A model of parental behavior change: a qualitative study

Objectives: A qualitative approach was undertaken to explore the factors affecting parental adoption and maintenance of dentally-healthy behaviors following a child's general anesthesia (GA). Methods: Twenty six in-depth individual interviews were conducted with parents of pre-school aged children at various time periods following their child's dental surgery. Data was analysed with a grounded theory approach. The responses of “relapse” families (child with new caries at recall) and “no-relapse” families (child caries-free at recall) were compared. Sixty three codes were identified and grouped under six main categories. An explanatory model was generated based on the differences between “relapse” and “no-relapse” group. Results: Parents expressed a diverse range of opinions about “baby” teeth. “Relapse” parents were quite confident that their child would be resistant to new caries once the teeth were fixed. However, they were pessimistic about their ability to protect their child from getting another “cavity” in the future. While the “no-relapse” parents assumed responsibility and even blamed themselves for the state of their child's teeth, the “relapse” parents absolved themselves of responsibility and even blamed their child or professionals for the problem. “Relapse” families were at an early stage of readiness to change, were generally unreceptive to advice from others including professionals, and were permissive regarding their child's desires. They had no immediate plans to change their home-care behaviors. Conclusion: Although an early, positive outcome of the GA was reported improvement in dental health practices, the GA did not appear to have a long-term effect on preventive behaviors for most parents. The factor that emerged as a key predictor of adoption and maintenance of healthy behaviors was parental readiness to change. Oral health counselling should include an assessment of parental readiness. This study was supported by CIHR Grant #124326.