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      Parental beliefs and attitudes towards child caries prevention: assessing consistency and validity in a longitudinal design

      research-article
      1 , 2 , , 2 , 1 , 1
      BMC Oral Health
      BioMed Central

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          Abstract

          Background

          Exploring the stability of self-reports over time in observational studies may give valuable information for the planning of future interventions. The aims of the present study were: 1) to explore the consistency of parental self-reports of oral health habits, beliefs and attitudes towards child oral health care over a two-year period; 2) to evaluate possible differences in item scores and consistency between parents with different immigrant status; and 3) to assess the construct validity of items measuring parental beliefs and attitudes towards child oral health care.

          Methods

          The sample (S1, n = 304) included parents of 3-year-old children in Oslo, Norway; 273 mothers of western origin (WN-group) and 31 of non-western origin (IM-group). They were surveyed in 2002 (child age 3 years) and in 2004 (child age 5 years). Two additional samples of parents were also included; one with 5-year old children in 2002 (S2, n = 382) and one with 3-year-old children in 2004 (S3, n = 427). The questionnaire included items measuring child oral health habits and parental beliefs and attitudes towards child oral health care.

          Results

          In 2002, 76.8% of the parents reported that they started to brush their child's teeth before the age of 1 year. Eighty-five percent of them reported the same in 2004; 87.0% of the WN-group and 33.3% of the IM-group ( P < 0.001). For 17 of 39 items measuring beliefs and attitudes the responses were more positive for the WN-compared to the IM-group. Parents of caries-free children in 2004 reported significantly more positive beliefs and attitudes towards child oral health care in 2002 compared to parents of children with caries in 2004 ( P < 0.05, P < 0.01 and P < 0.001). No differences in mean item scores were found between the three samples S1, S2 and S3.

          Conclusion

          The results showed a fair to good consistency of parental self-reports from 2002 to 2004. They also indicate that parents with different cultural backgrounds should be evaluated separately and in a cultural context.

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          Most cited references13

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          Risk factors for dental caries in young children: a systematic review of the literature.

          To conduct a systematic review of the literature on risk factors for dental caries in deciduous teeth of children aged six years and under, to give a scientific framework for the international collaborative studies on inequalities in childhood caries. Accepted guidelines were followed. Studies were identified by electronic searching and reviewed on the basis of key words, title and abstract by two reviewers to assess whether inclusion criteria were met. Copies of all articles were obtained and assessed for quality according to the study design. 1029 papers were identified from the electronic search, 260 met the prima facie inclusion criteria. 183 were excluded once full copies of these papers were obtained. Of the 77 studies included, 43 were cross sectional, 19 cohort studies, 8 case control studies and 7 interventional studies. Few obtained the highest quality scores. 106 risk factors were significantly related to the prevalence or incidence of caries. There is a shortage of high quality studies using the optimum study design, i.e. a longitudinal study. The evidence suggests that children are most likely to develop caries if Streptococcus Muttans is acquired at an early age, although this may be partly compensated by other factors such as good oral hygiene and a non-cariogenic diet. Diet and oral hygiene may interact so that if there is a balance of 'good' habits by way of maintaining good plaque control and 'bad' habits by way of having a cariogenic diet, the development of caries may be controlled.
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            Measuring change over time: assessing the usefulness of evaluative instruments.

            Reliability, the ratio of the variance attributable to true differences among subjects to the total variance, is an important attribute of psychometric measures. However, it is possible for instruments to be reliable, but unresponsive to change; conversely, they may show poor reliability but excellent responsiveness. This is especially true for instruments in which items are tailored to the individual respondent. Therefore, we suggest a new index of responsiveness to assess the usefulness of instruments designed to measure change over time. This statistic, which relates the minimal clinically important difference to the variability in stable subjects, has direct sample size implications. Responsiveness should join reliability and validity as necessary requirements for instruments designed primarily to measure change over time.
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              Familial and cultural perceptions and beliefs of oral hygiene and dietary practices among ethnically and socio-economicall diverse groups.

              OBJECTIVE; The aim of this international study was to develop a valid and reliable psychometric measure to examine the extent to which parents' attitudes about engaging in twice-daily tooth brushing and controlling sugar snacking predict these respective behaviours in their children. A supplementary objective was to assess whether ethnic group, culture, level of deprivation or children's caries experience impact upon the relationships between oral health related behaviours, attitudes to these respective behaviours and to dental caries. Nurseries, health centres and dental clinics in 17 countries. 2822 children aged 3 to 4 years and their parents. Dental examination of children and questionnaire to parents. Factor analysis identified 8 coherent attitudes towards toothbrushing, sugar snacking and childhood caries. Attitudes were significantly different in families from deprived and non-deprived backgrounds and in families of children with and without caries. Parents perception of their ability to control their children's toothbrushing and sugar snacking habits were the most significant predictor of whether or not favourable habits were reported. Some differences were found by site and ethnic group. This study supports the hypothesis that parental attitudes significantly impact on the establishment of habits favourable to oral health. An appreciation of the impact of cultural and ethnic diversity is important in understanding how parental attitudes to oral health vary. Further research should examine in a prospective intervention whether enhancing parenting skills is an effective route to preventing childhood caries.
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                Author and article information

                Journal
                BMC Oral Health
                BMC Oral Health
                BioMed Central
                1472-6831
                2008
                23 January 2008
                : 8
                : 1
                Affiliations
                [1 ]Faculty of Dentistry, UoB, PB 7800, N-5020, Bergen, Norway
                [2 ]Faculty of Dentistry, UoO, P.b. 1142, Blindern, N-0317 Oslo, Norway
                Article
                1472-6831-8-1
                10.1186/1472-6831-8-1
                2258292
                18215270
                c4304551-2df6-46b0-9948-3b83a78e95aa
                Copyright © 2008 Skaret et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 September 2007
                : 23 January 2008
                Categories
                Research Article

                Dentistry
                Dentistry

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