Dataset Information

Motivational interviewing with American Indian mothers to prevent early childhood caries: study design and methodology of a randomized control trial.

ABSTRACT: This randomized control trial assesses the effectiveness of motivational interviewing (MI) to encourage behavior change in new mothers relating to caries prevention when caring for their newborn American Indian (AI) infants and young AI children.The study is a randomized control trial. We hypothesize that when motivational interviewing is added to enhanced community oral health education services, the new mothers will achieve greater reduction of caries experience in their AI children compared to those who are receiving enhanced community services (ECS) alone. Six hundred mothers or caregivers of AI newborns will be enrolled into the study and randomized to one of the two intervention groups over a two-year period. The children will be followed until the child's third birthday. A cost analysis of the study is being conducted in tandem with the enhanced community services, motivational interviewing behavioral interventions, and the dental screenings for the length of the study.The trial is now in the implementation phase and a number of threats to successful completion, such as recruitment and retention challenges in a vast, rural geographic area, have been addressed. The protocol provides a unique model for oral health interventions using principles of community-based participatory research and is currently on schedule to meet study objectives. If the study is successful, motivational interviewing intervention can be applied in AI communities to reduce ECC disparities in this disadvantaged population, with study of further applicability in other populations and settings.ClinicalTrials.gov, NCT01116726.

SUBMITTER: Batliner T

PROVIDER: S-EPMC4011767 | biostudies-literature | 2014 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Motivational interviewing with American Indian mothers to prevent early childhood caries: study design and methodology of a randomized control trial.

Batliner Terrence T Fehringer Karen A KA Tiwari Tamanna T Henderson William G WG Wilson Anne A Brega Angela G AG Albino Judith J

Trials 20140414

<h4>Background</h4>This randomized control trial assesses the effectiveness of motivational interviewing (MI) to encourage behavior change in new mothers relating to caries prevention when caring for their newborn American Indian (AI) infants and young AI children.<h4>Methods/design</h4>The study is a randomized control trial. We hypothesize that when motivational interviewing is added to enhanced community oral health education services, the new mothers will achieve greater reduction of caries ...[more]

PMID: 24735707

Similar Datasets

Project description:Introduction:In a randomized controlled trial, the effectiveness of motivational interviewing (MI) combined with enhanced community services (MI + ECS) was compared with ECS alone for reducing dental caries in American Indian children on the Pine Ridge Reservation. The intervention was developed and delivered with extensive tribal collaboration. Methods:A total 579 mother-newborn dyads were enrolled and randomized to the MI + ECS and ECS groups. They were followed for 36 mo. Four MI sessions were provided, the first shortly after childbirth and then 6, 12, and 18 mo later. Both groups were exposed to ECS, which included public service announcements through billboards and tribal radio, as well as broad distribution of brochures on behavioral risk factors for early childhood caries (ECC), toothbrushes, and toothpaste. MI impact was measured as decayed, missing, and filled tooth surfaces (dmfs). Secondary outcomes included decayed surfaces, caries prevalence, and maternal oral health knowledge and behaviors. Modified intention-to-treat analyses were conducted. Eighty-eight percent of mothers completed at least 3 of 4 MI sessions offered. Results:After 3 y, dmfs was not significantly different for the 2 groups (MI + ECS = 10, ECS = 10.38, P = 0.68). In both groups, prevalence of caries experience was 7% to 9% after 1 y, 35% to 36% at 2 y, and 55% to 56% at 3 y. Mean knowledge scores increased by 5.0, 5.3, and 5.9 percentage points at years 1, 2, and 3 in the MI + ECS group and by 1.9, 3.3, and 5.0 percentage points in the ECS group (P = 0.03), respectively. Mean maternal oral health behavior scores were not statistically significantly different between the treatment arms. Conclusion:In summary, the MI intervention appeared to improve maternal knowledge but had no effect on oral health behaviors or on the progression of ECC (ClinicalTrials.gov NCT01116726). Knowledge Transfer Statement:The findings of this study suggest that motivational interviewing focusing on parental behaviors may not be as effective as previously hoped for slowing the development of childhood caries in some high-risk groups. Furthermore, social factors may be even more salient determinants of oral health than what we previously supposed, perhaps interfering with the capacity to benefit from behavioral strategies that have been useful elsewhere. The improvement of children's oral health in high-risk populations characterized by poverty and multiple related life stresses may require more holistic approaches that address these formidable barriers.

