Early childhood caries (ECC) is defined as dental caries in the teeth of children 0-6 years of age. Although largely preventable, dental caries remains the single most common chronic condition in childhood and large disparities exist. Poor children have more than twice the rate of dental caries as non-poor children. A child's ECC risk pivots directly on how their teeth are taken care of by their caregivers. These oral health behaviors are influenced by social determinants of health, including individual attitudes and norms of the caregiver as well as those of their normative groups such as their families and social networks. Narrative videos have had success at changing behaviors. Short videos have been successfully used in social marketing campaigns. The provision of basic preventive dental services at WCC visits provides an opportunity to access high risk children who otherwise lack access to these services. Providing a narrative video at WCC visits directed at improving caregiver oral health behaviors has the potential to reduce the burden of ECC disease in this population. We are proposing to test the feasibility of delivering narrative videos at the WCC visits of poor, Hispanic children who have a disproportionate share of ECC. Innovation: The overall goal of the pilot project is to develop and conduct preliminary testing of theory-based narrative videos and a survey that can be used in a future NIDCR U01 clinical trial aimed at improving the oral health behaviors of caregivers of young children and reducing their children's ECC prevalence. The PRECEDE-PROCEED planning model will provide a structure to apply the Theories of Planned Behavior (TPB) and Normative Social Behavior (TNSB) to the development of the narrative video intervention and will involve collaboration between caregivers and researchers in all aspects of the research. Approach: The research collects relevant attitudes and norms related to oral health through qualitative elicitation interviews. We will develop, administer and analyze a survey using theory-based structural modeling to determine the specific attitudes and norms that influence oral health intentions and behaviors. We will develop video narratives on oral health care in collaboration with caregivers using real stories from the interviews and survey results to specifically target the predisposing, reinforcing and enabling factors that are most strongly associated with oral health intentions and behaviors in this population. Lastly, we will test the feasibility of delivering these video narratives at WCC visits and evaluate them using focus groups. Impact: If this research is successful, the video narratives could be readily integrated into a NIDCR UO1 clinical trial to measure their effectiveness at reducing ECC in this high risk population. Ultimately, we envision that these video narratives will be incorporated into a comprehensive oral health promotion program aimed at high-risk families and be delivered at multiple opportunities in the medical home, dental home, WIC programs, parenting skills development programs and could be incorporated into large public health media campaigns.
Early childhood caries remains the single most common chronic condition in childhood, largely impacting poor children, and yet it is preventable. A child's risk for developing caries is dependent on how their teeth are cared for by their parents/caregivers. This proposal pilots a novel, theory-based, practical and sustainable narrative video intervention intended to impact how parents/caregivers care for their children's teeth.