A Comparison of Innovative Oral Health Educational Programs for Caregivers of Preschool Children

Background: Oral health care is the primary preventive method of tooth decay (caries or cavities) and infection in children below the age of five.  However, poor oral health (OH) in preschool children can have several detrimental outcomes.  Nonetheless, many children still suffer with multiple infectious tooth decay, unnecessary sedative extractions, and tooth loss; resulting in pain, nutritional concerns, and weight loss.  These outcomes can lead to speech delays and impairments, growth and developmental delays, and eventually negative systemic effects.  The gap in the literature as it relates to caregiver knowledge towards oral health for their young children and the effects that preventive oral health care can contribute to a child’s healthy lifestyle are deficient.

Purpose:  The purpose of this study was to explore the effects of an oral health educational program (OHEP) on knowledge and behavior-specific cognitions and effect in caregivers of preschool children; promote good OH behaviors among caregivers of preschool children; improving OH outcomes, and compare the innovative health-promoting interventions. 

Methods: The first intervention was a descriptive quasi-experimental study utilizing a pre-test post-test method, with a convenience sample of 425 Head Start (HS) caregivers from seven program sites in South Florida.  The HS enrolled, English speaking family, attended one of 18 oral health educational programs.  Research questions addressed the relationship between the oral health educational program and prior related behavior, personal factors, behavior-specific cognitions and affect, knowledge, and intent.  Caregivers completed the demographic survey and oral health behavior questionnaire, a knowledge pre-test, then viewed a 16- minute video designed by Colgate^®, and completed another knowledge post-test.  The second intervention was an innovative PowerPoint-style musical program, with the aim of enhancing knowledge retention in caregivers.  The OHEP not only provided information on the devastating outcomes of poor OH during the preschool years, but also on preventive OH behaviors and practices.  Caregivers completed a demographic questionnaire, a knowledge pre-test, viewed the OHEP, and completed the knowledge post-test.  There were two additional post-tests given two weeks apart to evaluate knowledge retention.

Results: The first intervention showed that there was an overall significant effect on caregivers’ prior related behaviors, r = .43, p (two-tailed) < .01; behavior-specific cognitions and affect, r = .43, p (two-tailed) < .01; intention to provide oral health care for their children, r = .27, p (two-tailed) < .01; and post-test for knowledge of oral health care (M = 60.57, SE = .30) compared to pre-test for knowledge (M = 59.03, SE = .26), t (399) = -6.35, p < .01, r = .30).  On average, the second intervention showed that there was no significant difference between pre-educational program scores on knowledge M = 43.52 (sd = 3.72) and post-educational program scores M = 44.05 (sd = 3.79), t(16) = -.376, p > .05, r = .71.  Additionally, the second post-educational program scores were not significant M = 42.71 (sd = 3.26), t(13) = .485, p > .05, r = .63 nor the third post-educational program scores M = 44.07 (sd = 3.04), t(13) = -.770, p > .05, r = .45.

Conclusions: Educational programs have a positive impact on caregivers to increase knowledge and intent to perform preventive oral health-promoting behaviors in this underserved population.  While an oral health educational program is beneficial to its participants, as stated in the review of the literature, the results of this study suggested that this sample was already an educated one, and thus, the improvement from their high level of preexisting knowledge was not significant.  Nursing practice will implement educational programs for caregivers and the opportunity to affect governmental policy that supports oral health care services for young children, as indicated by Healthy People 2020.