Project description:IntroductionCaries experience among preschool-age children has remained relatively unchanged for the past 2 decades, despite recently documented decreases in untreated decay.ObjectivesIn a community-based cluster-randomized controlled trial, a motivational interviewing (MI) intervention administered to primary caregivers was hypothesized to reduce caries increment over 2 y as compared with controls, among children aged 0 to 5 y at baseline living in public housing.MethodsPublic housing residents, who served as interventionists, were trained in MI with a focus on early childhood caries prevention. All 26 eligible public housing developments were randomized to either control (quarterly clinical examinations, fluoride varnish applications, toothbrush/toothpaste, and educational brochures) or intervention (same procedures as control plus MI counseling). Quarterly MI sessions were delivered in English or Spanish over 2 y, audio recorded, and assessed for treatment fidelity. The primary outcome was the increment in dmfs (decayed, missing, and filled tooth surfaces) as assessed by clinical examination at baseline, 12 mo, and 24 mo. Secondary outcomes included caregiver oral health knowledge and child oral health behaviors (child toothbrushing and sugar-sweetened beverage intake). Baseline characteristics were compared between groups and adjusted for housing-site clusters. Longitudinal outcomes were analyzed with mixed models.ResultsA total of 1,065 children (49% female, 55% non-White, 61% Hispanic, 89% below poverty level, n = 686 control) and their caregivers were enrolled. During 2 y of follow-up, the mean dmfs increment increased in both groups; however, there were no statistically significant group differences at 24 mo or group × time interactions. The mean increase in intervention caregivers' knowledge was significantly greater than that of control, F(2, 1,593) = 3.48, P = 0.0310, but there were no significant intervention effects on caregiver-reported child sugar-sweetened beverage intake or child toothbrushing.ConclusionMI counseling plus intensive caries prevention activities resulted in knowledge increases but did not improve oral health behaviors or caries increment (ClinicalTrials.gov NCT01205971).Knowledge transfer statementWhen viewed in light of the findings from the companion Pine Ridge study and other recent MI studies, the results of this study suggest that when the complex disease of early childhood caries is addressed in high-risk populations, MI is not effective, and alternative approaches are warranted.

Project description:OBJECTIVES:The objective of this study was to examine the association among psychological and social variables reported by American Indian parents/caregivers of preschool children and changes in their Oral Health Knowledge and Behaviors related to care of their children's teeth. We also investigated the relationship of these factors with progression of caries, as reflected by changes in their children's dmfs. METHODS:The data used for this study were collected at baseline in a clinical trial of an oral health promotion intervention comprising behavioural and clinical interventions for caries prevention delivered by tribal members on a large Southwestern American Indian reservation. Linear regression analyses were performed for changes (baseline to Year 1) in dmfs, Oral Health Knowledge and Oral Health Behavior scores, with baseline psychosocial measures, taken individually, as the independent variables. RESULTS:Parents' attitudes and beliefs were associated with increases in their Oral Health Knowledge and Behavior and also with the progression of caries for their children. When all participants were considered together, increases in children's dmfs were smaller when the caregiver had higher Internal Oral Health Locus of Control (e = -1.33, P = .004), higher Health Literacy (e = -1.55, P < .01), and higher Financial Stability (e = -4.46, P = .03), and lower scores for the Barriers subscale (e = 1.57, P < .01) of the Health Belief Model. For parents in the Intervention group, higher scores on Locus of Control, reflecting beliefs that chance, or other people determine their children's oral health, were associated with larger increases in Oral Health Knowledge (e = 1.73, P = .04) and Behaviors (e = 4.00, P = .005). CONCLUSIONS:Prevention of early childhood caries in American Indian children has proved to be especially challenging. Some of the measures identified in this report may suggest promising directions to prevention through approaches that build on competencies and skills to be learned and used within a context more broadly focused on parenting and management of health and family challenges.

