Perceived discrimination, self-efficacy, and adolescents’ oral health

Objectives: The aim of this study was to examine if perceived discrimination mediated the relationship between self-efficacy and oral health behaviours.

Methods: Participants of this cross-sectional study were adolescents aged 12 to 18 years recruited from university dental clinics and community centres. They asked to complete a questionnaire comprising three sections: demographics (14 items), oral health behaviors (6 items), general self-efficacy (GSE) and self-efficacy for self-care (SESS) (25 items, validated). Perceived discrimination was evaluated based on a question asking if the adolescent has ever been treated unfairly or discriminated against based on their race. Univariate and adjusted multi variate analyses were conducted to generate the results.

Results: Of 347 children, mean (SD) age of 14 (1.8) years, who participated in this study, 58% were female, 70% were born in Canada, 58% identified themselves as non-white, and 27% perceived some degree of discrimination. Significant correlations were observed between all task-specific self-efficacies and general self-efficacy. All subscales of task-specific self-efficacies were significantly correlated with respective behaviours (frequency of brushing, sugar intake, and dental visit) (p-value < 0.05). In those with perceived discrimination experience, only diet self-efficacy was significantly different (p=0.001). In univariate analysis, non-white participants reported discrimination 4.6 times more than the white counterparts (95% CI 2.58 – 8.24). For each unit of increase in age, perceived discrimination increased 37% (95% CI 0.20 – 1.57). Participants with dental insurance perceived discrimination 59% (95% CI 0.20 – 0.82) less than those without insurances. In a multivariate analysis, after adjusting for participants’ demographics and discrimination experience, self-efficacy for diet was 8% (95% CI: 0.87 - 0.98) lower in those who consumed sugar more than once a day.

Conclusions: Perceived discrimination significantly contributed in association of diet subclass of self-efficacy with it’s respective behaviour, sugar consumption.