RM, Smolen D, Sutherland M, Gates PA, Weinstein P: Providing a dental home for pregnant women: a community program to address dental care access–a brief communication. J Public Health Dent 2008, 68(3):170-173.
• [24]Le M, Riedy C, Weinstein P, Milgrom P: Barriers to utilization of dental services during pregnancy: a qualitative analysis. J Dent Child (Chic) 2009, 76(1):46-52.
• [25]Di Clemente CC: Motivational interviewing and the stages of change. In Motivational Interviewing: Preparing People to Change Addictive Behavior. Edited by Miller WR, Rollnick S. New York: Guilford Press; 1991:191-202.
• [26]Milgrom P, Sutherland M, Shirtcliff RM, Ludwig S, Smolen D: Children’s tooth decay in a public health program to encourage low-income pregnant women to utilize dental care. BMC Publ Health 2010, 10:76. BioMed Central Full Text
• [27]Köhler B, Andréen I: Mutans streptococci and caries prevalence in children after early maternal caries prevention: a follow-up at eleven and fifteen years of age. Caries Res 2010, 44(5):453-458.
• [28]Finlayson TL, Siefert K, Ismail AI, Delva J, Sohn W: Reliability and validity of brief measures of oral health-related knowledge, fatalism, and self-efficacy in mothers of African American children. Pediatr Dent 2005, 27(5):422-428.
• [29]Evens CC: Snacking patterns as a risk factor for early childhood caries. University of Washington, ProQuest, UMI Dissertations Publishing; 1997:9736267.
• [30]Coolidge T, Skaret E, Heima M, Johnson EK, Hillstead MB, Fario N, Asmyhr O, Weinstein P: Thinking about going to the dentist: a Contemplation Ladder to asses dentally-avoidant individuals’ readiness to go to a dentist. BMC Oral Health 2011, 11:4. BioMed Central Full Text
• [31]Radloff LS: The CES-D scale: A self report depression scale for research in the general population. Appl Psychological Meas 1977, (1):385-401.
• [32]Cohen S, Kamarak T, Mermelstein R: A global measure of perceived stress. J Health Soc Behav 1983, 24:385-396.
• [33]Cohen S, Williamson G: Perceived stress in a probability sample of the U.S. In The Social Psychology of Health. Edited by Spacapam S, Oskamp S. Newbury Park, CA: Sage; 1988:31-67.
• [34]De Oliveira BH, Nadanovsky P: The impact of oral pain on quality of life during pregnancy in low-income Brazilian women. J Orofac Pain 2006, 20(4):297-305.
• [35]Humphris GM, Morrison T, Lindsay SJ: The Modified Dental Anxiety Scale: validation and United Kingdom norms. Community Dent Health 1995, 12(3):143-150.
• [36]Adair PM, Pine CM, Burnside G, Nicoll AD, Gillett A, Anwar S, Broukal Z, Chestnutt IG, Declerck D, Ping FX, Ferro R, Freeman R, Grant-Mills D, Gugushe T, Hunsrisakhun J, Irigoyen-Camacho M, Lo EC, Moola MH, Naidoo S, Nyandindi U, Poulsen VJ, Ramos-Gomez F, Razanamihaja N, Shahid S, Skeie MS, Skur OP, Splieth C, Soo TC, Whelton H, Young DW: Familial and cultural perceptions and beliefs of oral hygiene and dietary practices among ethnically and socio-economically diverse groups. Community Dent Health 2004, 21(1 Suppl):102-111.
• [37]Pahel BT, Rozier RG, Slade GD: Parental perceptions of children’s oral health: the Early Childhood Oral Health Impact Scale (ECOHIS). Health Qual Life Outcomes 2007, 5:6. BioMed Central Full Text
• [38]Bellg AJ, Borrelli B, Resnick B, Hecht J, Minicucci DS, Ory M, Ogedegbe G, Orwig D, Ernst D, Czajkowski S: Treatment Fidelity Workgroup of the NIH Behavior Change Consortium: Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychol 2004, 23(5):443-451.
• [39]Carroll KM, Farentinos C, Ball SA, Crits-Christoph P, Libby B, Morgenstern J, Obert JL, Polcin D, Woody GE: MET meets the world: design issues and clinical strategies in the Clinical Trials Network. J Substance Abuse Treat 2002, 23:73-80.
• [40]Rotnitzky A, Scharfstein D, Su TL, Robins J: Methods for conducting sensitivity analysis of trials with potentially nonignorable competing causes of censoring. Biometrics 2001, 57(1):103-113.
• [41]Sobel ME: Asymptotic confidence intervals for indirect effects in structural equation models. In Sociological Methodology. Edited by Leinhardt S. San Francisco: Jossey-Bass; 1982:290-312.
• [42]MacKinnon DP: Contrasts in multiple mediator models. In Multivariate Applications In Substance Use Research: New Methods For New Questions. Edited by Rose JS, Chassin L, Presson CC, Sherman SJ. Mahwah, New Jersey: Lawrence Erlbaum Associates; 2000:141-160.
• [43]Preacher KJ, Hayes AF: SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behav Res Methods, Instrum, and Comput 2004, 36:717-731.
• [44]Ismail AI, Lim S, Sohn W, Willem JM: Determinants of early childhood caries in low income African American young children. Pediatr Dent 2008, 30(4):289-296.
• [45]Nunn ME, Dietrich T, Singh HK, Henshaw MM, Kressin NR: Prevalence of early childhood caries among very young urban Boston children compared with US children. J Public Health Dent 2009, 69(3):156-162.
• [46]Hardison JD, Cecil JC, White JA, Manz M, Mullins MR, Ferretti GA: The 2001 Kentucky Childrens Oral Health Survey: findings for children ages 24 to 59 months and their caregivers. Pediatr Dent 2003, 25(4):365-372.
• [47]Kopycka-Kedzierawski DT, Bell CH, Billings RJ: Prevalence of dental caries in Early Head Start children as diagnosed using teledentistry. Pediatr Dent 2008, 30(4):329-333.
• [48]Ramos-Gomez FJ, Tomar SL, Ellison J, Artiga N, Sintes J, Vicuna G: Assessment of early childhood caries and dietary habits in a population of migrant Hispanic children in Stockton, California. ASDC J Dent Child 1999, 66(6):395-403.
• [49]Anderson L, Martin NR, Burdick A, Flynn RT, Blaney DD: Oral health status of New Hampshire Head Start children, 2007-2008. J Public Health Dent 2010, 70(3):245-248.
• [50]Vargas CM, Monajemy N, Khurana P, Tinanoff N: Oral health status of preschool children attending Head Start in Maryland, 2000. Pediatr Dent 2002, 24(3):257-263.
• [51]Kleijka J, Swanzy M, Whistler B, Jones C, Bruce MG, Hennessy TW, Bruden D, Rolin S, Beltràn-Aguilar E, Byrd KK: Dental caries in rural Alaska Native children--Alaska, 2008. MMWR Morb Mortal Wkly Rep 2011, 60(37):1275-1278.
• [52]Mason S, Gutelius B: Oregon Smile Survey 2012 Report. Portland, OR: Oregon Health Authority, Maternal and Child Health Section. 2013. https://apps.state.or.us/Forms/Served/le8667.pdf webcite
• [53]Lee GH, McGrath C, Yiu CK, King NM: A comparison of a generic and oral health-specific measure in assessing the impact of early childhood caries on quality of life. Community Dent Oral Epidemiol 2010, 38(4):333-339.
• [54]Martins-Junior PA, Vieira-Andrade RG, Correa-Faria P, Oliveira-Ferreira F, Marques LS, Ramos-Jorge ML: Impact of early childhood caries on the oral health-related quality of life of preschool children and their parents. Caries Res 2013, 47(3):211-218.
• [55]Easton JA, Landgraf JM, Casamassimo PS, Wilson S, Ganzberg S: Evaluation of a generic quality of life instrument for early childhood caries-related pain. Community Dent Oral Epidemiol 2008, 36(5):434-440.
• [56]Filstrup SL, Briskie D, Da Fonseca M, Lawrence L, Wandera A, Inglehart MR: Early childhood caries and quality of life: child and parent perspectives. Pediatr Dent 2003, 25(5):431-440.
• [57]Braveman P: What is health equity: and how does a life-course approach take us further toward it? Matern Child Health J 2013. http://link.springer.com/article/10.1007%2Fs10995-013-1226-9#page-1 webcite