Project description:BackgroundChildhood obesity is associated with serious physiological and psychological consequences including type 2 diabetes, higher rates of depression and low self-esteem. With the population of overweight and obese youth increasing, appropriate interventions are needed that speak to the issue of readiness to change and motivation to maintain adherence to healthy behavior changes. Motivational Interviewing (MI) is a method of therapy found to resolve ambivalence, enhance intrinsic motivation and promote confidence in a person's ability to make behavior changes. While MI has shown promise in the adult obesity literature as effecting positive lifestyle change, little is known about the effectiveness of MI with overweight and obese youth. This study aims to: 1) demonstrate that MI is an effective intervention for increasing a person's self-efficacy; 2) demonstrate that exposure to MI will facilitate healthy behavior changes; 3) explore psychological changes related to participation in MI and 4) compare physiological and anthropometric outcomes before and after intervention.Methods/designThe current investigation is a prospective study conducted with ongoing participants who regularly attend an outpatient pediatric care center for weight-loss. Overweight youth (BMI > 85th %ile) between the ages of 10 and 18 who meet eligibility criteria will be recruited. Participants will be randomly assigned to a control group (social skills training) or a treatment group (MI). Participants will meet with the therapist for approximately 30 minutes prior to seeing the dietician, over the course of 6 months. Participants will also undergo a full day assessment at the beginning and end of psychology intervention to evaluate body fat, and metabolic risk (screening for diabetes, high cholesterol, high blood pressure and fitness level). The paper and pencil portions of the assessments as well as the clinical testing will occur at baseline and at the conclusion of the intervention (6 months) with a repeat assessment 6 months following the completion of the intervention.DiscussionResults from this study are expected to enhance our understanding of the efficacy of MI with children and adolescents who are overweight or obese.

Project description:BackgroundSilver Diamine Fluoride (SDF) has gained attention as one of the minimally invasive modalities to manage ECC although it causes black staining of treated carious lesions. A possible affordable alternative may be Sodium Fluoride (NaF) varnish combined with good oral hygiene promoted by parental Motivational Interviewing (MI). The study compared the effectiveness of 38% SDF solution and 5% NaF varnish supported by parental MI in arresting ECC.Materials and methodsChildren aged ≤ 4 years old with at least one active carious lesion (ICDAS score ≥ 3) were randomly assigned to treatment by a single application of 38% SDF solution or a single application of 5% NaF varnish supported by two MI sessions for mothers at baseline and after three months. Chi-Squared test was used to compare groups and multilevel logistic regression analysis was used to assess the effect of the interventions on ECC arrest adjusting for confounders. The interaction between the type of intervention and baseline lesion severity, moderate (ICDAS 3/4) or advanced (ICDAS 5/6), was also assessed.ResultsThe study included 165 children with 949 active lesions. After 6 months, there were no significant differences between SDF and NaF/MI groups in overall caries arrest (63.7% and 58.1%, p = 0.08), and in moderate lesions (72.9% and 69.6%, p = 0.52). However, in advanced lesions, the arrest rate was significantly higher in the SDF than the NaF/ MI group (60.3% and 50.0%, P = 0.01). Multilevel multiple logistic regression showed no significant differences between the interventions (AOR = 1.56, P = 0.27) with significant interaction between the intervention and baseline lesion severity (p < 0.001). Moderate lesions treated with SDF (AOR = 3.69, P = 0.008) or NaF/MI (AOR = 3.32, P < 0.001) had significantly higher odds of arrest than advanced lesions treated with NaF/ MI with no difference between advanced lesions treated with SDF or NaF/ MI (AOR = 1.85, P = 0.155) in arrest rate.ConclusionNaF/ MI can be an alternative to SDF in arresting advanced and moderate ECC lesions without staining with stronger effect on moderate lesions (ICDAS 3/4).Trial registrationThe trial was retrospectively registered at clinicaltrial.gov registry (#NCT05761041) on 9/3/2023.

Dataset Information

Motivational interviewing with American Indian mothers to prevent early childhood caries: study design and methodology of a randomized control trial.

Publications

Motivational interviewing with American Indian mothers to prevent early childhood caries: study design and methodology of a randomized control trial.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets